scholarly journals Evaluation of Systemic Effects of Negative Pressure Wound Therapy in Open Wound Treatment in Dogs

VCOT Open ◽  
2019 ◽  
Vol 02 (02) ◽  
pp. e1-e8
Author(s):  
Rebecca Albert ◽  
Sven Reese ◽  
Mirja C. Nolff ◽  
Andrea Meyer-Lindenberg
Keyword(s):  
Negative Pressure ◽  
Total Protein ◽  
Wound Closure ◽  
Negative Pressure Wound Therapy ◽  
Systemic Effects ◽  
Wound Treatment ◽  
Characteristic Analysis ◽  
Open Wound ◽  
Wound Therapy ◽  
Open Wound Treatment

Objectives The aim of this study was to evaluate the systemic effect of negative pressure wound therapy (NPWT) on the treatment of complicated wounds in dogs. Materials and Methods Dogs undergoing open wound treatment were randomly assigned to one of two groups: NPWT (n = 11) or polyurethane foam dressing (n = 11). Rectal temperature, heart rate as well as haematocrit, thrombocytes, leucocyte count, band neutrophils, C-reactive protein (CrP), total protein and albumin were recorded daily from the beginning of therapy (day 0) until day 5, as well as on day 10. The effect of treatment on systemic parameters was evaluated as well as the prognostic power of the individual parameters with regard to successful wound closure. Results A more profound systemic decrease was found in total protein under NPWT. This difference was non-significant. Patients with non-successful closure displayed a non-significant trend towards lower initial leukocyte and thrombocyte counts and significantly higher CrP values on days 4, 5 and 10 (p < 0.05) compared with successfully treated patients. Receiver operating characteristic analysis revealed an optimal cutoff value of 70.2 mg/L at day 4 (sensitivity 80; specificity of 85.7). Conclusion There might be an increased loss of protein in NPWT-treated patients, which does not affect albumin levels, otherwise no systemic effects were detected compared with the control treatment. The parameter with the best sensitivity and specificity to detect serious complications (no wound closure achieved) was CrP at day 4.

scholarly journals Successful surgical closure of infected abdominal wounds following preconditioning with negative pressure wound therapy

2021 ◽  
Author(s):  
Johanna C. Wagner ◽  
Anja Wetz ◽  
Armin Wiegering ◽  
Johan F. Lock ◽  
Stefan Löb ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Wound Closure ◽  
Negative Pressure Wound Therapy ◽  
Wound Complications ◽  
Skin Closure ◽  
Wound Treatment ◽  
Open Wound ◽  
Wound Therapy ◽  
Significant Difference ◽  
Open Wound Treatment

Abstract Purpose Traditionally, previous wound infection was considered a contraindication to secondary skin closure; however, several case reports describe successful secondary wound closure of wounds “preconditioned” with negative pressure wound therapy (NPWT). Although this has been increasingly applied in daily practice, a systematic analysis of its feasibility has not been published thus far. The aim of this study was to evaluate secondary skin closure in previously infected abdominal wounds following treatment with NPWT. Methods Single-center retrospective analysis of patients with infected abdominal wounds treated with NPWT followed by either secondary skin closure referenced to a group receiving open wound therapy. Endpoints were wound closure rate, wound complications (such as recurrent infection or hernia), and perioperative data (such as duration of NPWT or hospitalization parameters). Results One hundred ninety-eight patients during 2013–2016 received a secondary skin closure after NPWT and were analyzed and referenced to 67 patients in the same period with open wound treatment after NPWT. No significant difference in BMI, chronic immunosuppressive medication, or tobacco use was found between both groups. The mean duration of hospital stay was 30 days with a comparable duration in both patient groups (29 versus 33 days, p = 0.35). Interestingly, only 7.7% of patients after secondary skin closure developed recurrent surgical site infection and in over 80% of patients were discharged with closed wounds requiring only minimal outpatient wound care. Conclusion Surgical skin closure following NPWT of infected abdominal wounds is a good and safe alternative to open wound treatment. It prevents lengthy outpatient wound therapy and is expected to result in a higher quality of life for patients and reduce health care costs.

scholarly journals Retrospective comparison of negative pressure wound therapy and silver-coated foam dressings in open-wound treatment in cats

2016 ◽  
Vol 19 (6) ◽  
pp. 624-630 ◽  
Author(s):  
Mirja Christine Nolff ◽  
Michael Fehr ◽  
Sven Reese ◽  
Andrea E Meyer-Lindenberg
Keyword(s):  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Previous Treatment ◽  
Wound Treatment ◽  
Open Wound ◽  
Wound Therapy ◽  
Antiseptic Treatment ◽  
Group A ◽  
Group B ◽  
Open Wound Treatment

Objectives The objective of this study was to evaluate negative pressure wound therapy (NPWT) for the treatment of complicated wounds in cats. Methods Twenty cats undergoing open-wound treatment in two clinics were classed according to treatment method: NPWT (group A, n = 10) and polyurethane foam dressing (group B, n = 10). Pairs of patients from each group were matched based on wound conformation, localisation and underlying cause. Cats from both groups were compared in terms of duration of previous treatment, time to closure and complications. Results Signalment, duration of previous treatment, antibiotic and antiseptic treatment, and bacterial status were comparable between groups. Total time to wound closure was significantly shorter ( P = 0.046, strong effect size; Cohen d = 0.8) in group A (25.8 days, range 11.0–57.0 days) compared with group B (39.5 days, range 28.0–75.0 days). NPWT-treated wounds suffered fewer complications and became septic less frequently during treatment compared with wounds treated with a foam dressing. The progression of fat tissue necrosis was particularly well controlled under NPWT, resulting in fewer deaths due to this condition in this group. However, although a strong effect of NPWT on the progression of infection, fever and sepsis was detected (Cramer-V 0.5), this difference was not significant. Conclusions and relevance This study demonstrated that time to healing was considerably shorter, and complication rate lower, in NPWT-treated animals compared with foam dressing-treated cats. In particular, the effective management of infection by NPWT emphasises the value of NPWT in the treatment of cats suffering from infected wounds.

Negative pressure wound therapy, silver coated foam dressing and conventional bandages in open wound treatment in dogs

2015 ◽  
Vol 28 (01) ◽  
pp. 30-38 ◽  
Author(s):  
M. Fehr ◽  
A. Bolling ◽  
R. Dening ◽  
S. Kramer ◽  
S. Reese ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Previous Treatment ◽  
Wound Treatment ◽  
Open Wound ◽  
Wound Therapy ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Open Wound Treatment

SummaryObjectives: To evaluate negative pressure wound therapy (NPWT) for treatment of complicated wounds in dogs.Study type: Retrospective multicentre study.Materials and methods: Dogs (n = 50) undergoing open wound treatment were classified according to treatment method used: bandage (Group A, n = 7), NPWT (Group B, n = 18), and foam dressing (Group C, n = 25). Pairs of patients matched based on wound conformation, localization, and underlying cause were compared between Group A and C (n = 7 pairs) and between groups B and C (n = 18 pairs) in terms of duration of previous treatment, time to closure, and complications.Results: Signalment, antibiotic medications, antiseptic treatment, and bacterial status of wounds were comparable between groups. The duration of previous treatment was significantly higher in patients assigned to Group B (p = 0.04) compared to Group C, while no significant difference was found between groups A and B. Total time to wound closure was significantly shorter in Group C compared to Group A (p = 0.02) and in Group B compared to Group C (p = 0.003). Wounds treated with NPWT suffered significantly less complications (p = 0.008) and were significantly less septic during treatment (p = 0.016) than wounds treated with a foam dressing.Conclusion: This study shows that time to healing was halved in NPWT treated patients compared to foam dressing treated patients, which in turn healed faster than patients treated with conventional bandage, underlining the value of NPWT therapy for the treatment of complicated wounds.

Comparison of Negative Pressure Wound Therapy and Silver-Coated Foam Dressings in Open Wound Treatment in Dogs: A Prospective Controlled Clinical Trial

2018 ◽  
Vol 31 (04) ◽  
pp. 229-238 ◽  
Author(s):  
Sven Reese ◽  
Andrea Meyer-Lindenberg ◽  
Mirja Nolff ◽  
Rebecca Albert
Keyword(s):  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Wound Treatment ◽  
Open Wound ◽  
Wound Therapy ◽  
Randomized Clinical Study ◽  
Days Of Therapy ◽  
Group A ◽  
Group B ◽  
Open Wound Treatment

Objectives To evaluate negative pressure wound therapy (NPWT) for treatment of complicated wounds in dogs. Study Type Prospective randomized clinical study Materials and Methods Dogs (n = 26) undergoing open-wound treatment were randomly assigned to one of two groups: Group A (n = 13) NPWT; Group B (n = 13) silver-coated foam dressing. Pairs of patients were matched based on wound conformation, localization, and underlying cause and compared in terms of duration of previous treatment, development of wound size (wound planimetry), time to closure, bacterial bio-burden and complications. Wound dressing changes were performed every 3 days during the first 9 days of therapy for both groups. Statistical analysis was performed. Results Pre-treatment signalment and bacterial status were comparable between groups. Total time to closure was significantly (p = 0.018) shorter in Group A (14.2 days) compared with Group B (28.6 days), and wound planimetry on days 3, 6 and 9 showed significant greater reduction in total wound area for Group A at all-time points (p < 0.05). Furthermore, wounds in Group A showed less progression of local infection than did wounds in Group B (p = 0.01). Conclusion NPWT-treated wounds showed faster closure, improved macro-deformation and less local signs of infection.

Vergleich offener Wundheilungsverfahren beim Hund

2019 ◽  
Vol 47 (01) ◽  
pp. 60-60
Author(s):  
Rebecca Albert
Keyword(s):  
Clinical Trial ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Controlled Clinical Trial ◽  
Wound Treatment ◽  
Open Wound ◽  
Wound Therapy ◽  
Open Wound Treatment

Nolff MC, Albert R, Reese S, Meyer-Lindenberg A. Comparison of negative pressure wound therapy and silver-coated foam dressings in open wound treatment in dogs: a prospective controlled clinical trial. Vet Comp Orthop Traumatol 2018; 31 (4): 229–238. Die vakuumassistierte Wundtherapie (Negative Pressure Wound Therapy, NPWT) hat in den letzten Jahren in der Kleintiermedizin starken Einzug gehalten. In einer prospektiven Studie wurde dieses Verfahren mit der Anwendung eines silberbeschichteten Wundkissens hinsichtlich Wundheilungsrate, bakterieller Besiedelung der Wunde und möglicher Komplikationen verglichen.

659 Non-Burn Etiologies Treated with Autologous Skin Cell Suspension: A Case Series Demonstrating the Efficacy in Complex Wounds

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S195-S195
Author(s):  
Nicole M Kopari ◽  
Yazen Qumsiyeh
Keyword(s):  
Soft Tissue ◽  
Cell Suspension ◽  
Negative Pressure ◽  
Wound Closure ◽  
Negative Pressure Wound Therapy ◽  
Case Series ◽  
Dermal Substitute ◽  
Wound Therapy ◽  
Skin Cell ◽  
Complex Wounds

Abstract Introduction Complex wounds (CW) resulting from necrotizing soft tissue infections (NSTIs) and soft tissue traumatic injuries create unique challenges. Radical debridement is often the first step in management but can result in disfigurement with impaired function and compromised cosmesis. The standard of care at our institution for full-thickness burn injuries of similar complexity is widely meshed autografting with application of autologous skin cell suspension (ASCS). Our study is a case series reviewing outcomes using ASCS for CW from non-burn etiology. Methods A retrospective chart review from March 2019 through July 2020 was performed to evaluate the effectiveness of ASCS and widely meshed autografting in CW. Patients presenting with CW underwent serial excisions of devitalized tissue by acute care and burn surgeons. Dermal substitute utilization for wound preparation was at the discretion of the surgeon. Definitive wound closure was achieved using ASCS in combination with a widely meshed autograft. The wounds were covered with a non-adherent, non-absorbent, small pore primary dressing along with bismuth-impregnated, petroleum-based gauze or negative pressure wound therapy dependent on wound bed contour. Further padding with gauze was applied along with compressive dressing. Results In total, 8 patients with CW were included in this review. The mean age was 58 years (range 27-85) with an equal number of males and females. Wound etiology included NSTI (n=5), degloving injury (n=2), and traumatic amputation (n=1). The average wound size measured 1,300cm2 (range 300-3,000). 50% of the patients were treated with a dermal substitute and negative pressure wound therapy prior to ASCS and autograft placement. 7 of 8 patients received split-thickness skin grafting in the ratio of 3:1 with one patient grafted at a 2:1 expansion. 7 of the 8 patients had &gt;90% wound closure within 8-10 days of ASCS and autograft application. One patient had significant graft failure after removing surgical dressings and autograft in the early post-operative period secondary to dementia. One patient expired during the follow-up period secondary to medical comorbidities. The 6 remaining patients had durable wound closure and acceptable cosmetic outcome. All patients were discharged within 10 days of ASCS application with 4 patients discharging home and 4 patients discharging to an acute inpatient rehabilitation. Conclusions This study is the first case series to review ASCS in combination with widely meshed skin grafts in the management of CW from a non-burn etiology. Durable, timely wound closure and an acceptable cosmetic outcome was achieved in these often-challenging CW.

653 Capillary Suction Device-a Novel Approach to Negative Pressure Wound Therapy

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S172-S173
Author(s):  
George F Babcock ◽  
Ranjit Chatterjee ◽  
Tara Riddle
Keyword(s):  
Negative Pressure ◽  
Wound Closure ◽  
Negative Pressure Wound Therapy ◽  
Donor Site ◽  
Large Cell ◽  
Wound Therapy ◽  
Capillary Suction ◽  
Fluid Uptake ◽  
Study Results ◽  
Negative Pressures

Abstract Introduction Negative Pressure Wound Therapy (NPWT) is a well-established procedure used for non-healing wounds including burn wounds. In NPWT, a special sealed dressing of large cell foam (&gt;400 µm) or gauze is connected to a pump. The sealed dressing acts as a conduit to pressure transfer and aids in the passive flow of fluid. Most commonly, negative pressures between -10 and -125 millimeters of mercury (mm Hg) are used. The mechanism of healing is unknown but maybe due to removal of the exudate and bacteria, and the stimulation of tissue repair through micro deformation. Reticulated foams with micron-size open cells (100 to 5µm) exerts capillary suction between 10 and 60 mm of Hg with a multilayered foam dressing. The negative pressures produced are within the range of suction by mechanical pumps. Therefore, the long-term goal our research is to examine effectiveness of Capillary Suction Devices (CSD) as a topical device in both preventing and healing complicated wounds, burn and donor site wounds. Our hypothesis is that CSD is an effective, safe and lower cost alternative to vacuum-assisted NPWT. Methods Yorkshire pigs received 4 surgical posterior excision wounds, measuring 2 in. by 2 in. The wounds were covered with a NPWT dressing (110 mm Hg negative pressure by a pump), CSD with capillary suctions of 30 mm Hg (CSD-30) and 60+ mm Hg (CSD-60), and a conventional gauze dressing. The wounds were measured on 2 day and then every 4 to 5 days until wounds closed. We also measured and compared the total fluids collected with each dressing. Results By post-wound day 20, the wounds treated with CSD-60 and NPWT were 100% closed while the wounds treated with CSD-30 and gauze were 65 and 45%, respectively. This indicated comparable wound closure efficacies for CSD-60 and NPWT. The CSD-30 product was superior to gauze, but less efficacious than the tested NPWT protocol. The average total fluid uptake measured in grams dry weight were similar for CSD-60 and NPWT, 36 and 38g., respectively while the values were 24g for CSD-30 and 12g for gauze. However, the maximum fluid uptake observed at day 2 indicated that CSD-60 and CSD 30, 24 and 14g respectively, were superior to NPWT and gauze 12 and 7g respectively. Conclusions This data indicates comparable wound closure efficacies for CSD-60 capillary suction and NPWT. The CSD product with 30 mmHg suction was superior to gauze, but less efficacious than NPWT or CSD-60 protocol. The study results provide impetus for further research on the use of high suction CSD for replacement of pump mediated NPWT and the moderate suction CSD for preventing progression of high-risk wounds to an ulcerous stage. Applicability of Research to Practice This small study suggests that CSD maybe alternative in to NPWT. CSD provides a significant cost and weight advantage to the patient, as well is allowing for increased mobility.

scholarly journals Application of a simple skin stretching system and negative pressure wound therapy in repair of complex diabetic foot wounds

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yaojun Wu ◽  
Liang Chen ◽  
Shaokun Wu ◽  
Liying Yu ◽  
Mimi Chen ◽  
...  
Keyword(s):  
Median Time ◽  
Negative Pressure ◽  
Diabetic Foot ◽  
Wound Closure ◽  
Negative Pressure Wound Therapy ◽  
Defect Size ◽  
Wound Therapy ◽  
Skin Stretching ◽  
Safe Approach ◽  
Large Skin

AbstractThe management of complex diabetic foot wounds with large skin defects poses a challenge for surgeons. We presented a simple skin stretching system and negative pressure wound therapy for the repair of complex diabetic foot wounds to examine the effectiveness and safety.A total of 16 patients with diabetic foot ulcers were retrospectively reviewed between January 2015 and October 2020. All patients underwent the treatment by 3 stages. In stage 2, these difficult-to-close wounds of diabetes foot were residual. This method was applied to the wounds with a median defect size of 20.42 cm2 (range, 4.71–66.76 cm2).The median time for closure of complex diabetic foot wounds was 14 days ranging from 8 to 19 days. With respect to the absolute rates of reduction, it was observed with a median of 1.86 cm2/day, ranging from 0.29 cm2/day to 8.35 cm2/day. In accordance with the localization of the defect, the patients were divided into 3 groups: side of the foot (37.5%), dorsum of the foot (50.0%), and others (12.5%). There was no statistical difference between side of the foot and dorsum of the foot in terms of the median defect size with P = 0.069 (Kruskal–Wallis test). Otherwise, there were statistically significant differences regarding the median time and the median absolute rates (P < 0.05; Kruskal–Wallis test). No severe complications were encountered in this study.In summary, our results show that application of the simple skin stretching system and NPWT is an effective and safe approach to complex diabetic foot wounds. Nevertheless, more attention should be paid to the appropriate patient selection and intraoperative judgment to ensure wound closure and avoid undue complications.

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