Document Detail


Comparison of vacuum-assisted closure to the antibiotic bead pouch for the treatment of blast injury of the extremity.
MedLine Citation:
PMID:  20192138     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The surgical care of modern combatants involves treatment of massive extremity wounds from blast mechanism. Currently up to 70% of combat wounds are extremity related. Clinical outcomes for these patients are dependent on the care of these wounds. The Vacuum-Assisted Closure (VAC) Therapy system (KCI Inc, San Antonio, Texas) is ubiquitous in theater and is often considered the only way to treat these wounds. However, the VAC Therapy system is not without problems. It is expensive and requires extensive amounts of product and machinery, as well as functioning suction, and therefore a power source at all times. In addition, the VAC Therapy system requires a trained and vigilant nursing staff. We hypothesized that the antibiotic bead pouch would be a viable alternative to the VAC Therapy system for such blast injuries. We retrospectively analyzed 2 matched groups of 12 patients in terms of outcome and cost. We found that the VAC Therapy system produced more late methicillin-resistant Staphylococcus aureus infections (30%), more unanticipated returns to the operating room for wound problems (4:12 vs 0:12), and required more surgeries overall until closure of the wounds. In addition, the VAC Therapy system cost $12,000 more for 12 patients than the antibiotic bead pouch. We recommend the bead pouch be considered as an equivalent option to the VAC Therapy system in the treatment of blast injury.
Authors:
Meredith Warner; Chance Henderson; Warren Kadrmas; Darius T Mitchell
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Orthopedics     Volume:  33     ISSN:  1938-2367     ISO Abbreviation:  Orthopedics     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-03-02     Completed Date:  2010-06-02     Revised Date:  2011-01-03    
Medline Journal Info:
Nlm Unique ID:  7806107     Medline TA:  Orthopedics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  77-82     Citation Subset:  IM    
Copyright Information:
Copyright 2010, SLACK Incorporated.
Affiliation:
Wilford Hall Medical Center, San Antonio, TX 78240, USA. warner.meredith@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Anti-Bacterial Agents / economics*,  therapeutic use*
Arm Injuries / economics*,  therapy*
Blast Injuries / economics*,  therapy*
Female
Humans
Leg Injuries / economics,  therapy
Male
Negative-Pressure Wound Therapy / economics*
Retrospective Studies
Texas / epidemiology
Treatment Outcome
Young Adult
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents
Comments/Corrections
Comment In:
Orthopedics. 2010 Dec;33(12):868   [PMID:  21117560 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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