Combined Approach to Severe Fournier’s Gangrene with Negative Pressure Wound Therapy, Dermal Regeneration, and Split-Thickness Skin Graft

2018 ◽  
pp. 309-314
Author(s):  
Tommaso Agostini ◽  
Raffaella Perello ◽  
Paolo Boffano
Keyword(s):  
Skin Graft ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Fournier’S Gangrene ◽  
Split Thickness Skin Graft ◽  
Combined Approach ◽  
Fournier's Gangrene ◽  
Wound Therapy ◽  
Thickness Skin ◽  
Dermal Regeneration

scholarly journals Efficacy Of Gauze-based Negative Pressure Wound Therapy After Split-thickness Skin Graft In The Care Of Large Wounds

2018 ◽  
Vol 08 (02) ◽  
pp. 82-86
Author(s):  
Irfan Ilahi ◽  
M. Uzair Ilyas Tahir Kheli ◽  
Ehtesham- ulHaq
Keyword(s):  
Skin Graft ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Cost Effective ◽  
Military Hospital ◽  
Split Thickness Skin Graft ◽  
Wound Therapy ◽  
Thickness Skin ◽  
User Friendly ◽  
Over The Top

Background: Negative-pressure wound therapy (NPWT) or vacuum dressings involve the application of a controlled negative pressure on the wound. Traditionally, STSGs were fixed with bolster technique, where sutures are used to fix pressure dressings over the top of recently placed grafts. Taking it a step further in our study we applied an effective and user friendly filler material (surgical roll gauze) on very large defects. The objective of this study was to assess the clinical efficacy of gauze-based negative pressure wound therapy as an adjunctive therapy to STSG, over complex and very large wounds. Material & Methods: This descriptive study was conducted at Army Burn Center, Combined Military Hospital Kharian and PNS Shifa Hospital Karachi from January 2016 to June 2017. Gauze based VAC system used. Negative pressure was applied at -80 mm Hg. Evaluation was carried out to assess the performance of gauze-based NPWT. Results: Total of 63 patients, 42 males and 21 females, with mean age of 32 years SD+15 were included in the study. The wound size included in the study ranged from 12x10 cm to 88x66 cm. Mean duration of NPWT dressings was 15 days and 313 dressings were employed in total with satisfactory healing achieved in 3 to 4 VAC dressings in most of the cases. Mean duration of hospital stay was 23.92 days at which point graft uptake percentage was in the range of 90% (n=7) to 100% (n=20). Only 3.2% (n=2) cases required partial re-grafting for complete coverage of residual wounds. Conclusion: Gauze-based Negative-pressure wound therapy over split thickness skin graft is a cost-effective addition to the care and management of large and complex wounds

Antimicrobial-Impregnated Dressing Combined with Negative-Pressure Wound Therapy Increases Split-Thickness Skin Graft Engraftment

2015 ◽  
Vol 28 (1) ◽  
pp. 21-27 ◽  
Author(s):  
Cheng-Chun Wu ◽  
Khong-Yik Chew ◽  
Chien-Chang Chen ◽  
Yur-Ren Kuo
Keyword(s):  
Skin Graft ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Split Thickness Skin Graft ◽  
Wound Therapy ◽  
Thickness Skin

scholarly journals Miniaturized Negative-Pressure Wound Therapy for Split-Thickness Skin Graft Donor Sites

2018 ◽  
Vol 03 (02) ◽  
pp. e46-e49
Author(s):  
Stuart Mitchell ◽  
Edward Ray ◽  
Peter Cordeiro
Keyword(s):  
Skin Graft ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Donor Site ◽  
Cost Benefit ◽  
Split Thickness Skin Graft ◽  
Potential Cost ◽  
Wound Therapy ◽  
Skilled Nursing ◽  
Thickness Skin

Background Multiple therapeutic options exist for the treatment of split-thickness skin graft (STSG) donor sites, but there is no clear consensus among surgeons about the best option. Negative-pressure wound therapy (NPWT) has rapidly gained in popularity since its invention. Recently, several miniaturized, single-patient NPWT (SP-NPWT) devices have become available. Compared with traditional NPWT devices, SP-NPWT devices are associated with equal wound healing capability and reliability, but offer several advantages. We present a series of 10 consecutive patients whose STSG donor sites were treated with a commercially available SP-NPWT device. Methods We performed a retrospective review for 10 consecutive patients who underwent STSG procedures and were treated with SP-NPWT devices. Results From 2015 to 2017, 10 consecutive patients underwent oncologic reconstruction using STSG and had their donor sites treated with SP-NPWT devices. The SP-NPWT dressing had been left in place for 2 weeks after surgery. The average donor site area measured 80 cm2 (range: 76–106 cm2). In all 10 patients, the donor sites healed uneventfully and with no complications. Conclusion Off-the-shelf, miniaturized, SP-NPWT systems appear to be at least as effective as traditional dressings for STSG donor sites and require no maintenance (skilled nursing or dressing changes). Compared with larger and less portable standard NPWT devices, SP-NPWT dressing systems provide a potential cost benefit as well as enhanced convenience and portability.

scholarly journals Split Thickness Skin Graft of the Foot and Ankle Bolstered With Negative Pressure Wound Therapy in a Diabetic Population: The Results of a Retrospective Review and Review of the Literature

2019 ◽  
Vol 13 (5) ◽  
pp. 383-391
Author(s):  
Efthymios Gkotsoulias
Keyword(s):  
Skin Graft ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Split Thickness Skin Graft ◽  
Foot And Ankle ◽  
Wound Therapy ◽  
Surgical Wounds ◽  
Thickness Skin ◽  
Diabetic Population ◽  
Treatment Of Wounds

Split thickness skin graft (STSG) is a versatile procedure performed for the treatment of wounds resulting from varying pathology. This remains very useful because of its ability for quick healing and low complication rate. The surface of the foot and ankle is an area frequently affected by severe skin and soft tissue structure infections (SSTIs) whose treatment results in wounds. These infections and resultant surgical wounds are commonly seen patients with diabetes. The objective of the present study was to retrospectively evaluate initial healing and immediate post-operative outcomes following STSG application in a diabetic population when negative pressure wound therapy (NPWT) was used as a bolster. Ten patients were identified, including 11 surgical wounds, who underwent STSG bolstered with NPWT from January 2016 to October 2018. Mean follow-up was 13 months (range 1-33 months) with an average time to heal of 17 days (range 14-30 days) for 11 surgical wounds averaging 57 cm2 (range 6.3 - 91 cm2). Consistent improved outcomes have been demonstrated when compared to alternative bolstering techniques available in the literature making a STSG bolstered with NPWT a powerful tool in the reconstruction of diabetic foot wounds resulting from the treatment of infection. Levels of Evidence: Level IV

scholarly journals Hidradenitis Suppurativa: Combined Treatment with Dermal Template, Skin Graft and Negative Pressure Wound Therapy, a Case Study

2018 ◽  
Vol 31 (1) ◽  
pp. 59 ◽  
Author(s):  
Luís Mata Ribeiro ◽  
Ana Silva Guerra
Keyword(s):  
Skin Graft ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Combined Treatment ◽  
Psychological Impact ◽  
Chronic Inflammatory Disease ◽  
Split Thickness Skin Graft ◽  
Wound Therapy ◽  
Thickness Skin

Hidrosadenitis supurativa is a chronic inflammatory disease with great physical and psychological impact. Although conservative treatments may be effective in mild forms of the disease, extensive surgical resection and reconstruction are necessary in more severe forms of the disease. The purpose of this paper is to describe our two-stage reconstructive procedure regarding this kind of disease. We present a clinical case of a patient with severe, bilateral axillary hidrosadenitis. In the first surgical step we excised the lesions and applied the artificial dermis secured with negative pressure wound therapy. In the second step we used a split thickness skin graft to close the wound and again applied negative pressure wound therapy. The graft take was very good, without complications. The cosmetic outcome is acceptable and shoulder mobility was not compromised. No recurrence was detected (nine months follow up).

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