Venous leg ulcers (VLU) occurs in 1% of adult population and are associated with chronic disability, diminished quality of life and high health care costs. Treatment is often slow, difficult and recurrence is high because of inappropriate conditions of the wound bed. Negative pressure wound therapy (NPWT) very fast developing method of the wounds treatment. The aim of this study was to evaluate effectiveness of NPWT of large venous leg ulcers treatement.
This study involves 14 patients with chronic venous ulcers larger than 100 cm2 treated with negative pressure wound therapy. Patients underwent a radical debridement of all devitalised tissues and partial stripping of insufficient great saphenous vein in the first operation. After adequate haemostasis, NPWT kit was applied. Once the wounds were determined to be clean and adequate granulation tissue formation was achieved, splitthickness skin grafts were applied. Dressing impregnated with neutral triglycerides and silver ions was used as a first layer and the black polyurethane NPWT foam was applied over it. The pain assessment was performed for 7 patients using 10 cm visual analog scale (VAS).
The mean number of NPWT dressing changes prior to grafting was 5.8. The mean number of NPWT foam changes was 2.8 after skin grafting. We accomplished complete healing of 92% of applied skin grafts surface. One patient had recurrence of venous ulcers in the follow-up period. Moreover, one patient required regrafting.
The application of NPWT provides quick wound-bed preparation and high graft take in venous ulcer treatment.