Successful Treatment of Stage 4 Sacral Pressure Ulcers using Vacuum-assisted Closure Therapy
Main Article Content
Abstract
Abstract
Pressure ulcers are a significant health issue, particularly among the elderly and immobile individuals, resulting in considerable human suffering and financial costs. They pose a clinical challenge for both healthcare providers and patients, as they can be difficult to heal, expensive to treat, with a significant negative impact on quality of life. Therefore, prevention is crucial.
Here, we report the successful treatment of a 75-year-old male patient presenting with persistent sacral pressure ulcer infection with Vacuum-Assisted Closure (VAC) therapy. This patient had a history of bedridden dementia and a previous cerebral infarction, which predisposed him to persistent deep-pressure ulcers. With effective management, he experienced clinical improvement, highlighting the importance of using VAC therapy in challenging cases.
Downloads
Article Details
Copyright (c) 2025 Oskay T.

This work is licensed under a Creative Commons Attribution 4.0 International License.
Mervis JS, Phillips TJ. Pressure ulcers: Pathophysiology, epidemiology, risk factors, and presentation. J Am Acad Dermatol. 2019;81:881-890. Available from: https://doi.org/10.1016/j.jaad.2018.12.069
Gould LJ, Alderden J, Aslam R, Barbul A, Bogie KM, El Masry M, et al. WHS guidelines for the treatment of pressure ulcers-2023. Wound Repair Regen. 2024;32:6-33. Available from: https://doi.org/10.1111/wrr.13130
Whitney J, Phillips L, Aslam R, Barbul A, Gottrup F, Gould L, et al. Guidelines for the treatment of pressure ulcers. Wound Repair Regen. 2006;14:663-79. Available from: https://doi.org/10.1111/j.1524-475x.2006.00175.x
Jaul E. Assessment and management of pressure ulcers in the elderly: current strategies. Drugs Aging. 2010;27:311-25. Available from: https://doi.org/10.2165/11318340-000000000-00000
Agarwal P, Kukrele R, Sharma D. Vacuum assisted closure (VAC)/negative pressure wound therapy (NPWT) for difficult wounds: A review. J Clin Orthop Trauma. 2019;10:845-848. Available from: https://doi.org/10.1016/j.jcot.2019.06.015
Li W, Zheng J. Negative Pressure Wound Therapy for Chronic Wounds. Ann Plast Surg. 2024;93:19-26. Available from: https://doi.org/10.1097/sap.0000000000003891
Kim PJ, Attinger CE, Constantine T, Crist BD, Faust E, Hirche CR, et al. Negative pressure wound therapy with instillation: International consensus guidelines update. Int Wound J. 2020;17:174-86. Available from: https://doi.org/10.1111/iwj.13254
Normandin S, Safran T, Winocour S, Chu CK, Vorstenbosch J, Murphy AM, et al. Negative Pressure Wound Therapy: Mechanism of Action and Clinical Applications. Semin Plast Surg. 2021;35:164-170. Available from: https://doi.org/10.1055/s-0041-1731792
Argenta LC, Morykwas MJ. Vacuum-assisted closure: a new method for wound control and treatment: clinical experience. Ann Plast Surg. 1997;38:563-76. Available from: https://pubmed.ncbi.nlm.nih.gov/9188971/
Gupta S, Baharestani M, Baranoski S, de Leon J, Engel SJ, Mendez-Eastman S, et al. Guidelines for managing pressure ulcers with negative pressure wound therapy. Adv Skin Wound Care. 2004;17:1–16. Available from: https://doi.org/10.1097/00129334-200411002-00001
Gupta S, Gabriel A, Lantis J, Téot L. Clinical recommendations and practical guide for negative pressure wound therapy with instillation. Int Wound J. 2016;13:159-74. Available from: https://doi.org/10.1111/iwj.12452
Gupta S, Ichioka S. Optimal use of negative pressure wound therapy in treating pressure ulcers. Int Wound J. 2012;9:8–16. Available from: https://doi.org/10.1111/j.1742-481x.2012.01012.x
Arowojolu OA, Wirth GA. Sacral and Ischial Pressure Ulcer Management With Negative-Pressure Wound Therapy With Instillation and Dwell. Plast Reconstr Surg. 2021;147:61S-67S. Available from: https://doi.org/10.1097/prs.0000000000007613
Shrateh ON, Jobran AWM, Adwan R, Al-Maslamani Z, Tarifi A. Successful management of extensive stage four sacral pressure ulcer in a paraplegic patient: A case report. Int J Surg Case Rep. 2023;105:107990. Available from: https://doi.org/10.1016/j.ijscr.2023.107990
Batra RK, Aseeja V. VAC Therapy in Large Infected Sacral Pressure Ulcer Grade IV-Can Be an Alternative to Flap Reconstruction? Indian J Surg. 2014;76:162-4. Available from: https://doi.org/10.1007/s12262-012-0770-7
Ploumis A, Mpourazanis G, Martzivanou C, Mpourazanis P, Theodorou A. The Role of Vacuum Assisted Closure in Patients with Pressure Ulcer and Spinal Cord Injury: A Systematic Review. World J Plast Surg. 2019;8:279-284. Available from: https://doi.org/10.29252/wjps.8.3.279
de Laat EH, van den Boogaard MH, Spauwen PH, van Kuppevelt DH, van Goor H, et al. Faster wound healing with topical negative pressure therapy in difficult-to-heal wounds: a prospective randomized controlled trial. Ann Plast Surg. 2011;67:626-31. Available from: https://doi.org/10.1097/sap.0b013e31820b3ac1
Schwien T, Gilbert J, Lang C. Pressure ulcer prevalence and the role of negative pressure wound therapy in home health quality outcomes. Ostomy Wound Manage. 2005;51:47–60. Available from: https://pubmed.ncbi.nlm.nih.gov/16230764/
Suissa D, Danino A, Nikolis A. Negative-pressure therapy versus standard wound care: a meta-analysis of randomized trials. Plast Reconstr Surg. 2011;128:498-503. Available from: https://doi.org/10.1097/prs.0b013e31822b675c
Baynham SA, Kohlman P, Katner HP. Treating stage IV pressure ulcers with negative pressure therapy: a case report. Ostomy Wound Manage. 1999;45:28–32. Available from: https://pubmed.ncbi.nlm.nih.gov/10347508/
Ford CN, Reinhard ER, Yeh D, Syrek D, De Las Morenas A, Bergman SB, et al. Interim analysis of a prospective, randomized trial of vacuum-assisted closure versus the healthpoint system in the management of pressure ulcers. Ann Plast Surg. 2002;49:55-61. Available from: https://doi.org/10.1097/00000637-200207000-00009
Latouche V, Devillers H. Benefits of negative pressure wound therapy with instillation in the treatment of hard-to-heal wounds: a case series. J Wound Care. 2020;29:248-253. Available from: https://doi.org/10.12968/jowc.2020.29.4.248
Papp AA. Incisional negative pressure therapy reduces complications and costs in pressure ulcer reconstruction. Int Wound J. 2019;16:394-400. Available from: https://doi.org/10.1111/iwj.13045