Vacuum instillation for the treatment of chronic wound infections

Background. The therapy of chronic wound infections includes an intravenous antibiotic therapy and vacuum therapy in addition to radical surgical debridement. For local wound treatment antiseptics are often additionally applied. A newer automated method of vacuum therapy provides intermittent delivery of an antiseptic. The aim of this treatment is a reduction of the microbial load of chronic wound infections in order to achieve improved wound healing. Material and methods. On the basis of the current literature an overview of vacuum instillation therapy in the treatment of chronic wound infections is presented. Commonly used antiseptics and their properties for topical wound treatment are briefly discussed. Results. Initial clinical studies indicate a positive effect of vacuum instillation therapy on the microbial load of chronic wound infections. The average time of hospitalization, duration of therapy and wound closure could be reduced compared to conventional antiseptic dressings. Conclusion. The vacuum instillation therapy complements a well-established treatment of chronic wound infections by the intermittent delivery of antiseptics. There are only a few studies concerning the influence on the microbial load. Although initial estimations assume a reduction of the microbial load, more randomized controlled studies are needed to develop evidence-based guidelines for the clinical use of this procedure.