Negative Pressure Wound Therapy With Flap Reconstruction for Extensive Soft Tissue Loss in the Foot: A Case Report

Abstract

Negative pressure wound therapy (NPWT) can create the healing granulation tissue that will form a wound bed for the skin graft, thereby reducing the volume of the soft tissue defect. The application of uniform negative pressure, which is delivered by vacuum-assisted closure (VAC) therapy, induces a physical response (macrostrain) and a biological response (microstrain). The patient in the current case report presented with an alleged history of a road traffic accident, sustaining a crush injury to his right heel pad, resulting in an open comminuted fracture of the right calcaneum with bone loss. A total of seven days of NPWT was allowed. Negative pressure sponge dressing was then applied in this region and adhesive drapes were sealed. Once sealed, suction was set at the continuous pressure of -125 mm Hg. The authors noted that the benefits significantly outweigh the costs of the VAC system, making it an essential treatment option for patients similar to the one presented in this case report.