Vacuum-assisted closure therapy in reconstructive surgery

Area of Science:

• Maxillofacial Surgery
• Wound Healing
• Negative Pressure Wound Therapy

Background:

• Vacuum-assisted closure (VAC) therapy, a negative pressure dressing system, has demonstrated success in treating various complicated wounds across multiple surgical specialties.
• Its application in managing surgical wounds of free flaps, particularly in the maxillofacial region, remains largely underexplored in existing literature.

Observation:

• This study presents three cases of maxillofacial reconstruction involving exposed bone after fibular free flap surgery, treated with VAC therapy.
• The VAC system was employed to manage these complex wounds prior to loco-regional flap reconstruction.

Findings:

• VAC therapy offers advantages over traditional wet-to-dry dressings by reducing edema, managing exudates, promoting debridement, and increasing blood perfusion.
• The system leads to accelerated wound healing and decreased bacterial colonization, preparing the wound bed for definitive reconstruction.

Implications:

• VAC therapy represents an innovative approach and a potential standard of care for complex maxillofacial wounds, including those with exposed bone post-free flap surgery.
• It can facilitate primary wound closure or serve as a crucial preparatory step for subsequent reconstructive procedures.