Modern wound care for the poor: a randomized clinical trial comparing the vacuum system with conventional saline-soaked gauze dressings.
BACKGROUND
A clinical randomized trial was performed to determine whether a simple homemade wound vacuum-dressing system (HM-VAC) is a feasible alternative to the use of conventional saline-soaked gauze dressings (WET) for the treatment of complex wounds in a resource-poor hospital.


METHODS
Forty patients were analyzed to compare the HM-VAC and the WET dressings. The HM-VAC was assembled with tools available in most operating room worldwide. The primary outcome measure was the time of complete wound healing. Additionally, the costs of both methods were calculated.


RESULTS
The time required to achieve complete healing was 16 days in the HM-VAC group compared with 25 days in the WET group (P = .013). The HM-VAC costs US $360 per case, and the WET technique costs US $271 per case (P = .008).


CONCLUSIONS
The HM-VAC should be considered in underdeveloped countries to provide modern management for complex wounds because healing is significantly faster compared with conventional wound care. Although the HM-VAC is more costly than the conventional approach, it is probably affordable for most resource-poor hospitals.
Department of General Surgery, Hôpital Albert Schweitzer, Deschapelles, Haiti. danielperezch@yahoo.com
Daniel
D
Perez
Matthias
M
Bramkamp
Chauvet
C
Exe
Christian
C
von Ruden
Anna
A
Ziegler
D000328:Adult; D001458:Bandages / Q000191:economics*; D017046:Cost Savings; D003646:Debridement / Q000379:methods; D003906:Developing Countries; D005260:Female; D005500:Follow-Up Studies; D006205:Haiti; D017721:Hospital Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy / Q000191:economics* / Q000379:methods; D005791:Patient Care / Q000191:economics / Q000379:methods; D011203:Poverty; D011336:Probability; D018570:Risk Assessment; D012965:Sodium Chloride / Q000494:pharmacology; D013530:Surgical Wound Infection / Q000517:prevention & control / Q000628:therapy*; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology; D014947:Wounds and Injuries / Q000175:diagnosis / Q000191:economics / Q000628:therapy*
D012965:Sodium Chloride