title: A prospective randomized trial comparing subatmospheric wound therapy with a sealed gauze dressing and the standard vacuum-assisted closure device.
abstract: OBJECTIVE
  Two methods of subatmospheric pressure wound therapy--wall suction applied to a sealed gauze dressing (GSUC) and the vacuum-assisted closure device (VAC)--were compared in hospitalized patients at University of Chicago Medical Center.
  
  
  BACKGROUND
  VAC therapy is widely used, but can be expensive and difficult to apply; it also fails in some patients.
  
  
  METHODS
  A randomized prospective study of 87 patients (N = 45 in the GSUC arm and N = 42 in the VAC arm) was undertaken between October 2006 and May 2008. The study comprised patients with acute wounds resulting from trauma, dehiscence, or surgery.
  
  
  RESULTS
  Demographics and wound characteristics were similar in both groups. There were significant reductions in wound surface area and volume in each group. In the GSUC group, the reductions in wound surface area and volume were 4.5%/day and 8.4%/day, respectively (P < 0.001 for both), and in the VAC group, this was 4.9%/day and 9.8%/day, respectively (P < 0.001 for both). The reductions in wound surface area and volume were similar in both groups (P = 0.60 and 0.19, respectively, for the group-by-time interaction). The estimated difference (VAC - GSUC) was 0.4% (95% confidence interval: -1.0, 1.7) for wound surface area and 1.4% (95% confidence interval: -0.7, 3.5) for volume. The mean cost per day for GSUC therapy was $4.22 versus $96.51 for VAC therapy (P < 0.01) and the average time required for a GSUC dressing change was 19 minutes versus 31 minutes for a VAC dressing change (P < 0.01). The sum of pain intensity differences was 0.50 in the GSUC group compared with 1.73 for the VAC group (P = 0.02).
  
  
  CONCLUSIONS
  GSUC is noninferior to VAC with respect to changes in wound volume and surface area in an acute care setting. In addition, GSUC dressings were easier to apply, less expensive, and less painful.
authors.affiliation: Division of Plastic and Reconstructive Surgery, Johns Hopkins Medical Institute, Baltimore, MD, USA.
authors.forename: Amir H
authors.initials: AH
authors.lastname: Dorafshar
authors.forename: Mieczyslawa
authors.initials: M
authors.lastname: Franczyk
authors.forename: Lawrence J
authors.initials: LJ
authors.lastname: Gottlieb
authors.forename: Kristen E
authors.initials: KE
authors.lastname: Wroblewski
authors.forename: Robert F
authors.initials: RF
authors.lastname: Lohman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001458:Bandages; D002641:Chicago; D005260:Female; D017721:Hospital Costs; D006801:Humans; D057194:Intention to Treat Analysis; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy / Q000191:economics / Q000295:instrumentation / Q000379:methods*; D010147:Pain Measurement; D011446:Prospective Studies; D016896:Treatment Outcome; D014945:Wound Healing; D014947:Wounds and Injuries / Q000191:economics / Q000628:therapy*