# Reverse aqua pump vacuum-assisted closure alternative and affordable solution for emerging cost in wound therapy: A case series

## TL;DR

A low-cost reverse aqua pump vacuum-assisted closure system (RAP-VAC) effectively promotes wound healing and reduces treatment costs in a developing country setting.

## Contribution

The novel RAP-VAC device reverses fan direction for improved suction, offering a cost-effective alternative to traditional vacuum-assisted closure systems.

## Key findings

- Average wound size decreased by 9.8% over the treatment period.
- The mean granulation rate was 92.13%, indicating effective wound bed preparation.
- Treatment costs averaged IDR 2,376,923 per patient, demonstrating cost-efficiency.

## Abstract

Soft tissue defects managed with conventional wound therapies are often inadequate. Vacuum-Assisted Closure (VAC) has proven to be an effective method for discharge removal, edema reduction, perfusion enhancement, and granulation tissue stimulation. This study assesses the novel Reverse Aqua Pump Vacuum-Assisted Closure (RAP-VAC), a low-cost innovation option in a developing country, designed to facilitate successful wound healing while mitigating financial limitations.

This case series was reported at a tertiary referral hospital in Indonesia, involving 13 patients with soft tissue defects utilizing RAP-VAC. The average wound size diminished by 9.8 %, from 50.19 ± 36.96 cm2 on day 0 to 45.25 ± 36.43 cm2 at the endpoint measurement. The mean granulation rate was 92.13 %, and the average wound bed preparation duration was 20.92 ± 2.69 days. The whole expenditure for care expenses to IDR 2,376,923 per patient. The linear mixed model analysis significantly associated with intercept estimate of 50.19 (p = 0.001) with 0.32 reduction per day in the outcome (p = 0.010).

NPWT accelerates wound shrinkage, resulting from the consistent negative pressure. The mechanical motion facilitates cell migration, hence expediting wound closure. The cost-effectiveness of NPWT has been established, diminishing the necessity for expensive therapies. A study reported using an aqua pump-based VAC, but without detailing the mechanism. In contrast, our device reverses the fan direction for improved suction. We employed the IMITO app measurement for objective evaluation. The RAP-VAC system, characterized by low costs, may provide substantial financial benefits while maintaining therapeutic outcomes in developing countries, as a viable choice for wound management in both hospital and community care environments.

The findings indicate that RAP-VAC is efficacious in facilitating wound healing and serves as a cost-effective alternative to expensive VAC systems.

•Innovative reverse aqua pump mechanism reported in case series of reliable outcome of a modification from the traditional VAC system using a reverse aqua pump, offering a cost-effective and efficient alternative for wound management in developing country.•Effective reduction in wound size clinical results demonstrate significant reduction in wound size, validating the reverse aqua pump as a practical innovation for promoting wound contraction and closure.•The reverse aqua pump mechanism facilitated robust granulation tissue formation, indicating its capacity to stimulate a favorable wound healing environment comparable to conventional VAC system.•Cost-efficiency without compromising outcomes by utilizing simplified technology, this approach markedly reduces treatment costs while maintaining effectiveness, making it accessible for broader clinical application.•This case series provides real-world evidence supporting the reverse aqua pump VAC as a sustainable solution for managing complex wounds, particularly in healthcare systems with limited infrastructure or funding.

Innovative reverse aqua pump mechanism reported in case series of reliable outcome of a modification from the traditional VAC system using a reverse aqua pump, offering a cost-effective and efficient alternative for wound management in developing country.

Effective reduction in wound size clinical results demonstrate significant reduction in wound size, validating the reverse aqua pump as a practical innovation for promoting wound contraction and closure.

The reverse aqua pump mechanism facilitated robust granulation tissue formation, indicating its capacity to stimulate a favorable wound healing environment comparable to conventional VAC system.

Cost-efficiency without compromising outcomes by utilizing simplified technology, this approach markedly reduces treatment costs while maintaining effectiveness, making it accessible for broader clinical application.

This case series provides real-world evidence supporting the reverse aqua pump VAC as a sustainable solution for managing complex wounds, particularly in healthcare systems with limited infrastructure or funding.