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Negative-pressure wound therapy (NPWT), also known as a vacuum assisted closure (VAC), is a therapeutic technique using a suction pump, tubing, and a dressing to remove excess exudate and promote healing in acute or chronic wounds and second- and third-degree burns. The therapy involves the controlled application of sub-atmospheric pressure to ...
Passive drains rely on gravity or capillary action to remove fluid, whereas active drains rely on a suction/vacuum force, whether that be through connection to wall suction, a portable suction device, or a bulb that has been squeezed to create a vacuum. Open drains are commonly used for superficial wounds and drain into dressings or a stoma bag.
The purpose of a drain is to prevent fluid (blood or other) build-up in a closed ("dead") space, [2] which may cause either disruption of the wound and the healing process or become an infected abscess, with either scenario possibly requiring a formal drainage/repair procedure (and possibly another trip to the operating room).
An increasingly common aid to both pre-operative wound maintenance and post-operative graft healing is the use of negative pressure wound therapy (NPWT). This system works by placing a section of foam cut to size over the wound, then laying a perforated tube onto the foam. The arrangement is then secured with bandages.
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The wound can be allowed to close by secondary intention. Alternatively, if the infection is cleared and healthy granulation tissue is evident at the base of the wound, the edges of the incision may be reapproximated, such as by using butterfly stitches , staples or sutures .
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The wound is initially cleaned, debrided and observed, typically 4 or 5 days before closure. The wound is purposely left open. Examples: healing of wounds by use of tissue grafts. If the wound edges are not reapproximated immediately, delayed primary wound healing transpires. This type of healing may be desired in the case of contaminated wounds.
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