Vacuum-compression therapy for the treatment of an ischemic ulcer

Department of Physical Therapy, School of Allied Health Professions, Louisiana State University Medical Center, Shreveport 71130-3932.

This case report describes the use of a new medical device that utilizes vacuum-compression therapy (VCT) in the management of a 30-year-old female patient with severe arteriosclerosis and an associated nonhealing fasciotomy wound. Attempts were made to treat the patient with local care consisting of debridement and saline-moistened gauze dressings. Following a poor response to nonsurgical management, a skin graft was performed in an attempt to encourage more rapid healing. Infection and poor healing followed the graph, and only 40% of the graft remained viable after 12 days. Outpatient physical therapy management consisted of hydrotherapy and hydrocolloid dressings. This treatment resulted in minimal success until combined with VCT. The patient received hydrotherapy, VCT, and hydrocolloid dressings three times per week for 11 weeks. Wound healing occurred at an average rate of 0.64 cm2 per day, and the wound completely reepithelialized by the end of the eighth week of VCT therapy. Increased capillary filling is proposed as a primary factor in the improved healing.