scholarly journals Using a bio-scanner and 3D printing to create an innovative custom made approach for the management of complex entero-atmospheric fistulas

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Virginia Durán Muñoz-Cruzado ◽  
Francisco José Calero Castro ◽  
Andrés Padillo Eguía ◽  
Luis Tallón Aguilar ◽  
José Tinoco González ◽  
...  
Keyword(s):  
3D Printing ◽  
Negative Pressure Wound Therapy ◽  
Wound Therapy ◽  
Accelerate Wound Healing ◽  
Surgical Expertise ◽  
Custom Made ◽  
Enteroatmospheric Fistula ◽  
Healing Wounds ◽  
Clinical Conditions ◽  
First Time

AbstractEnteroatmospheric fistulae are challenging clinical conditions that require surgical expertise and that can result in chronic debilitating conditions placing the patient in a vicious cycle characterized by non healing wounds and malnutrition. They are a complex entity that presents great variability depending on the number, shape, and size of the fistulous orifices, their debit, and the dimensions of the wound. This means that, at present, there is no device that adapts to the anatomical characteristics of each patient and manages to control the spillage of intestinal effluvium from the wound. The aim of this study is to describe the manufacturing technique and to assess the preliminary results of a custom device designed through bioscanner imaging and manufactured using 3D printing for use with negative pressure wound therapy (NPWT) in the management of enteroatmospheric fistula. A proof of concept is given, and the design of the device is presented for the first time. After obtaining images of each fistula with a bioscanner, a personalised device was designed for each patient by 3D printing shape of a prism and a hollow base, taking into account the dimensions of the fistulous area in order to perform a floating ostomy to isolate the wound from the debit enteric. The polycaprolactone (PCL) device was placed including inside the fistulous surface and surrounding it with the NPWT system in order to accelerate wound healing.

The Use Of Negative Pressure Wound Therapy (NPWT) In The Management Of Enteroatmospheric Fistula – Case Report And Literature Review

2015 ◽  
Vol 87 (10) ◽  
Author(s):  
Rajmund Jaguścik ◽  
Dominik A. Walczak ◽  
Joanna Porzeżyńska ◽  
Piotr W. Trzeciak
Keyword(s):  
Negative Pressure ◽  
Metabolic Disorders ◽  
Multidisciplinary Approach ◽  
Negative Pressure Wound Therapy ◽  
Open Abdomen ◽  
Oral Intake ◽  
Surgical Team ◽  
Wound Therapy ◽  
Necrotic Pancreatitis ◽  
Enteroatmospheric Fistula

AbstractAn enteric fistula that occurs in an open abdomen is called an enteroatmospheric fistula (EAF) and is the most challenging complication for a surgical team to deal with. The treatment of EAF requires a multidisciplinary approach. First of all, sepsis has to be managed. Any fluid, electrolyte and metabolic disorders need to be corrected. Oral intake must be stopped and total parenteral nutrition introduced. The control and drainage of the effluent from the fistula is a separate issue. Since there are no fixed algorithms for the treatment of EAF, surgeons need to develop their own, often highly unconventional solutions.We present the case of a 24-year-old man who developed enteroatmospheric fistula after laparotomy and relaparotomy due to acute necrotic pancreatitis. Both the laparostomy and the fistula were successfully managed using modified negative pressure wound therapy. The literature regarding this issue was also reviewed.

Negative-pressure wound therapy for high-risk surgical incision wounds using an ultra-portable device: 11 cases

2019 ◽  
Vol 7 (2) ◽  
pp. e000751
Author(s):  
Sofia Garcia-Pertierra ◽  
Nuria Vizcaino Reves ◽  
Araceli Calvo Aguado
Keyword(s):  
High Risk ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Healing Process ◽  
Case Series ◽  
Portable Device ◽  
Wound Therapy ◽  
Surgical Incision ◽  
Early Ambulation ◽  
Healing Wounds

Negative-pressure wound therapy (NPWT) involves the application of subatmospheric pressure to a wound to help in the healing process. The objective of this case series was to evaluate the clinical experience using ultra-portable NPWT devices on high-risk closed incisions after surgical management of complex non-healing wounds. Data were available for eight dogs and three cats. Wound aetiologies varied from traumatic, neoplastic and foreign body. Application and maintenance of the portable device were technically easy in most cases, finding some difficulties when applied to curved body surfaces. All patients’ outcome was highly rewarding. This case series suggests that portable NPWT helps in achieving full recovery, increases comfort allowing early ambulation and feeding, and reduces hospitalisation time. Their reduced size is suitable for smaller animals, enhancing their therapeutic use in veterinary medicine.

scholarly journals Management of enteroatmospheric fistula with negative pressure wound therapy in open abdomen treatment: a multicentre observational study

2016 ◽  
Vol 14 (1) ◽  
pp. 255-264 ◽  
Author(s):  
Adam Bobkiewicz ◽  
Dominik Walczak ◽  
Szymon Smoliński ◽  
Tomasz Kasprzyk ◽  
Adam Studniarek ◽  
...  
Keyword(s):  
Observational Study ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Open Abdomen ◽  
Wound Therapy ◽  
Enteroatmospheric Fistula

scholarly journals Negative pressure wound therapy: eleven-year experience at a tertiary care hospital

2017 ◽  
Vol 5 (5) ◽  
pp. 1835
Author(s):  
Haroon Rashid Zargar ◽  
Mir Mohsin ◽  
Peerzada Umar Farooq Baba ◽  
Adil Hafeez Wani ◽  
Shabir Iqbal ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Wound Care ◽  
Low Cost ◽  
Tertiary Care ◽  
Care Hospital ◽  
Wound Therapy ◽  
Major Complications ◽  
Custom Made ◽  
A Prospective Study

Background: Management of complicated wounds is a reconstructive challenge. A reconstructive surgeon has to be ready to face new challenges every day. Negative pressure wound therapy has revolutionized the management of complex wounds. We are presenting our experience with this wound care modality in the past 11 years.Methods: It was a prospective study conducted from January 2006 to December 2016 on patients having wounds of varied etiologies, who consented to participate in this study. Custom made low cost NPWT was used till definitive wound closure.Results: A total of 568 patients consented to participate in the study during these 11 years. No major complications were seen. Most of these were males (60.73%) in their 3rd and 4th decade. Trauma was the leading cause of wounds in 38.14%, followed by diabetic foot wounds in 21.5%. Ankle and foot was the most common site of wounds (30.92%) followed by leg (24.01%). A total of 322 small, 218 medium and 97 large size dressings were used. Most of the patients improved with the NPWT.  No major complications were seen.Conclusions: NPWT is safe, effective and has proved to be revolutionary in managing difficult wounds. With the use of customized low cost NPWT the benefit can be extended to underprivileged population in under developed nations too.

scholarly journals Effects of Negative Pressure Wound Therapy on Levels of Angiopoetin-2 and Other Selected Circulating Signaling Molecules in Patients with Diabetic Foot Ulcer

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Jerzy Hohendorff ◽  
Anna Drozdz ◽  
Sebastian Borys ◽  
Agnieszka H. Ludwig-Slomczynska ◽  
Beata Kiec-Wilk ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Diabetic Foot ◽  
Negative Pressure Wound Therapy ◽  
Foot Ulcer ◽  
Annexin V ◽  
Diabetic Foot Ulcer ◽  
Entire Group ◽  
Wound Therapy ◽  
Accelerate Wound Healing ◽  
Premature Deaths

Background and Aims. Diabetic foot ulcers (DFUs) are linked to amputations and premature deaths. Negative pressure wound therapy (NPWT) has been used for DFUs. The mechanism of NPWT’s action may be associated with its influence on circulating molecules. We assessed NPWT’s effect on the plasma levels of angiopoietin-2 (Ang2), a key regulator of angiogenesis, and its microvesicular receptors (Tie2) as well as the microvesicles (MVs) themselves in DFU patients. Materials and Methods. We included 69 patients with type 2 diabetes mellitus (T2DM) and neuropathic, noninfected DFUs—49 were treated with NPWT and 20 were treated with standard therapy (ST). Assigning patients to the NPWT group was not random but based on DFU characteristics, especially wound area. Ang2 was measured by ELISA in the entire group, while in a subgroup of 19 individuals on NPWT and 10 on ST, flow cytometry was used to measure Tie2+ and the corresponding isotype control (Iso+) and annexin V (AnnV+) as well as total MVs. Measurements were performed at the beginning and after 8±1 days of therapy. Results. Treatment groups were similar for basic characteristics but differed by their median DFU areas (10.3 (4.2-18.9) vs. 1.3 (0.9-3.4) cm2, p=0.0001). At day 0, no difference was observed in Ang2 levels, total MVs, MV Tie+, and MV AnnV+ between the groups. Ang2 decreased after 8 days in the NPWT group, unlike in the ST group (3.54 (2.40-5.40) vs. 3.32 (2.33-4.61), p=0.02, and 3.19±1.11 vs. 3.19±1.29 ng/mL, p=0.98, respectively). No other parameters were identified that may have been influenced by the NPWT treatment. Conclusion. NPWT in T2DM patients with neuropathic, noninfected DFU seems to lead to reduction of the Ang2 level. Influencing the level of Ang2 may constitute one of NPWT-related mechanisms to accelerate wound healing.

scholarly journals Experimental study of negative pressure wound therapy combined with platelet-rich fibrin for bone-exposed wounds

2021 ◽  
Author(s):  
Hong Zhang ◽  
Songyu Wang ◽  
Chen Lei ◽  
Guanmin Li ◽  
Biao Wang
Keyword(s):  
Negative Pressure ◽  
Wound Closure ◽  
Negative Pressure Wound Therapy ◽  
Contraction Rate ◽  
Sprague Dawley ◽  
Wound Therapy ◽  
Closure Rate ◽  
Platelet Rich Fibrin ◽  
Accelerate Wound Healing ◽  
Sprague Dawley Rats

Aim: To evaluate the efficacy of negative pressure wound therapy (NPWT) combined with platelet-rich fibrin (PRF) in treating bone-exposed wounds and explore its possible mechanism. Materials & methods: A bone-exposed wound was created in a total of 32 healthy Sprague-Dawley rats, which were treated with either control, NPWT group, PRF group or both (N + P group). The bone-exposed area, skin contraction rate and granulation coverage and the level of growth factors in granulation tissue were determined on days 4, 7 and 10. Results: The N + P group showed significantly higher wound closure rate than that achieved with others respectively. Four factors were significantly higher in N + P group than in the other three groups. Conclusion: Combination of NPWT and PRF can repair bone-exposed wounds effectively and accelerate wound healing.

scholarly journals Negative pressure wound therapy use in the treatment of patient with an active process of anal cancer in order to the further treatment – case report.

2016 ◽  
Vol 3 (1) ◽  
Author(s):  
Magdalena Kicińska ◽  
Dorota Błażejewska ◽  
Tomasz Banasiewicz
Keyword(s):  
Anal Cancer ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Wound Therapy ◽  
Septic Complications ◽  
Oncologic Patients ◽  
End Colostomy ◽  
Treatment Morbidity ◽  
Cosmetic Effect ◽  
Healing Wounds

A common treatment of bad healing wounds is vacuum assisted therapy (negative pressure wound therapy). The main clinical goal are: reduced time of wound healing, decreasing frequency of septic complications, and better functional and cosmetic effect. One of the main contraidications include a malignant process in the patient, however, it is reported that in some cases it has achieved possitive results.68 years-old man was admitted to the hospital due to resection of giant anal cancer. Because of severe problems with passing stool, size of the lesions, sphincter infiltration and full dysfunction, according to the patient’s acceptation abdominoperineal rectal resection with end colostomy was performed. An open, non-healed wound was a contraindication for radiotherapy – the most advisable type of treatment in advanced anal cancer. Despite of potential malignancy in the wound, because the non-healed wound delaying the radiotherapy the negative pressure wound therapy was introduced to improve healing, close the wound and enable radiotherapy.Potential benefits and risks of npwt treatment should always be considered. In some selected cases of oncologic patients after the surgery npwt can be considered, especially when our treatment is used in palliative management or even when the proliferation of neoplastic tissues does not affect the duration of life (paliative treatment, morbidity, old age etc.)  

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.

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