The current standard for negative pressure wound therapy is the Vacuum Assisted Closure
Device (VAC), a commercial system that utilizes a computerized suction pump to apply
negative pressure to an open-cell poly-urethane foam dressing sealed over a wound. The VAC
system is effective but has some drawbacks:
- The system is expensive.
- There us conflicting data about the effectiveness of VAC therapy for infected wounds.
- VAC therapy is difficult to use (and frequently fails) in wounds with excess fluid
drainage, and in wounds near body orifices.
Over the past 4 years, we have accumulated additional experience with negative pressure
wound therapy using wall suction applied to sealed gauze dressings with about 30 patients.
We call this method G-SUC and have used it when we have been unable to maintain a dressing
seal with the VAC system (due to excess drainage or wound location), for management if
infected wounds. We have found this method to be effective without any specific negative
Our specific aims are:
1. Compare the effectiveness of G-SUC and standard VAC therapy. Outcomes measured for each
method will include the proportional change in wound size over 1 - 2 weeks.
2. Compare the effectiveness of G-SUC and VAC system in controlling wound infections as
measured by the number of patients who are able to clear infection by 4 days.
3. Compare the failure of each method of therapy by documenting the number of dressing
that cannot be maintained because of fluid or suction.
4. Measure and compare the cost of wound treatment with the two methods including direct
cost and time spent at the bed side performing the dressing change.
Our hypotheses are:
1. G-SUC and VAC are equivalent for the treatment of uncomplicated wounds in the acute
care, in-patient setting.
2. G-SUC is more effective than VAC for management of infected wounds.
3. G-SUC is more versatile than VAC, and functional G-SUC dressings can be maintained in
situations where functional VAC dressings cannot.
4. Negative pressure therapy with G-SUC is less costly than VAC.
- Hospitalized patients at the University of Chicago Medical Center with acute wounds
resulting from ether trauma, dehiscence or surgical complications
- Patients with systemic sepsis caused by wound infection
- Those with grossly necrotic wounds
- Malignancy in the wound
- Wounds with untreated osteomyelitis
- Patients with allergy to sulfamylon and Dakin's (sodium hypochlorite) Patients with 2
first criteria would become eligible once their sepsis resolves and/or necrotic
tissue has been debrided from the wound.