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VAC therapy in Dubai: how we use it to close wounds, not just cover them
Quick answer: VAC (vacuum-assisted closure) therapy applies gentle suction to a wound through a sealed foam dressing. On its own, it keeps the wound clean and stimulates healing tissue. We use it as part of a closure plan: timing each change to draw the edges together, reducing the foam size step by step and adding internal sutures, so the surrounding skin closes the wound.
VAC therapy is one of the most useful tools in wound care, but how it is used matters more than the machine itself. Here I explain what VAC does, why applying it alone is not enough, and how my team uses it to bring wounds to closure, including wounds over bone and deep cavities.
| Other names | Negative pressure wound therapy (NPWT), vacuum dressing |
|---|---|
| What it does | Removes fluid, reduces swelling, stimulates new tissue (granulation) |
| What we add | Timed changes, smaller foam each time, internal approximating sutures |
| How often it is changed | Every 48 hours to 5 days, depending on fluid and signs of infection |
| Bony areas | Small drill holes in exposed bone to bring up bone-marrow stem cells (legs, arms, sacral region) |
| Deep cavities | Curettage and gradually reduced packing so tissue fills from the base |
| Final step | Closure with surrounding skin, or a skin graft when needed, then further VAC |
| Used for | Wounds that open, infected or slow wounds, cavities after surgery done in Dubai or abroad |
Why is VAC therapy alone not enough?
A VAC dressing helps a wound stay clean and build healthy tissue. But simply applying it and changing it on a fixed schedule does not, by itself, make a wound close fast. The wound still has to fill and the edges still have to meet.
What shortens healing is how the VAC is used. I treat each dressing change as a step towards closure, not just a clean-up.
How do we use VAC to close a wound?
- Timing the changes. Each change is timed so the wound edges can be drawn closer together while the tissues are ready to move.
- Reducing the foam step by step. At each change, the foam is cut a little smaller than the wound. The suction then pulls the edges inwards over the smaller foam.
- Internal approximating sutures. Stitches placed under the skin bring the deeper layers and edges together. This lets the elasticity of the surrounding skin take up the gap gradually, the same "skin creep" principle used in tissue expansion.
- Closing at the right time. Once the wound is small and clean, it is closed with the surrounding skin. When that is not possible, a skin graft is used, often followed by a further period of VAC to help it take.
You can see this approach in our case of large arm and thigh wounds after necrotising fasciitis, closed without skin grafts after only 2 days in hospital. The case was also reported by Gulf News.
How are wounds over bone treated?
When bone is exposed at the base of a wound, new tissue struggles to grow over it. In these areas I prefer to drill small holes in the outer surface of the bone. This brings bone-marrow cells, including stem cells, to the surface, and they help form a healthy bed of tissue that can then be covered. I use this most often for wounds on the legs, arms and sacral region (lower back).
How are deep wound cavities treated?
For a deep cavity, I first clean the walls by curettage to remove unhealthy tissue. Then the packing or foam is reduced gradually, so that granulation tissue builds up from the base and forms a scaffold. As the cavity becomes shallower, the edges are brought together and the wound is closed.
What is a VAC dressing change like?
Most changes are done in the clinic or at the bedside. The dressing is removed, the wound is checked and cleaned, and new foam is shaped and sealed. Larger or more uncomfortable changes may be done with local anaesthetic or sedation. Changes are made every 48 hours to 5 days, depending on how much fluid the wound produces and whether there are signs of infection or general illness.
VAC therapy: frequently asked questions
Does VAC therapy make wounds heal faster?
It helps, but not on its own. VAC keeps a wound clean and builds new tissue. Healing becomes faster when the changes are planned to bring the edges together, with smaller foam and internal sutures at each stage.
How often is a VAC dressing changed?
Usually every 48 hours to 5 days. The interval depends on how much fluid the wound produces and whether there are signs of infection or general illness.
Is VAC therapy painful?
Most patients feel a pulling sensation when the suction starts, which settles quickly. Dressing changes can be uncomfortable, and pain relief or local anaesthetic is used when needed.
Can I go home with a VAC?
Often yes. Portable VAC units allow many patients to go home or back to work between changes. In our case of large arm and thigh wounds, the patient spent only 2 days in hospital.
Will I need a skin graft?
Not always. Our first aim is to close the wound with the surrounding skin. A graft is used only when the gap cannot be closed that way, and further VAC can help it take.
Can you treat a wound from surgery done abroad?
Yes. Bring your operation notes and medication list, or send us a photo first and our team will advise on the next step.
Send a photo and a short description and our team will advise on the next step.
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Related pages
- Wound opening after tummy tuck
- Wound opening after arm or thigh lift
- Post-surgical wound care: common mistakes
- Wound problems after surgery abroad: what to do back home
This article gives general information and does not replace medical advice. Treatment decisions are made only after an in-person examination. In an emergency, go to the nearest emergency department.