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Aims and objectives 1. To study effectiveness of lower limb problems like: lower limb injuries, difficult to heal wounds like amputation stumps, necrotizing fasciitis, diabetic foot, burns wounds and deep electrical burns wounds, cellulitis and extensively oozing wounds. 2. Improvement in take of graft or flap. 3. Reduction of infection and surface bacterial count in wounds reducing morbidity and mortality and making treatment cost effective, also. 4. Salvaging lower limbs. Methods: Standard method of VAC application is used in our study with step wise manner. Wound debridement, hemostasis done, VAC applied by standard method. Negative pressure around 125 to 150 kept in our study. Out of 100 cases, 50 cases are lower limb injuries due to trauma, accident, amputation stumps, 40% cases are due to necrotising fasciitis and cellulitis, septicaemia. 10% cases are due to bedsore and its infection management. Lower limb wounds with exposed tendons or bones, orthopaedic implants exposed,-are well managed with VAC. Standard method of VAC application is followed in each case. Result: Out of 100 cases of lower limb problems with difficult to heal wounds, amputation stumps treated, we found infection is effectively reduced, wound discharge is reduced, wounds granulated well and early, and wound bed prepared early for skin graft take or flap take. Conclusion: Vacuum assisted closure (VAC) is very good modality of treatment, which assists plastic surgeons in healing wounds specially in difficult to treat lower limb wounds.

Role of vacuum assisted closure (VAC) in treatment of difficult to heal wounds in lower extremity- our experience in 100 cases