Outcomes of Reconstructive Surgery Using Vacuum-Assisted Closure in Patients With Complex Wounds

This study aimed to assess the results of reconstructive surgery with vacuum-assisted closure (VAC) therapy in patients with complex wounds. The sample included 60 patients with a mean age of 53.03 years. The sample was ethnically diverse, with significant representation from various regions, including Khyber Pakhtunkhwa (KPK), Punjab, Sindh, Balochistan, Gilgit-Baltistan, and Kohistan. The most common comorbidities were obesity (26.7%), diabetes (25.0%), and cardiovascular disease (13.3%). Patients had varied wound types, including diabetic ulcers (26.7%) and pressure ulcers (23.3%) in the lower extremities, constituting 25.0%. VAC therapy was given to 53.3% of the patients with different parameters varying from continuous to intermittent mode with pressure between 50-149 mmHg. Pre- and post-operative laboratory results showed raised inflammatory markers and poor nutritional status, which are strongly related to delayed wound healing. The most common complications were infection (21.7%) and hemorrhage (15.0%). The type of surgical site was significantly associated with the complications. Surgical outcomes ranged from fully healed wounds to 23.3% to partially healed wounds and 28.3% of reopened wounds. While VAC therapy proves beneficial, comorbidities, as well as wound characteristics, play important roles in determining a greater degree of success. More research must be conducted to optimize VAC therapy protocols for more complex wounds.