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PubMedDate not supplied

Test methods for evaluating the filtration and particulate emission characteristics of vacuum cleaners.

The overall filtration efficiency of a vacuum cleaner traditionally has been tested by placing the vacuum cleaner in a test chamber and measuring aerosol concentrations at the chamber inlet and outlet. The chamber test method was refined and validated in this study. However, this chamber test method shows an overall filtration efficiency of close to 100% for most of the industrial vacuum cleaners and for most of the newly developed household vacuum cleaners of midprice range or higher because all these vacuum cleaners have a high-efficiency particulate air (HEPA) or other highly efficient filter installed at the exhaust. A new test method was therefore developed through which the vacuum cleaner was probed in various internal locations so that the collection efficiency of the individual components could be determined. For example, the aerosol concentration upstream of the final HEPA filter can thus be measured, which permits one to estimate the life expectancy of this expensive component. The probed testing method is particularly suitable for field evaluations of vacuum cleaners because it uses compact, battery-operated optical particle size spectrometers with internal data storage. Both chamber and probed tests gave the same results for the aerosol filtration efficiency. The probed testing method, however, also gives information on the performance of the individual components in a vacuum cleaner. It also can be used to determine the dust pickup efficiency and the degree of reaerosolization of particles collected in the vacuum cleaner.

Air Pollution, Indoor↗
PubMedDate not supplied

Particle emission characteristics of filter-equipped vacuum cleaners.

Industrial vacuum cleaners with final high-efficiency particulate air (HEPA) filters traditionally have been used for cleanup operations in which all of the nozzle-entrained dust must be collected with high efficiency, for example, after lead-based paint abatement in homes. In this study household vacuum cleaners ranging from $70 to $650 and an industrial vacuum cleaner costing more than $1400 were evaluated relative to their collection efficiency immediately after installing new primary dust collectors in them. Using newly developed testing technology, some of the low-cost household vacuum cleaners equipped with a final HEPA filter were found to have initial overall filtration efficiencies comparable to those of industrial vacuum cleaners equipped with a final HEPA filter. The household vacuum cleaners equipped with a final HEPA filter efficiently collect about 100% of the dry dust entrained by the nozzle. For extensive cleaning efforts and for vacuum cleaning of wet surfaces, however, industrial vacuum cleaners may have an advantage, including ruggedness and greater loading capacity. The methods and findings of this study are applicable to field evaluations of vacuum cleaners.

Aerosols↗
PubMed2003

The survival and recovery of bacteria in vacuum cleaner dust.

The possibility exists that environmental dust could be a source of gastro-intestinal infection in the domestic environment and that the causative microbes are collected during vacuum cleaning. This study examines the survival of total bacterial populations, Enterobacteriaceae and salmonella species in vacuum cleaner dust in vitro and in use. Total counts remain constant at around 10(6)-10(8) colony forming units (cfu) g-1 for at least 60 days. Enterobacteriaceae showed only a slight decline over the same period. Recovery of salmonellae artificially inoculated into vacuum dust was dose and time dependent: even relatively small inocula (< 100 cfu g-1) were recoverable more than one month after inoculation. Questionnaires and vacuum cleaner dust samples were received from 76 households. A significant association was found between total bacterial counts and whether the household was in a rural or urban situation and the number of people in the household. No association was found between total bacterial counts and the number of children in the household, the presence of pets, wearing shoes indoors, the makes, model and age of the vacuum cleaner, the type of dust collector or dust bag, how often the vacuum cleaner was used and the length of time between sample collection and microbiological testing. Salmonella species were isolated from vacuum cleaner dust from three of the 76 households although no factors could be identified linking the homes. This study shows that vacuum cleaners are effective collectors and reservoirs of microbial contamination and that these contaminants are able to survive for up to two months. Vacuum cleaner dust could thus be a useful indicator of environmental contamination in the home.

Colony Count, Microbial↗
PubMed2001

Sildenafil versus the vacuum erection device: patient preference.

PURPOSE: We evaluated the preference of patients with erectile dysfunction who had been effectively treated with a vacuum erection device and then switched to sildenafil. MATERIALS AND METHODS: A total of 52 patients with erectile dysfunction who achieved satisfactory erectile function according to the International Index of Erectile Function (IIEF) while using a vacuum erection device were switched to an increasing dose of sildenafil (range 25 to 100 mg.) until satisfactory erection was maintained at least twice a week for at least 1 month. The 2 treatment methods were not used concomitantly. A total of 36 patients with a mean age of 59 years (range 35 to 77) who claimed to have achieved satisfactory erections with a vacuum erection device and sildenafil reported their preference to continue sildenafil or resume the use of a vacuum erection device, reasons for the choice and any adverse side effects. RESULTS: Of the 36 participants in whom the efficacy of sildenafil was similar to that of a vacuum erection device according to the IIEF scores (mean plus or minus standard deviation 61.6 +/- 10.4 and 62.5 +/- 6, respectively), 12 (33.3%) decided to resume use of a vacuum erection device (group 1) while 24 (66.6%) preferred to continue sildenafil (group 2). There were no statistically significant differences between the groups regarding patient age or the etiology and duration of erectile dysfunction. The increase in the IIEF score while using a vacuum erection device was higher in group 1 than 2, with a mean of 66.75 versus 60.4, respectively (p = 0.002). The adverse side effects of sildenafil were the main reasons for preferring a vacuum erection device. Fewer ejaculatory difficulties, efficacy, comfort and ease of use were the main reasons for choosing sildenafil. CONCLUSIONS: Even in an era of effective oral medication, the vacuum erection device remains a preferred treatment option for a substantial number of patients with erectile dysfunction.

Adult↗
PubMed2002

Vacuum cleaning does not sufficiently reduce mite allergens from beddings.

INTRODUCTION: Conflicting results exist with regard to the efficacy of vacuum cleaners on the removal of mite allergens from bedding. OBJECTIVES: The authors prospectively compared a short term efficacy of two types of regular vacuum cleaners (National-N and Hoover-H) with a specialized cleaner (Vorwerk-V) in the removal of mite allergens from mattresses. MATERIAL AND METHOD: Thirty-five dormitory beds with high mite allergen concentrations at the baseline period (month 0) were selected. They were matched into three groups according to group I mite allergen concentrations (N 11 beds, H 12 beds, V 12 beds). Vacuuming was performed on months 1 and 4 by the assigned vacuum cleaner in each group. Immediately after, mattresses were vacuumed by a reference cleaner (another National vacuum cleaner) at both months. Vacuuming was performed over the entire bed for 2 minutes/square meter. Group I mite allergens (sums of Der p 1 and Der f 1) were measured; concentrations and total mite allergens removed by the tested cleaners as well as by the reference cleaner, at various time points, were compared. RESULTS: Ability to remove mite allergens by vacuum cleaners depends on weight of dust removed and also on mite concentrations in the dust samples. Despite the fact that H and V appeared to remove higher mite allergens than N, such differences were not statistically significant (p > 0.05), both at month 1, and 4. Surprisingly, mattress mite concentrations removed by both high capacity cleaner groups (V & H) increased at month 4, whereas, it remained unchanged in the third group (N). This increase led to a concomitant increase in total allergen removed by V and H. Nevertheless, remaining total allergens in the mattresses in V and H, as judged from the amount of allergens obtained by the reference cleaner, increased at month 1 and 4 compared to baseline values (p < 0.05), whereas, no change was observed in N. CONCLUSION: Although high capacity vacuum cleaners removed a large amount of mite allergens from mattresses, they did not sufficiently reduce mattress mite allergen burden as determined by the reference cleaner during this short term study.

Allergens↗
PubMed2000

Vacuum extraction versus forceps for assisted vaginal delivery.

BACKGROUND: Proponents of vacuum delivery argue that it should be chosen first for assisted vaginal delivery, because it is less likely to injure the mother. OBJECTIVES: The objective of this review was to assess the effects of vacuum extraction compared to forceps, on failure to achieve delivery and maternal and neonatal morbidity. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group trials register. Date of last search: February 1999. SELECTION CRITERIA: Acceptably controlled comparisons of vacuum extraction and forceps delivery. DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed trial quality and extracted data. Study authors were contacted for additional information. MAIN RESULTS: Ten trials were included. The trials were of reasonable quality. Use of the vacuum extractor for assisted vaginal delivery when compared to forceps delivery was associated with significantly less maternal trauma (odds ratio 0.41, 95% confidence interval 0.33 to 0.50) and with less general and regional anaesthesia. There were more deliveries with vacuum extraction (odds ratio 1.69, 95% confidence interval 1.31 to 2.19). Fewer caesarean sections were carried out in the vacuum extractor group. However the vacuum extractor was associated with an increase in neonatal cephalhaematomata and retinal haemorrhages. Serious neonatal injury was uncommon with either instrument. REVIEWER'S CONCLUSIONS: Use of the vacuum extractor rather than forceps for assisted delivery appears to reduce maternal morbidity. The reduction in cephalhaematoma and retinal haemorrhages seen with forceps may be a compensatory benefit.

Extraction, Obstetrical↗
PubMedDate not supplied

Guide to the use of the vacuum extractor by nurse-midwives.

The vacuum extractor has become a widely used instrument in many settings. It has proven to be a reliable method of ensuring safe passage of the fetus and/or enhancing maternal effort during the second stage of labor. The principles of vacuum-assisted birth are learned relatively easily and have been incorporated into many nurse-midwifery practices. This article reviews the principles of vacuum extraction as they apply to the practice of nurse-midwifery. Vacuum extractors available to nurse-midwives are compared. Nurse-midwives are familiarized with vacuum extraction so that they can make an informed choice concerning the vacuum extractor as an appropriate tool within their practice. This article is not intended to teach nurse-midwives to use the vacuum extractor. It does, however, provide guidelines for credentialing those nurse-midwives choosing to incorporate the principles of vacuum extraction into their practice.

Clinical Protocols↗
PubMed2005

Clinical outcome after poststernotomy mediastinitis: vacuum-assisted closure versus conventional treatment.

BACKGROUND: The conventional treatment for poststernotomy mediastinitis usually involves surgical revision, closed irrigation, or reconstruction with omentum or pectoral muscle flaps. Recently, vacuum-assisted closure has been successfully used in poststernotomy mediastinitis. The aim of the present study was to compare the clinical outcome and survival in 101 patients undergoing vacuum-assisted closure therapy or conventional treatment for poststernotomy mediastinitis. METHODS: One hundred one consecutive patients underwent treatment for poststernotomy mediastinitis: vacuum-assisted closure therapy (January 1999 through December 2003, n = 61) or conventional treatment (July 1994 through December 1998, n = 40). Follow-up was made in April 2004 and was 100% complete. Actuarial statistics were used to calculate the survival rates. RESULTS: The 90-days mortality was 0% in the vacuum-assisted closure group and 15% in the conventional treatment group (p < 0.01). The failure rate to first-line treatment with vacuum-assisted closure and conventional treatment were 0% and 37.5%, respectively (p < 0.001). There was no statistically significant difference in the recurrence of sternal fistulas after vacuum-assisted closure therapy or conventional treatment: 6.6% versus 5.0%, respectively. Overall survival in the vacuum-assisted closure group was significantly better (p < 0.05) than in the conventional treatment group: 97% versus 84% (6 months), 93% versus 82% (1 year), and 83% versus 59% (5 years). CONCLUSIONS: Our findings support that vacuum-assisted closure therapy is a safe and reliable option in poststernotomy mediastinitis with excellent survival and a very low failure rate compared with conventional treatment.

Aged↗
PubMed1997

A prospective randomized trial of high versus low vacuum drainage after axillary dissection for breast cancer.

BACKGROUND AND METHODS: The influence of negative pressure on fluid production and complication rates after axillary dissection for breast cancer was studied in a prospective randomized trial. Patients were randomized for either a high or a low vacuum drainage system. Drainage volumes and complication rates were recorded. RESULTS: No statistically significant differences were found between the low vacuum group (n = 68) and the high vacuum group (n = 73) in volume (728 ml versus 780 ml) and duration (9.5 days versus 10 days) of seroma production, number of wound complications (5 versus 6), or infections (3 versus 2). There was a significant positive relationship between body mass index and seroma production, independent of the drainage system (P = 0.002). The drainage volume of the separately drained breast wound after mastectomy and lumpectomy was larger for the high vacuum system (55 ml versus 100 ml, P = 0.02). Vacuum loss was more frequent in the high vacuum drain group (11 versus 2, P = 0.01), where as leakage around the drain occurred more often in the low vacuum group (18 versus 6, P = 0.004). CONCLUSION: There are no differences in axillary fluid production or wound complication rates after axillary dissection and subsequent drainage between high and low vacuum drainage systems.

Adult↗
PubMed2005

[Can US-guided vacuum-assisted biopsies be an alternative to diagnostic surgery in cases of non-diagnostic core needle biopsy?].

PURPOSE: To assess US-guided vacuum-assisted biopsies in the diagnosis of suspicious sonographic breast lesions after non-diagnostic core needle biopsies (CNB). PATIENTS AND METHODS: Retrospective study of 42 females with suspicious breast lesions at US. CNB previously performed were non-diagnostic. Because of the larger sample size, vacuum-assisted biopsies were performed, instead of surgical biopsy. RESULTS: Vacuum-assisted biopsies showed 32 benign lesions. Histologic examination of the CNB showed non-specific fibrous tissue in 43% of cases as opposed to 7.1% for vacuum-assisted biopsies. The latter provided a more specific diagnosis (mainly fibrocystic breast disease). From a total of 4 lesions that were suspicious at CNB, 3 were diagnosed as malignancies after vacuum-assisted biopsy and one case was a "borderline" lesion. Three additional malignant and three additional borderline lesions were diagnosed on vacuum-assisted biopsies. In 11 cases, surgical excision was performed, and all diagnoses from vacuum-assisted biopsies were confirmed at microscopy, except in one case where it was underestimated (ADH versus DCIS). CONCLUSION: US-guided vacuum-assisted biopsy is a reliable technique. Because it provides more tissue than CNB, it can be an alternative to diagnostic surgery after non-diagnostic CNB. Indeed, it allows confirmation of the diagnosis and provides a more specific diagnosis of benign lesions. With regards to malignant and borderline lesions, it avoids the risk of false-negative CNB and overlooking carcinomas.

Adult↗
PubMed2002

Milkline vacuum stability in milking machine installations.

Transient vacuum drops in the milkline during one ordinary milking were recorded as a measure of vacuum stability in milking installations on 184 Norwegian dairy farms in the summer of 1997. An association between the frequency of vacuum drops and technical data including milkline diameter, length and slope, number of milking units and effective reserve was demonstrated. The direct connection between the transient vacuum drop and its cause could be established for most drops during milking observations. A high frequency of transient vacuum drops in the milkline was associated with a high level of mastitis and a high new infection rate as inferred from changes in somatic cell counts for individual cows. The frequency of vacuum drops during one milking is only a rough indication of the long-term vacuum stability in a specific installation, and must be interpreted with care. The dimensions and slope of the milkline and the effective reserve probably give as good information about the installation's ability to maintain a stable vacuum.

Animals↗
PubMed2003

Factors affecting mouthpiece chamber vacuum in machine milking.

The vacuum in the mouthpiece chamber (MPC) was measured in a factorial trial with two liners (DeLaval 964008-01 and DeLaval 999007-03), two pulsator ratios (60 and 70%) and morning and evening milking over eight milkings of ten cows. Teat length and diameter were measured before and after milking, and maximum milk flow rate and depth of penetration of the teat into the teatcup were also recorded. The MPC vacuum at peak flow rate was classified as stable, at various levels, in 79% of the recordings. In the rest of the milkings the vacuum declined gradually, and this decline was associated with gradually deeper penetration of the teat into the teatcup. The DeLaval 964008-01 liner with the narrower bore and larger mouthpiece opening gave lower MPC vacuum at peak flow rate than did the wider bore DeLaval 999007-03 with the smaller mouthpiece opening. Morning milking gave higher MPC vacuum than evening milking. Increased maximum milk flow rate and increased length and diameter of the teat gave decreased MPC vacuum. The teats were longer before milking in the morning than in the evening. However, during peak flow rate, the teats had penetrated deeper into the teatcup in the evening than in the morning. A marked change in MPC vacuum in the transition to the period of flow rate can be used to identify the start of over-milking of an individual teat. A general model explaining the MPC vacuum as the outcome of the balance between air leakage past the mouthpiece lip and the leakage past the teat in the liner barrel is suggested.

Animals↗
PubMed2004

Herpes simplex virus infection after vacuum-assisted vaginally delivered infants of asymptomatic mothers.

OBJECTIVE: To determine whether vacuum extraction technique is associated with an increased risk of herpes simplex virus (HSV) infection in infants born to asymptomatic mothers. PATIENTS AND METHODS: We reviewed the charts of all infants born at the Edith Wolfson Medical Center and admitted to the hospital's neonatal intensive care unit from January 1999 to June 2002 diagnosed with HSV infection. RESULTS: During the study period, 6953 infants were delivered at our institution and 11 infants had HSV infection. The prevalence of neonatal HSV infection was 1.6 per 1000 live births. In 699 infants, vacuum extraction was used for delivery. Five out of the 11 infants delivered vaginally by vacuum extraction developed HSV infection at the site of the vacuum extractor application. They were born to mothers who were asymptomatic at delivery and had no history of HSV genital infection. HSV type 2 was isolated from the vesicular fluid in all infected infants delivered by vacuum extraction, and none had central nervous system involvement. The prevalence of neonatal HSV infection in vacuum-assisted births was seven per 1000 live births as compared to 0.95 in 1000 in infants delivered vaginally or by cesarean section (p<0.0001). The relative risk of HSV infection in infants born in vacuum-assisted births was 7.45 (95% confidence interval (CI) 1.99 to 27.42, p=0.001). All patients were treated with intravenous acyclovir and no recurrences of HSV infection have been noticed at follow-up. CONCLUSIONS: Laceration of the fetal scalp by vacuum extraction technique may enhance the acquisition and the early appearance of cutaneous infection in infants exposed to HSV shedding in the genital tract of asymptomatic mothers, as the virus gains access through the lacerated scalp.

Female↗
PubMedDate not supplied

[A new vacuum extraction system with a ball joint and detachment warning--in vitro studies and clinical use].

BACKGROUND: The vacuum extractor is used in about 5% of deliveries. It is associated with a lower maternal morbidity than is forceps extraction. On the other hand, cephalhematomas, hyperbilirubinemia and cerebral hemorrhages in the baby are observed more frequently. The sudden detachment of the vacuum extractor with appreciable fluctuations in intracranial pressure in the baby is especially dangerous. In order to improve the conventional Malmström system, we have developed a new vacuum extractor and investigated its handling in vitro and in clinical application. PATIENTS AND METHODS: The essential constructional principle of the new vacuum extractor consists in a pivot lowered by ball bearings and a volume reduction of one third. Moreover, in two-chamber vacuum it is possible to give a warning of sudden detachment. The possible tractional force in kiloponds was determined at various angles (0 degree, 15 degrees, 30 degrees und 45 degrees) comparing the Malmström extractor with the new one and two-chamber system in a standardized apparatus. In addition, the new vacuum extractor was also used clinically in 43 women; besides the obstetric parameters, the handling was also appraised. RESULTS: In the in-vitro experiments, a distinct decrease of the possible tractional force with increasing angles was shown for the Malmström extractor (0 degree--15.7 kp, 15 degrees--12.7 kp, 30 degrees--8.6 kp, 45 degrees--7.3 kp). The values for the new one-chamber system were significantly greater from a tractional angle of 15 degrees (0 degree--15.6 kp, 15 degrees--14.4 kp, 30 degrees--14.0 kp, 45 degrees--13.8). The clinical application of the new vacuum system was unproblematic and confirmed the feasibility of good traction. A very much smaller caput succedaneum was found in the baby. Especially in the training situation, the warning system enables a good surveillance before sudden detachment, but reduces the possible tractional force. CONCLUSIONS: The new vacuum system appears to enable the vaginal surgical delivery to be improved compared to the conventional Malmström extractor. After these promising approaches, a multicenter study was commenced in order to enable better evaluation of their clinical significance.

Equipment Design↗
PubMed1994

[Dual chamber safety vacuum--initial experiences with a new suction cup].

The main problem with vacuum extraction methods, alongside the cephalhaematoma produced, is the premature separation of the suction cup under traction, since the resulting sudden change in pressure can lead to severe intra-cerebral damage to the child. To reduce the risk of vaginal operative delivery, a new double-chamber safety vacuum extractor has been developed by Hepp/King. The basic feature of this instrument is an additional chamber with a thin overlapping area, which surrounds the actual suction cup and serves as a safety vacuum. If the suction cup starts to slip, the external vacuum is released and sounds an alarm. In addition, the inner vacuum has been designed to be convex and to reduce the volume of scalp, which is sucked into the vacuum, thus reducing the size of the cephalhaematoma produced. First experiences in clinical use demonstrated the reliability of the early warning signal, if the direction of traction is false or the applied traction is too strong. The inner vacuum remains constant at 0.8 atu, so that with care, the extraction can continue without interruption. We have used the new instrument in 18 deliveries. In 15 cases, the indication was failure to progress into the second stage of labour; in one case history of retinal detachment and in two cases signs of foetal asphyxia. In all cases, the child was delivered following one or two contractions with traction, without losing the vacuum. The average weight of the newborn was 3566 g. As expected, the cephalohaematoma produced was very much smaller than usual. Further clinical trials are necessary before the value of this new instrument can be assessed.

Asphyxia Neonatorum↗
PubMed2001

The clinical significance of vacuum mixing bone cement.

This controlled study compared the strength and porosity of 48 polymethylmethacrylate cement-implant constructs prepared with open bowl versus vacuum mix technique. Forty-eight blast finished stainless steel rods of 13 mm diameter were implanted with centralizers into 17-mm inner diameter tubes that had been retrograde filled with polymethylmethacrylate cement. The eight cement preparations used were open bowl and vacuum mixed Simplex, Osteobond, Zimmer Dough Type, or Palacos R. Six replications of each condition were performed. The tubes were maintained at 37 degrees C. Each tube was cut transversely into five segments. The center three segments were used for data analysis: pushout strength, cycles to failure, and interface porosity analysis. Rod pushout data showed there was no significant difference between open bowl and vacuum mixed samples when all cement brands were combined. Mean sheer force for Palacos R vacuum mixed samples was greater than open bowl (634+/-47 versus 423+/-171), whereas the force for the Zimmer Dough Type cement open bowl was greater than that of the vacuum mixed samples (901+/-71 versus 705 +/-82). Cycles to failure data did not show significant differences when open bowl and vacuum mixed samples were compared when cements were analyzed individually or combined. Image analysis of cement-implant interfaces showed that vacuum mixing reduced void area significantly compared with open bowl mixing in the Palacos R and Osteobond preparations. Vacuum mixing does not appear to reduce cement prosthesis interface porosity or improve its mechanical properties in all cements.

Analysis of Variance↗
PubMed2004

Immediate maternal and neonatal effects of forceps and vacuum-assisted deliveries.

OBJECTIVE: To estimate the differences in immediate maternal and neonatal effects of forceps and vacuum-assisted deliveries. METHODS: We conducted a medical record review of all forceps and vacuum-assisted deliveries that occurred from January 1, 1998, to August 30, 1999, at Winthrop-University Hospital. Maternal demographics and delivery characteristics were recorded. Maternal outcomes, such as use of episiotomy and presence of lacerations, were studied. Neonatal outcomes evaluated were Apgar scores, neonatal intensive care unit admissions, cephalohematomas, instrument marks and bruising, and caput and molding. RESULTS: Of 508 operative vaginal deliveries, 200 were forceps and 308 were vacuum assisted. Forceps were used more often than vacuum for prolonged second stage of labor (P =.001). There was a higher rate of epidural (P =.02) and pudendal (P <.001) anesthesia, episiotomies (P =.01), maternal third- and fourth-degree perineal (P <.001) and vaginal lacerations (P =.004) with the use of forceps, whereas periurethral lacerations were more common in vacuum-assisted (P =.026) deliveries. More instrument marks and bruising (P <.001) were found in the neonates delivered by forceps, whereas there was a greater incidence of cephalohematomas (P =.03) and caput and molding (P <.001) in the neonates delivered with vacuum. Multivariable logistic regression analysis showed that forceps use was associated with an increase in major perineal and vaginal tears (odds ratio [OR] 1.85; 95% confidence interval [CI] 1.27, 2.69; P =.001), an increase in instrument marks and bruising (OR 4.63; 95% CI 2.90, 7.41; P <.001) and a decrease in cephalohematomas (OR 0.49; 95% CI 0.29, 0.83; P =.007) compared with the vacuum. CONCLUSIONS: Maternal injuries are more common with the use of forceps. Neonates delivered with forceps have more facial injuries, whereas neonates delivered with vacuum have more cephalohematomas. LEVEL OF EVIDENCE: II-3

Adult↗
PubMed2006

The clinical efficacy and cost effectiveness of the vacuum-assisted closure technique in the management of acute and chronic wounds: a randomized controlled trial.

BACKGROUND: Vacuum-assisted closure therapy is a relatively new concept described in the literature that increases wound-healing capacity. The authors aimed to investigate the effect of vacuum-assisted closure therapy on wound healing, granulation tissue formation, bacterial clearance, pain, time involvement of the staff, and total costs in all types of wounds in comparison with modern wound dressings. METHODS: Sixty-five patients with a chronic or acute wound were randomized to initial treatment with vacuum-assisted closure or modern dressings. The authors' primary endpoint was a granulated wound or a wound ready for skin grafting or healing by secondary intention. RESULTS: The time to the primary endpoint with vacuum-assisted closure therapy was not significantly shorter, except for patients with cardiovascular disease and/or diabetics. Vacuum-assisted closure therapy did not result in significantly faster granulation or wound surface reduction or better bacterial clearance, but patient comfort was an important advantage. Time involvement and costs of nursing staff were significantly lower for the vacuum-assisted closure therapy, but overall costs were similar for both groups. CONCLUSIONS: With vacuum-assisted closure therapy, wound healing is at least as fast as with modern wound dressings. Especially cardiovascular and diabetic patients benefit from this therapy. The total costs of vacuum-assisted closure are comparable to those of modern wound dressings, but the advantage is its comfort for patients and nursing staff.

Acute Disease↗