Wound Care Unit
What is Vacuum?
A term used for physical measurements and operations performed at pressures below normal atmospheric pressure.
Vacuum can be defined as suction (drainage) with pumps that can generate pressures below the open air pressure of 760mmHg.
What is Drainage?
The action of the vacuum medium in the wound is its action.
Draining fluid from the wound with a drain
In the vacuum method, active drainage is provided by the pump.
- Chronic open wounds (Diabetic ulcers, Pressure ulcers, Venous stasis ulcers)
- Acute and traumatic wounds (Subacute Wounds)
- Opened incisions
- Grafts, Flaps
- Abdominal wounds
- Other postoperative wounds
- Infected wounds
- Necrotic textured wounds
- Untreated osteomyelitis (Necrotic bone should be removed. Antibiotics should be given about 2 weeks before starting vacuum therapy.)
- Open arteries or veins
Wound Healing Process
Oxygen Ratio: Tissue hypoxia disrupts collagen synthesis, affects defense against bacterial infections, wound healing is adversely affected.
Smoking: Cutaneous causes vasoconstriction, increasing the rate of carboxyhemoglobin, limiting blood oxygen carrying capacity.
Infection: Prolongs the inflammatory process and delayed wound healing. The possibility of opening in the stitched wound increases and the tensile strength occurs late.
Nutritional Factors: In severe injuries, the need for energy increases (mostly for collagen synthesis). If there is no glucose for energy, fat and protein are used. Diabetes such as glucose metabolism disorder, protein malnutrition and lipid deficiency, zinc, vitamin C, vitamin A deficiency adversely affect wound healing.
Drugs: If corticosteroids are given within 3 days before and after injury, they inhibit wound healing and delay the formation of tensile strength. Topical steroids also inhibit wound healing. Immunosuppressives and antineoplastics interfere with wound healing by inhibiting inflammatory cell function. Leukopenia causes increased susceptibility to infection. Nonsteroidal anti-inflammatory agents (aspirin, phenylbutazone, etc.) have been shown to reduce wound tensile strength in animals. Causes increased risk of bleeding.
Radiotherapy: It inhibits wound healing by acting directly on fibroblasts. The growth factor may partially refuse this impaired wound healing.
Systemic delusions: Immunologic, insufficiency, malnutrition, malignancies (due to inflammatory cell malfunction and malnutrition), hepatic divisions, renal insufficiency
Question 1: What are the types of wound healing?
Primary recovery; Stitched wound
Secondary healing; Open wound
Question 2: How is primary recovery?
The re-epithelialization; occurs fast
Tensile strength; develops slowly.
Question 3: How is secondary recovery?
Superficial wound healing: from skin patches, fast.
Deep wound healing: Wound edges, slow.
Question 4: What are the factors affecting wound healing?
Wound Size: The healing time does not extend in proportion to the wound size. Big wounds close only slightly longer than small ones.
Wound: Those in the acral area heal later than the central area.
Wound Form: The healing time depends on the diameter of the largest circle that can be achieved in the wound.
Injury Method: The fastest recovery is wounds without denatured protein and necrotic debris. (Wounds from cryosurgery, electrosurgery, lasers or acids heal late.)
Agents and recurrent trauma: Some antiseptic or hemostatic agents delay healing.
Foreign Bodies: If the wound is not removed from the wound, the inflammatory response is prolonged, causing infection and delayed recovery.
Hematoma or Seroma: Provides an environment suitable for infection.
Heat: The expected tensile strength of the wound occurs later in hyportermia.