Topical Negative Pressure Wound Dressing and Its Applications in the Hand—A Review of the Literature

2021 ◽  
Author(s):  
James Logan ◽  
Georgia Scott ◽  
Christopher Peake ◽  
Jay James Watson ◽  
Rajive Jose
Keyword(s):  
Mechanism Of Action ◽  
Negative Pressure ◽  
Wound Dressing ◽  
Negative Pressure Wound Therapy ◽  
Attractive Potential ◽  
Topical Negative Pressure ◽  
Limb Injuries ◽  
Essential Components ◽  
Negative Pressure Dressings ◽  
Complex Wounds

AbstractThe use of topical negative pressure wound therapy (NPWT) has become increasingly popular in the management of complex wounds. There are many theories as to the mechanism of action of NPWT, but the essential components of the various systems remain consistent. There are many attractive potential properties of negative pressure dressings that lend themselves to the management of upper limb injuries. This article explores the technique of negative pressure wound dressing, the theories pertaining to mechanism of action, and the increasingly broad indications described for the use of NPWT in the hand. The literature pertaining to the efficacy of NPWT in general is also discussed.

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 >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.

The Application of Enhanced Recovery After Surgery and Negative-Pressure Wound Therapy in The Perioperative Period of Elderly Patients With Colorectal Cancer

2020 ◽  
Author(s):  
Hanrong Liu ◽  
Ping Yang ◽  
Song Han ◽  
Yu Zhang ◽  
Hui-ying Zhu
Keyword(s):  
Colorectal Cancer ◽  
Wound Healing ◽  
Negative Pressure ◽  
Wound Dressing ◽  
Readmission Rate ◽  
Negative Pressure Wound Therapy ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Perioperative Period ◽  
Wound Therapy

Abstract Objective: To Explore the perioperative application of enhanced recovery after surgery (ERAS) and negative-pressure wound therapy in the elderly patients with colorectal cancer. Methods: A retrospective clinical data were studied in the patients with colorectal cancer in Department of General Surgery in Shanghai Forth People,s Hospital (from March, 2017 to March, 2019), One hundred and fifty patients with undergoing radical surgery for colorectal cancer were divided into two groups: ERAS group(n=76 cases, accepting ERAS management) and Conventional treatment(CT) group(n=74 cases, accepting traditional treatment),Bleeding in operation, the time of postoperative anal flatus ,number of wound dressing changing, time of wound healing, the length of postoperative hospital stay, readmission rate, postoperative complication, were compared between the two groups. Results: ERAS was associated with less bleeding in operation, less Wound fat liquefaction, less wound dressing changing, less time of wound healing，less time of postoperative anal flatus compare to CT group（P<0.05）; anastomotic fistula、readmission rate is similar in two groups（P>0.05）. Conclusion: The modified ERAS can be safely applied to the perioperative period of elderly colorectal cancer patients and promote recovery; negative-pressure wound therapy is helpful for wound healing and promoting rehabilitation.

scholarly journals A comparative study of the efficacy of topical negative pressure moist dressings and conventional moist dressings in chronic wounds

2007 ◽  
Vol 40 (02) ◽  
pp. 133-140
Author(s):  
Surajit Bhattacharya ◽  
J Ravikrishnan ◽  
B S Satish Rao ◽  
H. Divakar Shenoy ◽  
S R Shetty ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Surface Area ◽  
Negative Pressure ◽  
Chronic Wounds ◽  
Tissue Formation ◽  
Granulation Tissue Formation ◽  
Topical Negative Pressure ◽  
Graft Take ◽  
The Mean ◽  
Negative Pressure Dressings

ABSTRACT Aim: To assess the efficacy of topical negative pressure moist wound dressing as compared to conventional moist wound dressings in improving the healing process in chronic wounds and to prove that negative pressure dressings can be used as a much better treatment option in the management of chronic wounds. Materials and Methods: This is a prospective comparative study of data from 112 patients with chronic wounds, of which 56 patients underwent topical negative pressure dressings (17 diabetic, 10 pressure sores, nine ischemic, two varicose, 10 post-infective raw areas and eight traumatic - six had bone exposed, two orthopaedic prosthesis exposed). The remaining 56 patients underwent conventional moist dressings (20 diabetic, two ischemic, 15 pressure sores, three varicose, eight post-infective raw areas and eight traumatic - five had bone exposed, three orthopaedic prosthesis exposed). The results were compared after 10 days. The variables compared were, rate of granulation tissue formation as a percentage of ulcer area covered, skin graft take up as the percentage of ulcer surface area and duration of hospital stay. The variables were compared using Unpaired Student′s t test. A " P" value < 0.05 was considered significant. Results: Out of 56 patients who underwent topical negative pressure dressings, six (10.71%) were failures, due to failure in maintaining topical negative pressure due to defective sealing technique; these were included into the study group. After 10 days, the mean rate of granulation tissue formation was 71.43% of ulcer surface area. All these 56 cases underwent split-thickness skin grafting. The mean graft take-up was 79.29%. The mean hospital stay was 32.64 days. In the remaining 56 patients, the mean rate of granulation tissue formation was 52.85% of ulcer surface area. The mean graft take-up was only 60.45% of the total ulcer surface area. The mean hospital stay was 60.45 days. Conclusion: To conclude, topical negative pressure dressings help in faster healing of chronic wounds and better graft take-up and reduce hospital stay of these patients.

Topical Negative Pressure Wound Therapy of Burned Hands

2017 ◽  
pp. 1
Author(s):  
Denis Ehrl ◽  
Paul I. Heidekrueger ◽  
P. Niclas Broer ◽  
Holger C. Erne
Keyword(s):  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Wound Therapy ◽  
Topical Negative Pressure

Systematic review of molecular mechanism of action of negative-pressure wound therapy

2014 ◽  
Vol 101 (13) ◽  
pp. 1627-1636 ◽  
Author(s):  
G. E. Glass ◽  
G. F. Murphy ◽  
A. Esmaeili ◽  
L.-M. Lai ◽  
J. Nanchahal
Keyword(s):  
Systematic Review ◽  
Molecular Mechanism ◽  
Mechanism Of Action ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Wound Therapy ◽  
Molecular Mechanism Of Action

scholarly journals Clinical Outcomes of Negative-Pressure Wound Therapy with Instillation without Commercial Devices in the Treatment of Complex Wounds

2020 ◽  
Vol 16 (1) ◽  
pp. 13-20
Author(s):  
Ji Yoon Sung ◽  
Yong Chan Bae ◽  
Su Bong Nam ◽  
Joo Hyoung Kim
Keyword(s):  
Clinical Outcomes ◽  
Negative Pressure ◽  
Surgical Procedure ◽  
Negative Pressure Wound Therapy ◽  
Chronic Wounds ◽  
Infection Type ◽  
Adjunctive Treatment ◽  
Wound Therapy ◽  
Infected Wounds ◽  
Complex Wounds

Background: Negative-pressure wound therapy with instillation (NPWTi) is an adjunctive treatment modality for complex and infected wounds. However, commercial devices are expensive and not readily available in many countries. The objective of this study is to introduce an NPWTi method that is applicable where commercial NPWTi devices are not available and to report the clinical outcomes of the NPWTi method for the adjunctive treatment of complex wounds.Methods: This prospective clinical experimental study included 51 patients who had wounds on which operative debridement was performed between January 2017 and March 2019. A negative-pressure wound therapy (NPWT) device was applied with an intravenous (IV) line for continuous instillation of 0.9% normal saline plus 1% povidone-iodine solution for chronic wounds. The outcomes measured were the number of operating room visits, time to final surgical procedure, number of infected wounds, time to resolution of infection, type of reconstruction operation, and occurrence of complications.Results: The average number of operations performed was 2.5±0.8, and the time to final surgical procedure was 28.4±15.4 days. The number of infected wounds was 35 (68.6%), and the time to resolution of infection was 15.0±14.6 days. All wounds were closed or covered. Though partial graft failure occurred in two cases, they healed completely by secondary healing in 2 weeks.Conclusion: A continuous-instillation NPWT system using an IV line could be an adjunctive modality in treating complex wounds at institutions where commercial NPWTi systems are not readily available.

scholarly journals The application of enhanced recovery after surgery and negative-pressure wound therapy in the perioperative period of elderly patients with colorectal cancer

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Han-rong Liu ◽  
Ping Yang ◽  
Song Han ◽  
Yu Zhang ◽  
Hui-yin Zhu
Keyword(s):  
Colorectal Cancer ◽  
Wound Healing ◽  
Negative Pressure ◽  
Wound Dressing ◽  
Readmission Rate ◽  
Negative Pressure Wound Therapy ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Perioperative Period ◽  
Wound Therapy

Abstract Objective To Explore the perioperative application of enhanced recovery after surgery (ERAS) and negative-pressure wound therapy in the elderly patients with colorectal cancer. Methods A retrospective clinical data were studied in the patients with colorectal cancer in Department of General Surgery in Shanghai Fourth People,s Hospital (from March, 2017 to March, 2019), One hundred and fifty patients with undergoing radical surgery for colorectal cancer were divided into two groups: ERAS group (n = 76 cases, accepting ERAS management) and Conventional treatment(CT) group (n = 74 cases, accepting traditional treatment), Bleeding in operation, the time of postoperative anal flatus, number of wound dressing changing, time of wound healing, the length of postoperative hospital stay, readmission rate, postoperative complication, were compared between the two groups. Results ERAS was associated with less bleeding in operation, less Wound fat liquefaction, less wound dressing changing, less time of wound healing, less time of postoperative anal flatus compare to CT group (P < 0.05); anastomotic fistula, readmission rate is similar in two groups (P > 0.05). Conclusion The modified ERAS can be safely applied to the perioperative period of elderly colorectal cancer patients and promote recovery; negative-pressure wound therapy is helpful for wound healing and promoting rehabilitation.

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