Incisional Wound Vac in Obese Patients
| Status: | Archived |
|---|---|
| Conditions: | Hospital |
| Therapuetic Areas: | Other |
| Healthy: | No |
| Age Range: | Any |
| Updated: | 7/1/2011 |
| Start Date: | December 2010 |
| End Date: | February 2012 |
It is the belief of the investigators that the current trends in complication rates
associated with fixation of pelvic ring injuries and acetabular fractures in the obese are
unacceptable. The overwhelming majority of these complications can be attributed to problems
with surgical wound healing. The investigators feel that if a cost effective and easily
performed intervention can be prospectively utilized in a specific at-risk orthopaedic
trauma population in order to control a potentially devastating complication, then efforts
in discovering such an intervention may prove valuable. It is our hypothesis that obese
patients treated with V.A.C. therapy after standard closure of trauma-related, operative
orthopaedic incisions will have fewer postoperative wound complications.
Obesity has been shown to be an independent risk factor for postoperative surgical
infections in a variety of obesity related and non-obesity related surgeries. With the risk
of an increasingly more obese society, complication rates that significantly differ based on
patients' relative obesity may become increasingly unacceptable. The purpose of the proposed
prospective study is to evaluate the role that vacuum assisted closure (VAC) may play in
reducing these complication rates. Negative pressure or vacuum assisted closure was first
introduced in 1997 as a way to control and potentially treat chronic wounds. Since that
time, the indications have exploded to include a variety of chronic and acute wound healing
problems. We have anecdotally been using VAC therapy (V.A.C.;KCI, San Antonio, Texas) in an
effort to control the postoperative draining that is nearly ubiquitous in our morbidly obese
orthopaedic trauma patients. The V.A.C. dressing is applied to the acute postoperative wound
and maintained during the immediate postoperative period. Although a novel approach to the
use of the V.A.C., this use has been previously reported in the orthopaedic literature as a
case series. To our knowledge, there has not been a prospective study evaluating the
efficacy of the immediate placement of a V.A.C. dressing on postoperative wound infection
rates in the setting of the morbidly obese orthopaedic trauma patient. It is our hypothesis
that obese patients treated with V.A.C. therapy after standard closure of trauma-related,
operative orthopaedic incisions will have fewer postoperative wound complications.
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