Biomed Res- India 2013 Volume 24 Issue 3 329 Biomedical Research 2013; 24 (3): 329-336 ISSN 0970-938X http://www.biomedres.info The use of vacuum-assisted wound closure system for management of difficult wounds. Cengiz Tavusbay, Haldun Kar, Necat Cin, Erdinc Kamer, Hayri Aksut, Onder Karahalli, Kemal Atahan, Mehmet Haciyanli Izmir Katip Celebi University, Ataturk Research and Training Hospital, Basinsitesi, 35360 Izmir, Turkey Abstract We aimed to present the results of our different clinical practise experience about the treat- ment and management of extremely difficult wounds using the vacuum-assisted closure sys- tem (VAC). In this retrospective study, we analysed the records of 51 consecutive patients who were applied VAC for different clinical practise between 2008 and 2012 at the Izmir Katip Celebi University, Ataturk Education and Training Hospital. There were 51 patients in our study with an average age of 54.6(16-78) years and 22(43.1%) were male, and 29(56.9%) were females. We used VAC system to manage the wound in 29(56.9%) patients with wound dehis- cence (with or without fascial necrosis), in 17(33.3%) patients with open abdomen, and in 5(9.8%) patients with Fournier gangrene. The average hospital stay was38.4 days (10-101). The average duration of VAC application was 24.3 (8-56) days. The average number the ap- plication of VAC dressingswas 12.01 (3 to 28).Directly VAC related complications (enteroat- mospheric fistula and wound haematoma) were seen in two patients (3.9%). A total of 27(52.9%) patients underwent delayed primary or graft closure. In the remaining 19(37.2%) patients, the wound was left to granulate and heal by secondary intention.5 (9.8%) patients died because of complications related to primary disease while on VAC application.We con- cluded that VAC is an important tool in the armamentarium of the surgeons managing in pa- tients with complex and difficult wounds, particularly, in cases of open abdomen. Keywords: Fournier’s gangrene, Open abdomen, wound dehiscence, Vacuum assisted closure therapy. AcceptedMay 05 2013 Introduction During the past decade, technologic advances have a major contribution to the management of acute or chronic wounds. One such treatment modality is the Vacuum- Assisted Closure Therapy System (KCI USA, Inc. San Antonio, Texas). The VAC system has been proved to be effective in evacuating wound fluid, increasing tissue blood flow and tissue oxygen tension, decreasing bacte- rial contamination, and stimulating granulation tissue formation [1-4]. Therefore, it promotes to more rapid wound healing compared to conventional methods. Re- cently, this system is widely used to manage for patients with chronic, acute, traumatic, subacute, and dehisced wounds; partial-thickness burns; ulcers (such as diabetic, venous and arterial ulcers or pressure); flaps; and meshed grafts and donor flap sites, and other wounds [5-7]. Addi- tionally, it has been shown to be useful in the patients with enteroatmospheric fistulas, severe abdominal trauma, abdominal compartment syndrome, or complex septic intraabdominal complications (8-10). Particularly, the open abdomen is often associated by serious clinical problems and management of these wounds can often be challenging. Thus, a temporary dressing for the open abdomen is essential to maintain patient’s stabilization before definitive closure can be achieved safely. VAC has been used for treatment of the open abdomen. The main advantages of the system are simple and easy application, low system-related morbid- ity, earlier discharge from the intensive care unit and a high rate of primary fascial closure [4,8-10]. In recent years, popularity and indications for use of VAC are con- stantly increased in various clinical applications. In this study, we analysed the efficiency and treatment results of VAC system in a total of 51 patients on whom vacuum assisted closure systems were used at the clinic due to various reasons.