Emily R. Kindal1, Kaitlin J. Larson2, Luis G. Fernandez3,4,5#, Sean F. O’Keefe6, Marc R. Matthews7*

1 Medical Student IV, Royal College of Surgeons in Ireland, Dublin, Ireland

2 Surgical Resident, The Arrowhead Surgical Residency, Glendale, Arizona

3 Department of Surgery, University of Texas Health Science Center, Tyler, USA

4 Trauma Wound Care, UT Health East, Tyler, USA

5 Department of Surgery, University of Texas Medical Branch, Galveston, USA

6 Business Development Manager, Saint Paul, US

7 University of Arizona & Creighton University Schools of Medicine, The Arizona Burn Center, Phoenix, Arizona

Email:★marc＿matthews@dmgaz.org.

How to cite this paper: Kindal, E.R., Larson, K.J., Fernandez, L.G., O’Keefe, S.F. and Matthews, M.R. (2022) The Use of the V.A.C. RX-4 for Multiple Soft Tissue Wound Application in the Single Patient: A Case Report. Surgical Science, 13, 155-163. https://doi.org/10.4236/ss.2022.133020

Received: January 28, 2022

Accepted: March 26, 2022

Published: March 29, 2022

Copyright © 2022 by author(s) and Scientific Research Publishing Inc. This work is licensed under the Creative Commons Attribution International License (CC BY 4.0). http://creativecommons.org/licenses/by/4.0/

Abstract

Contact burn injuries account for a considerable proportion of admissions that frequently require debridement. Such debridements of these multiple open wounds might benefit from the application of negative pressure wound therapy (NPWT) for the removal of proinflammatory mediators and to promote granulation tissue with macrostrain and microstrain. Having four or more Vacuum Assist Closure (V.A.C.) Ulta devices connected to the same patient for adequate wound coverage is cumbersome in the management of the patient’s wound care and tethers the patient to the bed. The V.A.C. RX-4 is a multichannel device that can deliver NPWT with a smaller footprint. In addition, the V.A.C. RX-4 has a weight of 16 lbs. versus one V.A.C Ulta which is 7.4 lbs. Therefore, collectively, four V.A.C. Ultas would equal 29.6 lbs. or almost double the weight of a single V.A.C. RX-4. Use of the V.A.C. RX-4 by healthcare providers can mean greater mobility for the patient and easier transport between patient destinations within the hospital. This case report demonstrates the utility of the V.A.C. RX-4 for open and freshly debrided, large soft tissue wounds in a burn patient.

# UT Texas, Assistant Clinical Professor of Surgery/Family Practice UT Health North East, Tyler, Texas, Adjunct Clinical Professor of Medicine and Nursing, University of Texas, Arlington, Texas, Past Commanding General TXSG Medical Brigade, Austin, TX USA, Chairman Emeritus, Division of Trauma Surgery/Surgical Critical Care, Associate Trauma Medical Director and Chief of Trauma Surgical Critical Care Unit, Christus Trinity Mother Frances Health System, Tyler, Texas, Surgical Attending, Adjunct Associate Professor, University of North Texas, Denton, Texas.

Keywords

V.A.C. RX-4, Negative Pressure Wound Therapy, Wounds, V.A.C. Ulta, Footprint, Burns

Nanotechnology has opened a new area of scientific research. This field deals with materials within the dimensions of 1–100nm and a plethora of new technologies have emerged. In wound care, silver nanoparticles are used to aid wound healing as an antimicrobial agent, but also as an anti-inflammatory agent. The properties of silver nanoparticles differ from that of the material on a larger scale and their production can be controlled to give varied properties and characteristics that have different uses. These resultant properties are very important and differences in characterisation can alter their biological and physical attributes. All wound dressings have to undergo rigorous scrutiny around toxicity and safety when regulatory review is undertaken, yet some users still have concerns over long-term effects of silver nanoparticles in vivo. This review will address some of these concerns and reviews the current health and safety data associated with introduction of new products containing silver nanoparticles using Venus Ag dressings (SFM LTD, UK) as an example.

KEY WORDS   Nanoparticles of silver   Safety   Silver dressings   Toxicity

VAL EDWARDS-JONES PhD,CSci, FIBMS, Independent Microbiology Consultant, Essential Microbiology Limited

There were an estimated 3.8 million patients with a wound managed by the NHS in 2017/2018 at a cost of £8.3 billion (Guest et al, 2017). The cost to the patient and their quality of life is immense. Evidence has shown that there are wide variations in the care of people with chronic wounds, with many patients not receiving the correct assessment or a diagnosis on which to base decisions about their care (Guest et al, 2015; Gray et al, 2018). Delivering efficient and effective care to patients with a venous leg ulcer (VLU) requires collaborative working across specialist and community settings to tackle inequalities in care, improve outcomes, enhance productivity, and provide value for money.

KEY WORDS   Venous leg ulcer   Compression Reducing variation  UrgoKTwo  DR CAROLINE DOWSETT  Clinical Nurse Specialist  Tissue  Viability, East London   NHS  Foundation Trust; Independent   Nurse Consultant

ABSTRACT: Biofilm formation in wounds contributes greatly to the lack of healing and increased healthcare expenditures. Antimicrobial efficacy is decreased significantly in the presence of biofilms, which can, in turn, promote the development of antibiotic resistance. Antibiofilm strategies to prevent the formation and persistence of biofilm in wounds would consequently decrease the incidence of chronic wounds and improve wound healing. The use of preclinical biofilm models to assess the antibiofilm efficacy of wound dressings is a prerequisite to identifying new technologies that can improve outcomes in hardto-heal wounds. Improvements to preclinical approaches (in vitro and in vivo) to biofilm models are needed. Living tissue (ex vivo) derived from pig and human skin donors is a developing approach that translates the research to the clinic, including the native microenvironment of the biofilm.

KEY WORDS Bacteria   Biofilm   Infection   Microbiology   Swab   Wound dressings

MARNIE PETERSON PharmD, PhD, Site Director, Perfectus Biomed Group, Now Part of NAMSA, 3545 South Park Dr., Jackson, Wyoming, 83001, US. marnie@perfectusbiomed.com

SAM WESTGATE PhD, Executive Director,  Perfectus Biomed Group, Now Part of NAMSA, Techspace One SciTech Daresbury, Keckwick Lane, Daresbury, Cheshire, WA4 4AB, UK, sam@perfectusbiomed.com