SOVREMENNAYA PEDIATRIYA.2017.3(83):107-111; doi 10.15574/SP.2017.83.107

Danilov O. A., Rybalchenko V. F., Talko M. O.
Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine
Kyiv Municipal Children's Clinical Hospital No. 1, Ukraine

Vacuum-therapy (VAC-therapy) represents the appliance of constant or alternating negative air pressure to the wound surface, creating the optimal conditions for regeneration processes, development of granulation and prevention of bacterial contamination.

Objective — to share the experience of vacuum therapy in children with pyoinflammatory and trophic diseases of soft tissues.

Material and methods. There have been treated 12 children aged 5 to 17 years who were admitted to the surgery department No. 2 of Kyiv Municipal Children's Clinical Hospital No. 1. Among the surgical pathology there were 2 cases of neuropathic foot ulcers II degree (according to Wagner), 1 case of suppurative coccygeal cyst, 2 intramuscular injection-related abscesses of the gluteal region, 4 cases of purulent lymphadenitis (2 of them were inguinal, one — axillary and one was in cervical area), a case of adenophlegmon of the submandibular area and a case of carbuncle of the cervical area. The vacuum-therapy in the postoperative period was provided by means of the portable devices VAC Via and Prevena 125, and Vario-8 Medela with vacuum-assisted bandages KCI. In addition, to provide the hermetization, the 3M™ Ioban™ Drapes and 3M™ Tegaderm Dressings were used. The vacuum-therapy was carried out in continuous or alternating mode of the negative pressure in the range of 75–125 mm Hg. The local dynamics, the patient's subjective impression on therapy and the terms of inpatient care were evaluated during the study.

Results. The vacuum therapy average duration of soft tissues pyoinflammatory diseases (purulent lymphadenitis, phlegmon adenitis, abscess, suppurative coccygeal cyst, and carbuncle) made up 3 days with the total volume of wound effluent of 15–20 ml. The accelerated dynamics of primarily local oedema regression, which was liquidated in 2–2.5 days, was observed. The average length of hospital stay was 5.5 days. The vacuum treatment duration of neuropathic foot ulcers was 10 days with a single replacement of bandages. During that period, it was found the fulfilment of wound with granulation tissue that led to reducing the lesion twice by the retraction of wound edges and the initial edge epithelialization. The total volume of wound effluent was up to 8 ml. The main effect of that case was provided by the granulation tissue stimulation and the macro- and microdeformations of wound bed. The length of hospital stay was 12 days, and then the patients continued their treatment in the outpatient department. The complete healing of the wound defect was observed in a month.

Conclusions. VAC-therapy is a promising method in paediatric surgical practice, particularly for treating pyoinflammatory diseases of soft tissues, the acute and chronic wounds by accelerating regeneration of tissues in wound, bacterial decontamination, and prevention of wound infection.

Key words: vacuum therapy, acute and chronic wounds, pyoinflammatory diseases of soft tissue, negative pressure treatment of wounds.

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