Study of Outcome of Vacuum Assisted Closure in Open Fractures of Tibia

Background: Long bone compound fractures remain a challenge for the treating surgeon despite many advancements. Standard wound dressings had poor patient compliance, required a long time, required repeated debridement, and caused trauma to granulation tissue. Vacuum-assisted closure provides an extremely efficacious method for treating difficult wounds. The purpose of this study was to examine the results of vacuum-assisted closure for open tibia fractures. Methods: This observational study was conducted at Department of Orthopaedics, SKMCH, Muzaffarpur, Bihar from March 2024 to August 2024 on patients who were older than eighteen, hemodynamically stable, and had open tibia fractures (G.A. II, IIIA, and IIIB) that had undergone primary internal fixation and vacuum assisted closure (VAC). Results: The mean age of the 30 patients in this study was 41.34 ± 14.56 years, with the majority (83.33%) being male. From the second day of the post-operative period, VAC dressings were applied every four days; 15 cases (50%) had five VAC dressings applied, 10 cases (33.33%) had four VAC dressings applied, and 5 cases (16.67%) had more than five VAC dressings applied. Mean Hospital stay was 18.82 ± 9.46 days. Post-primary Procedure, majority had Split skin-graft (63.33 %), Repeat debridement and then secondary closure (16.67 %), direct closure (10 %), Tissue transfer (6.67 %) & healing by secondary intension (3.33 %). Mean decrease in wound size was 10.23 ± 3.72 cm2. Two cases (6.67%) had implant-related infections, and one case (3.33%) had an exposed implant. At 6 months follow-up, the functional outcome was bad in one case (3.33%), fair in nine cases (30%), good in seventeen cases (56.67%), and excellent in three cases (10%). Conclusion: Applying VAC lowers the risk of wound infection, speeds up the healing process, and minimizes the need for further soft tissue defect covering procedures.