The effectiveness of negative pressure therapy on infected wounds: Preliminary results

Vacuum-assisted closure (VAC) therapy is a sophisticated system that maintains aclosed, humid, sterile and isolated environment. Wound infection is considered arelative contraindication. The objective of this study is to extend the indications forVAC therapy to include infected wounds by demonstrating its ability to increase theantibiotic concentration in the damaged and infected tissues. Patients who presentedwith ulcers infected with daptomycin-sensitive bacteria were eligible to be enrolledin this prospective study. They were given antibiotic therapy with daptomycin with aspecific protocol. A biopsy of the lesion was carried out to detect tissue concentrationof the drug at time 0. Afterwards, the patients were subjected to VAC therapy. At theend of VAC therapy, a second lesion biopsy was performed and analysed to detect tissueconcentration of the drug at time 1. A control group was enrolled in which patientsfollowed the same protocol, but they were treated with traditional dressings. Fisher’sexact test was used to compare the two groups. The results highlighted a significantincrease in the concentration of antibiotics in the study group tissue; the improvementwas sensibly lower in the control group. Statistical differences were not found betweenthe two groups. The preliminary analysis of the data showed an important increase ofantibiotic concentration in the tissue after VAC therapy. Despite the encouraging data,it is necessary to broaden the sample of patients and perform the same study with otherantibiotics.