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6Wound management

When the traumatic wound is too large for closure or exposed bone remains, a VAC may be applied.

Vacuum assisted closure (VAC)

Negative pressure wound dressings (“VACs”) can provide helpful temporary coverage of an open wound. They reduce external wound contamination, remove edema fluid, help to shrink wounds, and promote growth of granulation tissue, even over exposed bone. Such dressings may allow definitive closure by the subsequent use of split thickness skin grafts, instead of more complex flaps. In this manner, a VAC can be used as a bridge to definitive soft-tissue coverage for type IIIA and IIIB wounds. They should be changed every 48-72 hours.