Safdar Ali Shaikh, Amber Bawa, Fahad Hanif Khan, Muhammad Shahab Ghani
Lower limb wounds with exposed bones have typically shown remarkable results with Vacuum Dressing leading to simplification of reconstruction ladder from a complex flap to skin grafting. Vacuum Dressing has always shown problems in wounds with external fixation devices due to multiple pins that fail to create an absolute air tight dressing. We described a simple and cost effective method of dressing that effectively creates sub atmospheric pressure on wounds with external fixators. Methods and Materials: Two years prospective study (2016 -18) conducted at a teaching hospital in Karachi. Patients with lower limb open fracture, who gave consent for the study, were included. Fractures were managed with external fixator and had no exposed bare bone, tendon or neuro-vascular structure. Fabricated vacuum assisted dressing was applied ( detailed below) to prevent leakage from metal work. Results: Sixteen patients gave consent for inclusion in the study. All had granulation at the end of Vacuum Dressing sessions. We had 95% graft take on the wounds. Conclusion: We highlight an easy and effective fortification of Vacuum Dressing, especially when metal frames open wounds. It works just like a tradition all Vacuum Dressing system and is significantly cost effective.