Comparison of Wound Healing Duration Between Vacuum-Assisted Closure (VAC) and Conventional Dressings

This randomized controlled trial is designed to compare the mean duration of wound healing between vacuum-assisted closure (VAC) therapy and conventional wound dressings in patients with open contaminated or dirty wounds.

The study will be conducted in the Department of General Surgery, Jinnah Postgraduate Medical Centre (JPMC), Karachi. Patients aged 15-60 years of either sex with open contaminated or dirty wounds measuring 5-10 cm and classified as ASA grade I or II will be considered for inclusion. Written informed consent will be obtained from all participants before enrollment.

A total of 60 participants will be enrolled and randomly allocated in a 1:1 ratio to two parallel treatment groups. Group A will receive VAC therapy, while Group B will receive conventional wound dressings.

All wounds will be thoroughly irrigated with normal saline, and surgical debridement will be performed when clinically indicated. In Group A, the wound will be covered with polyurethane foam, followed by application of an airtight dressing connected to a negative-pressure system. Intermittent negative pressure of 125 mmHg will be applied using cycles of 45 minutes ON and 15 minutes OFF. VAC dressings will be changed every 48-72 hours.

In Group B, saline-soaked conventional dressings will be applied and changed every 24 hours. Participants in both groups will be assessed for wound healing and wound-related complications during the treatment period.

The primary outcome will be mean duration of wound healing, measured in days from initiation of the assigned treatment until complete wound healing according to predefined clinical criteria. Wound surface area may also be assessed as a separate secondary outcome if it is prespecified in the study protocol.

Data will be analyzed using SPSS version 23. Quantitative variables will be assessed for normality using the Shapiro-Wilk test. Normally distributed continuous variables will be summarized using mean and standard deviation, while non-normally distributed variables will be summarized using median and interquartile range. Categorical variables will be presented as frequencies and percentages. The duration of wound healing will be compared between groups using an independent-samples t-test or Mann-Whitney U test, as appropriate. A p-value of <0.05 will be considered statistically significant.

Inclusion criteria

• Patients having open contaminated and dirty wounds of size 5 - 10cm as per operational definition.

• Patients between ages 15 to 60 years.
• Both gender
• ASA grade I & II
• Willing to provide written informed consent.

Exclusion criteria

• Patients with wounds having dry eschar, malignancy in wound, untreated osteomyelitis, exposed blood vessels and organs, long term anticoagulant therapy, bleeding disorders and fistula to organ / body cavities. Dermatological disorders like acute dermatitis, fungal infections of perianal region.
• All the patients presented with exposed bone, tendons or nerve will be excluded from study
• Pregnant women.
• Patients on medications, such as corticosteroids, immunosuppressive agents or chemotherapy. All above will be assessed on history and documented medical history.