We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Clinical Note |

Vacuum-Assisted Closure in Revision Free Flap Reconstruction

Kiran Kakarala, MD; Jeremy D. Richmon, MD; Derrick T. Lin, MD; Daniel G. Deschler, MD
Arch Otolaryngol Head Neck Surg. 2011;137(6):622-624. doi:10.1001/archoto.2011.74.
Text Size: A A A
Published online


Since their introduction in 1997, vacuum-assisted closure (VAC) dressings have found widespread use in the treatment of complicated surgical and traumatic wounds.1 The VAC system consists of a porous foam and overlying occlusive dressing to which subatmospheric pressure is applied. The VAC dressing has many beneficial effects on wound healing, including increased tissue perfusion, decreased wound edema and bacterial counts, and microdebridement of nonviable tissue. Healthy vascularized granulation tissue forms in the wound bed, allowing for more rapid healing than with conventional dressings.1,2

Figures in this Article

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview


Place holder to copy figure label and caption
Figure 1.

Case 1. A, Postoperative day 10 following vacuum-assisted closure (VAC) dressing removal revealing healthy granulation tissue. B, Split-thickness skin graft applied over granulation tissue. C, VAC dressing applied as bolster over split-thickness skin graft. D, Postoperative day 23.

Graphic Jump Location
Place holder to copy figure label and caption
Figure 2.

Case 2. A, Composite oromandibular defect. B, Cutaneous defect following fibular free flap reconstruction with exposed free flap muscle (arrow). C, Postoperative day 1: vacuum-assisted closure dressing applied to cutaneous defect directly over free flap muscle. D, Postoperative day 22: defect epithelialized with small remaining area of healthy granulation tissue (arrow).

Graphic Jump Location




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

2 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles