scholarly journals Comparison of a standardized negative pressure wound therapy protocol after midline celiotomy to primary skin closure and traditional open wound vacuum-assisted closure management

2018 ◽  
Vol 31 (1) ◽  
pp. 25-29
Author(s):  
Justin L. Regner ◽  
Matthew J. Forestiere ◽  
Yolanda Munoz-Maldonado ◽  
Richard Frazee ◽  
Travis S. Isbell ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Skin Closure ◽  
Vacuum Assisted Closure ◽  
Open Wound ◽  
Wound Therapy ◽  
Therapy Protocol

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.

Negative-pressure wound therapy in the treatment of complex postoperative spinal wound infections: complications and lessons learned using vacuum-assisted closure

2007 ◽  
Vol 6 (5) ◽  
pp. 407-411 ◽  
Author(s):  
G. Alexander Jones ◽  
John Butler ◽  
Isador Lieberman ◽  
Richard Schlenk
Keyword(s):  
Blood Loss ◽  
Antibiotic Therapy ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Bleeding Complications ◽  
Vacuum Assisted Closure ◽  
Wound Therapy ◽  
Intravenous Antibiotic ◽  
Spinal Infections

Object Deep infections of the spine are a significant cause of morbidity and death. Such infections complicate 0.7 to 11.9% of spinal procedures. Management includes intravenous antibiotic therapy, debridement and irrigation with primary closure, placement of drains, use of irrigation systems, and/or healing through secondary intention with wound packing. Vacuum-assisted closure (VAC) is a new alternative for treatment of patients with complex postoperative spinal infections. The aim of this study was to investigate the safety of this treatment method in this patient population. Methods The authors reviewed the charts of 16 consecutive patients treated with negative-pressure wound therapy at their institution between 2002 and 2006. All had deep infections of the spine and were treated with surgical debridement and placement of VAC dressings. All infections were postoperative. Members of the infectious disease service were involved in the care of all patients, and all patients received intravenous antibiotic therapy. The authors reviewed operative notes, discharge summaries, and notes from follow-up visits and assessed outcome on the basis of the same records. Three patients were lost to follow up, leaving a group of 13 with follow up of at least 90 days. Two patients experienced bleeding complications related to the continuous negative pressure of the VAC device. In two cases, the infections persisted and required reoperation. In one case, a skin graft was required because of nonhealing granulation tissue. One of the patients with bleeding complications died as a result of delayed complications related to intraoperative blood loss, blood loss via the VAC system, and refusal of a blood transfusion on religious grounds. Conclusions Negative-pressure wound therapy has been employed as a treatment strategy for patients with complex postoperative spinal infections, but little is known of the complications associated with VAC in the spinal surgery patient population. Serious complications, including death, may be associated with use of the VAC system.

scholarly journals Primary Skin Closure of Stoma Site Wounds Along Skin Cleavage Lines with Negative Pressure Wound Therapy: A Report of Four Cases

2018 ◽  
Vol 71 (4) ◽  
pp. 192-196
Author(s):  
Yusuke Makutani ◽  
Shingo Noura ◽  
Toshinori Sueda ◽  
Tae Matsumura ◽  
Daiki Marukawa ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Skin Closure ◽  
Wound Therapy ◽  
Stoma Site ◽  
Cleavage Lines

scholarly journals Modified negative pressure wound therapy as an adjunct to antibiotics in the treatment of orthopaedic infected metalwork

2021 ◽  
Author(s):  
Selina Summers ◽  
Natasha Faye Daniels ◽  
Azeem Thahir ◽  
Matija Krkovic
Keyword(s):  
Antibiotic Therapy ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Senior Author ◽  
Skin Closure ◽  
Modified Technique ◽  
Wound Therapy ◽  
Implant Retention ◽  
Effective Adjunct

Abstract Purpose Infected orthopaedic metalwork is challenging to treat. Negative pressure wound therapy (NPWT) with irrigation is an emerging therapy for infected wounds as an adjunct to antibiotic therapy. The senior author had devised a modified technique to augment its efficacy, utilising high-flow rate irrigation and skin closure over the standard NPWT dressing. This novel technique was originally evaluated in a different centre and produced 100% success in metalwork retention. The present study is a reproducibility test of the same technique. Methods A retrospective review was performed on 24 patients with infected orthopaedic metalwork, including 3 upper limb and 21 lower limb cases, for outcomes relating to implant retention and infection resolution. Patients underwent a modified NPWT technique as an adjunct to antibiotic therapy and surgical debridement. Detailed medical and microbiology information were obtained from the patient records. Results 23 of 24 (96%) patients had successful metalwork retainment with healed wounds and resolution of infection, allowing fracture union. 27 infective organisms were identified in this cohort, and the antibiotic regimens for each patient are provided. The average follow-up was 663 days. No adverse effects were observed. Conclusion This series supports the modified NPWT technique as a safe, reliable and effective adjunct therapy to resolve metalwork infection. The same results have been reproduced as the previous cohort in a different centre.

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