Improvised Suction Apparatus for Closure of Large Soft Tissue Deficit

Background: Vacuum Assisted Closure (VAC) is an established method that can be used in order to cover for soft tissue defects. This study focuses on the use of a modified suction machine in the form of an aquarium pump as an economical substitute for the VAC dressing. The improvised suction apparatus was a regular aquarium pump, which was altered in order to draw air in instead of expelling it. The patients were followed-up for a period of three weeks in the wards. Methods: VAC was applied over the soft tissue defects. Sterilized foam was used and attached to a French 16 suction tube. A tight seal was ensured using a sterile adhesive covering. The tube was then attached to the modified vacuum machine, which maintained the negative pressure. Case Studies : Three cases are presented in this study. The first and second cases involved pediatric patients who sustained degloving injuries of the foot. The third case involved a 23 year-old male who sustained an open patellar fracture due to a motorcycle accident. The dressing was changed every five days and the progress was documented using photographs. The patients were placed on VAC dressing for a period of two weeks. On the 14th day, good granulation was evident on the soft tissue defects hence; the patients were scheduled and subsequently underwent splitthickness skin grafting. Discussion : The modified suction pump is an effective and economical alternative to the VAC machine for the purpose of providing constant negative pressure to promote tissue granulation and healing for large tissue defects. However, in order to establish the efficacy of the proposed intervention, the modified suction pump should be tested on more cases. KEY WORDS: Vacuum-assisted Closure (VAC) System, modified VAC, aquarium pump, soft tissue defect coverage, alternative negative pressure source