RT Journal Article
SR Electronic
T1 Vacuum-assisted closure (VAC) for craniocerebral wounds in severely injured patients: technical note of a damage control procedure
JF Journal of the Royal Army Medical Corps
JO J R Army Med Corps
FD British Medical Journal Publishing Group
SP e1
OP e1
DO 10.1136/jramc-2019-001201
VO 165
IS 6
A1 Christophe Joubert
A1 A Sellier
A1 J-B Morvan
A1 N Beucler
A1 J Bordes
A1 A Dagain
YR 2019
UL http://militaryhealth.bmj.com/content/165/6/e1.abstract
AB The management of a craniocerebral wound (CCW) remains challenging, particularly in a severely injured patient. Considering the complexity of the multilayer insult and damage control care in an unstable patient, every procedure performed should promptly benefit the patient. We report an illustrative case of a patient with a gunshot wound to the head that resulted in a CCW for which we applied vacuum-assisted closure (VAC) therapy according to damage control principles. We describe the technical approach and discuss the indications, results and technique by considering the literature available. VAC can be used for CCWs, particularly for large defects in selected patients according to clinical and CT evaluations following immediate resuscitation. In severely injured and unstable patients, VAC aims to delay definitive reconstructive and time-consuming treatment. Interestingly, it appears to be a safe treatment based on the previously described—but not exclusively trauma—cases with no secondary cerebrospinal fluid leakage encountered.