Working in a remote and limited resources hospital, access to such medical devices is not always easy task to manage (7,500 USD per unit and 75 USD for each dressing change). The granulation tissue obtained through this new approach was thicker and more ventilated, but the financial costs of acquisition and operation of this device were higher, making it inaccessible to low-income countries. It was Argenta and Morykwas who eventually popularized the technique using a combined system of open-cell polyurethane foam and NP applied in a controlled manner. successfully applied this new NP wound therapy (NPWT) to 15 patients with open fractures using foam dressing for an extended period of time in order to promote granulation and healing. ![]() It was only in the early 90s that Fleischman et al. Three years later, Chariker and Jeter published a method of NP dressing connecting wall suction via a drain to moist gauze pads covered with adhesive film, allowing a thin and dense granulation tissue. demonstrated, in a study of 116 patients, the superiority of NP dressing for infected wounds after surgical debridement compared to surgical debridement alone. And even if the widespread use of this technique in many surgical specialties is due to the commercial development of many innovative devices, the fact remains that the principle of its use goes back further. In the 1970s, pioneering Russian surgeons were already applying the principle of a vacuum chamber placed above the wound. The idea of using negative pressure (NP) to assist wound healing is not new. We present the technique used in our department and its results through a series of 3 cases with both acute and chronic lesions evolving in septic environment and where NPWT enabled us to ensure a genuine care protocol until healing while reducing the cost of therapy, the number of dressings and the length of hospital stay. However, the exorbitant cost of VAC (vacuum-assisted closure) devices for our limited resources health facilities and their unavailability led us to opt for a “low cost” solution using wall suction and disposable materials readily available in all surgical departments. With cellular, extracellular effects and bacterial clearance, it leads to the rapid formation of healthy budding granulation tissue, which provides wound bed for directed healing or secondary coverage by skin graft or flap. ![]() ![]() Negative pressure wound therapy (NPWT) is an alternative to standard treatment of acute wounds (such as traumatic or postoperative wounds) but also in that of chronic wounds (such as ulcers or stage 3 and 4 pressure ulcers).
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