scholarly journals Surgical treatment of pyoderma gangrenosum with negative pressure wound therapy and split thickness skin grafting under adequate immunosuppression is a valuable treatment option: Case series of 15 patients

2016 ◽  
Vol 74 (4) ◽  
pp. 760-765 ◽  
Author(s):  
Maria Pichler ◽  
Lorenz Larcher ◽  
Michael Holzer ◽  
Gerald Exler ◽  
Tobias Thuile ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Pyoderma Gangrenosum ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Case Series ◽  
Skin Grafting ◽  
Wound Therapy ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting ◽  
Valuable Treatment

scholarly journals NEGATIVE PRESSURE WOUND THERAPY AND INTEGRA® DRT FOR AVULSION INJURIES OF THE LOWER EXTREMITIES – PRESENTATION OF TWO CASES AND LITERATURE REVIEW

2019 ◽  
Vol 141 (5-6) ◽  
pp. 146-149
Keyword(s):  
Granulation Tissue ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Initial Period ◽  
Lower Extremities ◽  
Skin Grafting ◽  
Solid Layer ◽  
Wound Therapy ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting

Two cases which involved a massive avulsion injury of the lower extremities are presented. In both cases the treatment consisted of sequential debridement during the initial period after which negative pressure wound therapy was applied for a period of three to four weeks in order to enable the formation of a solid layer of granulation tissue and a clinically clean wound. Subsequently, INTEGRA® DRTwas fixed to the wound bed with negative pressure wound therapy. During the next three weeks INTEGRA® DRT „integrated“ which enabled split-thickness skin grafting with 0.2 mm thick grafts. In both cases the final outcome was functionally and cosmetically satisfying with near normal contours of the lower extremity restored. Negative pressure wound therapy for a period of three to four weeks enables control of the colonisation of the wound bed and a formation of a solid layer of granulation tissue. The application of INTEGRA® DRT enables formation of the neodermis which provides elasticity and better contours of the reconstructed tissue. A downside of this type of treatment is the price as well as the duration of therapy of about eight weeks.

Dermal Regeneration Template and Staged Skin Grafting for Extirpative Scalp Wound Reconstruction: A 14-Year Experience

2021 ◽  
pp. 019459982098658
Author(s):  
Jacob C. Maus ◽  
Kshipra Hemal ◽  
Mija Khan ◽  
Bennett W. Calder ◽  
Malcolm W. Marks ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Academic Medical Center ◽  
Case Series ◽  
Skin Grafting ◽  
Wound Therapy ◽  
Scalp Defects ◽  
Split Thickness Skin Grafting ◽  
Dermal Regeneration Template ◽  
Dermal Regeneration

Objective Dermal regeneration template and staged split-thickness skin grafting may mitigate the need for flap coverage of postoncologic scalp defects. This technique has been studied previously in small case series. We examine the effect of risk factors, surgical technique, irradiation, and dressing modalities on reconstructive outcomes in a highly comorbid patient cohort. Study Design Retrospective review. Setting Academic medical center. Methods Full- and partial-thickness extirpative scalp wounds reconstructed with dermal regeneration template and staged skin grafting were reviewed over a 14-year period. Stage 1 consisted of template application following burr craniectomy in cases lacking periosteum. Stage 2 consisted of skin grafting. Negative pressure wound therapy (NPWT) was variably used to support adherence. Results In total, 102 patients were analyzed (average age 74, mean follow-up 18 months). Eighty-one percent were American Society of Anesthesiologists class 3 or 4. Defect size averaged 56 cm2. Average skin graft take was 94.5% in full-thickness wounds. Seven patients failed this method. Preoperative scalp irradiation was associated with major complication and delayed graft healing. Comorbidities, wound size, and burring were not associated with complication. Patients were more likely to heal with NPWT compared to bolster (hazard ratio, 1.67; 95% CI 1.01-2.77; P = .046). Time between stages was 6.6 days shorter when NPWT was applied ( P < .001). Conclusion Dermal template and staged skin grafting is a reliable option for postcancer scalp reconstruction in poor flap candidates. Radiotherapy is associated with adverse outcomes. Negative pressure wound therapy simplifies postoperative wound care regimens and may accelerate healing.

scholarly journals Multi-stage surgical treatment of extensive gluteal localized hidradenitis suppurativa combined with negativ pressure wound therapy

2021 ◽  
Vol 97 (1) ◽  
pp. 56-63
Author(s):  
Tímea Pálházy ◽  
◽  
Stephan Bennemann ◽  
András Fülöp ◽  
L. Hunor Gergely ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Skin Graft ◽  
Negative Pressure ◽  
Hidradenitis Suppurativa ◽  
Successful Outcome ◽  
Split Thickness Skin Graft ◽  
Wound Therapy ◽  
Apocrine Glands ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting

Hidradenitis suppurativa (HS) is a chronic, recurrent infammatory disease of the hair follicles in the skinfolds containing apocrine glands, which greatly impairs the quality of life of patients. The fnal solution in extensive cases is surgical treatment. There is no ideal treatment or uniform therapeutic template equally suitable for all patients. Treatment is personalized. In this paper, we present the case of a 53-year-old patient who underwent a two-stage surgical treatment for therapy-resistant HS, Hurley stage III, causing permanent complaints. During the frst surgery, the fstula openings were flled with methylene blue, then the skin and the scary subcutaneous tissue were excised, and after 10 days, in a second step, the surgical site was covered with split thickness skin graft from the back. After both surgeries, negative pressure wound therapy (NPWT) was initiated. After the applied treatment, 98-100% graft adhesion was observed, and the patient was emitted without complaints after 3 weeks. Our case illustrates that in cases where the prospects for fap replacement in HS are poor or the healing tendency of the faps is questionable (infective wound base, poor quality surrounding skin), split thickness skin grafting combined with negative pressure therapy may be less stressful and provides a successful outcome. The combined treatment (NPWT + split thickness skin graft) is excellent not only for clearing and stimulating the wound base, but also provides an excellent wound base and allows successful wound closure / coverage, signifcantly shortening the duration of the long and cumbersome open treatment has been used so far. In this case, NPWT treatment can also be considered as a “bridging” step.

scholarly journals Role of customised negative-pressure wound therapy in the integration of split-thickness skin grafts: A randomised control study

2017 ◽  
Vol 50 (01) ◽  
pp. 043-049 ◽  
Author(s):  
Mir Mohsin ◽  
Haroon Rashid Zargar ◽  
Adil Hafeez Wani ◽  
Mohammad Inam Zaroo ◽  
Peerzada Umar Farooq Baba ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Financial Burden ◽  
Wound Therapy ◽  
Graft Take ◽  
Thickness Skin ◽  
Custom Made ◽  
Split Thickness Skin Grafting ◽  
Control Study

ABSTRACT Background: Split-thickness skin grafting (STSG) is a time-tested technique in wound cover, but many factors lead to suboptimal graft take. Role of custom-made negative-pressure wound therapy (NPWT) is compared with conventional dress in the integration of STSG and its cost is compared with widely used commercially available NPWT. Materials and Methods: This is a parallel group randomised control study. Block randomisation of 100 patients into one of the two groups (NPWT vs. non-NPWT; 50 patients each) was done. Graft take/loss, length of hospital stay post-grafting, need for regrafting and cost of custom-made negative pressure wound therapy (NPWT) dressings as compared to widely used commercially available NPWT were assessed. Results: Mean graft take in the NPWT group was 99.74% ± 0.73% compared to 88.52% ± 9.47% in the non-NPWT group (P = 0.004). None of the patients in the NPWT group required second coverage procedure as opposed to six cases in the non-NPWT group (P = 0.035). All the patients in the NPWT group were discharged within 4–9 days from the day of grafting. No major complication was encountered with the use of custom-made NPWT. Custom-made NPWT dressings were found to be 22 times cheaper than the widely used commercially available NPWT. Conclusions: Custom-made NPWT is a safe, simple and effective technique in the integration of STSG as compared to the conventional dressings. We have been able to reduce the financial burden on the patients as well as the hospital significantly while achieving results at par with other studies which have used commercially available NPWT.

Cost-efficacy of skin grafting techniques using negative pressure wound therapy and tissue-engineered skin for burns

2021 ◽  
Author(s):  
Muhammad Hanif Nadhif ◽  
Muhammad Satrio Utomo ◽  
Muhammad Farel Ferian ◽  
Farhan H. Taufikulhakim ◽  
Nadine H. P. Soerojo ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Skin Grafting ◽  
Wound Therapy ◽  
Cost Efficacy
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