The American Journal of Surgery
Volume 199, Issue 1 , Pages 14-20, January 2010

Modern wound care for the poor: a randomized clinical trial comparing the vacuum system with conventional saline-soaked gauze dressings

  • Daniel Perez, M.D.

      Affiliations

    • Department of General Surgery, Hôpital Albert Schweitzer, Deschapelles, Haiti
    • Department of General Surgery, General Hospital Zurich-Triemli, Birmensdorfstrasse 497, 8063 Switzerland
    • Corresponding Author InformationCorresponding author: Tel.: +41-44-4661049; fax: +41-44-466-3606
  • ,
  • Matthias Bramkamp, M.D.

      Affiliations

    • Department of Internal Medicine, University Hospital of Zurich, Switzerland
  • ,
  • Chauvet Exe, M.D.

      Affiliations

    • Department of General Surgery, Hôpital Albert Schweitzer, Deschapelles, Haiti
  • ,
  • Christian von Ruden, M.D.

      Affiliations

    • Department of Trauma Surgery, University Hospital of Zurich, Switzerland
  • ,
  • Anna Ziegler, M.D.

      Affiliations

    • Department of General Surgery, Hôpital Albert Schweitzer, Deschapelles, Haiti
    • Department of Paediatrics, University Children's Hospital of Zurich, Switzerland

Received 21 June 2008; received in revised form 17 December 2008 published online 13 April 2009.

Abstract 

Background

A clinical randomized trial was performed to determine whether a simple homemade wound vacuum-dressing system (HM-VAC) is a feasible alternative to the use of conventional saline-soaked gauze dressings (WET) for the treatment of complex wounds in a resource-poor hospital.

Methods

Forty patients were analyzed to compare the HM-VAC and the WET dressings. The HM-VAC was assembled with tools available in most operating room worldwide. The primary outcome measure was the time of complete wound healing. Additionally, the costs of both methods were calculated.

Results

The time required to achieve complete healing was 16 days in the HM-VAC group compared with 25 days in the WET group (P = .013). The HM-VAC costs US $360 per case, and the WET technique costs US $271 per case (P = .008).

Conclusions

The HM-VAC should be considered in underdeveloped countries to provide modern management for complex wounds because healing is significantly faster compared with conventional wound care. Although the HM-VAC is more costly than the conventional approach, it is probably affordable for most resource-poor hospitals.

Keywords: Wound care, Vaccuum dressing system

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PII: S0002-9610(09)00111-1

doi:10.1016/j.amjsurg.2008.12.029

The American Journal of Surgery
Volume 199, Issue 1 , Pages 14-20, January 2010