title: Wound closure of leg fasciotomy: comparison of vacuum-assisted closure versus shoelace technique. A randomised study.
abstract: BACKGROUND
  Fasciotomies, though essential for the prevention and management of compartment syndromes, may increase morbidity and prolong hospitalisation. Two widely applied methods of delayed primary closure are compared in leg fasciotomy wounds.
  
  
  METHODS
  Two groups, each of 25 patients with leg fasciotomies due to fractures and soft tissue injuries, who were randomly assigned to be treated either by vacuum assisted closure (VAC®, n=42 wounds, group V) or by the shoelace technique (n=40 wounds, group S), were evaluated in this study. Wound length, time to definite closure, complications, need for additional interventions and daily treatment costs were data collected and statistically assessed.
  
  
  RESULTS
  Wound closure time was significantly higher in group V compared to group S (p=0.001; 95% CI of the difference, 1.8-6.3 days). Five group V patients required split thickness skin grafts. In six group S patients, the vessel loops had to be replaced. The mean daily cost of negative pressure therapy alone was 135 euro (range 117-144 euro), whilst the mean daily cost of treatment for the shoelace technique was 14 euro ranging from 8 to 18 euro (p=<0.001).
  
  
  CONCLUSIONS
  Both VAC® and the shoelace technique are safe, reliable and effective methods for closure of leg fasciotomy wounds. VAC® requires longer time to definite wound closure and is far more expensive than the shoelace technique, especially when additional skin grafting is required.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Democritus University in Thrace Hospital, Alexandroupolis, Greece. Electronic address: despoinakakagia@yahoo.com.
authors.forename: D
authors.initials: D
authors.lastname: Kakagia
authors.affiliation: Department of Orthopedics, Democritus University in Thrace Hospital, Alexandroupolis, Greece; Department of Orthopedics, Hellenic Red Cross Hospital, Athens, Greece.
authors.forename: E J
authors.initials: EJ
authors.lastname: Karadimas
authors.affiliation: Department of Orthopedics, Democritus University in Thrace Hospital, Alexandroupolis, Greece.
authors.forename: G
authors.initials: G
authors.lastname: Drosos
authors.affiliation: Department of Orthopedics, Democritus University in Thrace Hospital, Alexandroupolis, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Ververidis
authors.affiliation: Department of Medical Statistics, Democritus University in Thrace, Alexandroupolis, Greece.
authors.forename: G
authors.initials: G
authors.lastname: Trypsiannis
authors.affiliation: Department of Orthopedics, Democritus University in Thrace Hospital, Alexandroupolis, Greece.
authors.forename: D
authors.initials: D
authors.lastname: Verettas
mesh_terms: D000293:Adolescent; D000328:Adult; D003161:Compartment Syndromes / Q000517:prevention & control; D003646:Debridement; D005205:Fascia / Q000098:blood supply / Q000473:pathology*; D000071938:Fasciotomy; D005260:Female; D050723:Fractures, Bone / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007869:Leg Injuries / Q000473:pathology* / Q000601:surgery; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy / Q000191:economics; D012826:Silicone Elastomers; D017695:Soft Tissue Injuries / Q000473:pathology* / Q000601:surgery; D013530:Surgical Wound Infection / Q000517:prevention & control; D013536:Suture Techniques / Q000191:economics; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing
chemical_list: D012826:Silicone Elastomers