The use of subatmospheric pressure to prevent burn wound progression: first experiences in burn wound treatment

Thermal injury applied to living tissue results in zones of injury. Cell death is complete in the zone of coagulation. Beneath this area, there is the zone of lesser injury, where most of the cells are initially viable. If this zone of stasis is not reversed, the burn wound will progress. One of the major aspects to prevent progression is to reduce the edema formation and to preserve microcirculation. We present our first experiences to prevent the progression by use of topical negative pressure. Within the last months, all patients with bilateral partial thickness hand burns were included into this treatment protocol. Within one patient, one hand was treated with the V.A.C. (KCI, Austria), the contra lateral one by use of Flammazine (Smith and Nephew, Germany). Our first observations and data indicate, that both important factors (edema and microcirculation) could be influenced positively by use of the V.A.C.