[Vacuum-assisted closure (V.A.C.) of disastrous wound conditions in XXXX ].

@entity1 @entity417 @entity28772 @entity39 @entity4 @entity158 @entity9427 @entity9031 @entity1909 @entity11885
INTRODUCTION: A 54 year old @entity1 presented with a @entity28772 . Symmetrically fatty deposits were present on both upper arms, at the abdomen and both thighs. @entity1909 was seen in the axillary fold at the skin bearing surfaces. Shoulder movement was impaired. Liposuction of both upper arms has already been performed, but no significant improvement was obtained. METHODS AND RESULTS: We performed a dermolipectomy of both upper arms. Postoperatively the @entity1 suffered from a severe wound dehiscence with fulminant wound infection and septic clinical condition. Because of the large wound surface ((1/3) of the upper arm circumference) @entity417 occurred and had to be treated with blood transfusions. Wound exsudation caused a @entity9427 . Multiple surgical debridements were necessary in order to clean the wound from @entity39 tissue and afterwards moist dressings were applied. Furthermore the @entity1 received intravenous antibiotic treatment. After stabilisation of the general condition of the @entity1 and the wound situation a @entity9031 sponge and a vacuum-sealing were applied and continuous suction was performed (125 mm Hg). This resulted in a significant improvement of the wound situation in regards to wound cleaning, induction of granulation tissue, diminished wound size, reduction of @entity4 and @entity158 reduction. After four weeks of vacuum therapy defect coverage was possible and split thickness skin grafting was performed. The skin graft was attached to the wound using a vacuum-dressing. After removal of the vacuum dressing on the fifth day the skin graft has completely healed. DISCUSSION: Vacuum therapy is suitable for disastrous wound conditions in order to achieve a @entity11885 , @entity158 reduction and create a clean wound with granulation tissue for further surgical defect coverage using skin grafts or flaps.
