Leg ulcers are the commonest cutaneous manifestation of sickle cell disease, typically running an indolent course. They commonly occur around the distal third of the leg, an area notorious for difficult-to-heal wounds. The vacuum-assisted closure (VAC) device has been found efficacious in the management of chronic ulcers of varying aetiologies. However, reports on its use in the management of sickle cell ulcers are at best scanty. The purpose of this study was to determine the usefulness of VAC therapy in the management of sickle cell ulcers. Over an 18-month period, consecutive patients presenting at the plastic surgery centre of the Imo State University Teaching Hospital were managed using VAC therapy and subsequent skin grafting for extensive ulcers. Data were extracted from the case records after completion of wound care and analysed using descriptive statistics. There were seven males and two females aged 14–34 years with 15 ulcers affecting the distal third of the leg. Ulcer duration before commencement of VAC care ranged from 2.5 to 84 months. All wounds showed remarkable reduction in size, had healthy granulation tissue and were ready for skin grafting within 6–10 days of VAC care. Graft take was 98% to 100%. Use of the VAC device is valuable in the management of sickle cell ulcers. This device rapidly improves the vascularity of the wound bed and permits early successful coverage of sickle cell ulcers.
European Journal of Plastic Surgery – Springer Journals
Published: Mar 1, 2012
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