High bacterial load in negative pressure wound therapy (NPWT) foams used in the treatment of chronic wounds

2013 ◽  
Vol 21 (5) ◽  
pp. 677-681 ◽  
Author(s):  
Erlangga Yusuf ◽  
Xavier Jordan ◽  
Martin Clauss ◽  
Olivier Borens ◽  
Mark Mäder ◽  
...  
2020 ◽  
Vol 99 (4) ◽  
pp. 183-188

Modern medicine offers a wide spectrum of wound healing resources for acute or chronic wounds. Negative pressure wound therapy (NPWT) is a very effective method, allowing complicated defects and wounds to heal. The basic set is usually provided with various special accessories to facilitate the use and support safe application of NPWT to high-risk tissue. Selected case reports are presented herein to document the special use and combinations of materials in negative pressure wound therapy.


2013 ◽  
Vol 12 (4) ◽  
pp. 436-442 ◽  
Author(s):  
Vijay Langer ◽  
Prem S Bhandari ◽  
Satyamoorthy Rajagopalan ◽  
Mrinal K Mukherjee

2005 ◽  
Vol 95 (2) ◽  
pp. 171-174 ◽  
Author(s):  
Stephen M. Geller ◽  
James A. Longton

Pyoderma gangrenosum is a skin disease characterized by wounds with blue-to-purple undermined borders surrounding purulent necrotic bases. This article reports on a patient with a circumferential, full-thickness, and partially necrotic lower-extremity ulceration of unknown etiology. Results of laboratory tests and arterial and venous imaging studies were found to be within normal limits. The diagnosis of pyoderma gangrenosum was made on the basis of the histologic appearance of the wound tissue after biopsy as a diagnosis of exclusion. Negative pressure wound therapy was undertaken, which saved the patient’s leg from amputation. Although negative pressure wound therapy has demonstrated efficacy in the treatment of chronic wounds in a variety of circumstances, this is the first documented use of this technique to treat an ulceration secondary to pyoderma gangrenosum. (J Am Podiatr Med Assoc 95(2): 171–174, 2005)


2020 ◽  
Vol 16 (1) ◽  
pp. 13-20
Author(s):  
Ji Yoon Sung ◽  
Yong Chan Bae ◽  
Su Bong Nam ◽  
Joo Hyoung Kim

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.


Cells ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 732
Author(s):  
Christian D. Taeger ◽  
Stefan Wallner ◽  
Teresa Martini ◽  
Daniel Schiltz ◽  
Andreas Kehrer ◽  
...  

Background: During negative pressure wound therapy (NPWT), open wounds are draped with a nontransparent sponge, making daily wound evaluation impossible. Sometimes, late or undetected bacterial infections and postoperative bleeding result in repetitive surgery, thus prolonging inpatient time. With the introduction of additional fluid instillation (NPWTi), the wound surface is rinsed, and bacteria, proteins and biomarkers are flushed into a collecting canister, which is later discarded. Methods: The aim of this pilot study was to analyze rinsing fluid samples (0.9% sodium chloride) from the NPWTi device in patients with acute and chronic wounds. In 31 consecutive patients a standardized laboratory analysis was performed to evaluate cellular composition and potassium, phosphate, lactate dehydrooxygenase, pH and total protein levels. Results: While there was an increase in the total cellular amount and the number of polymorphonuclear cells, the number of red blood cells (RBC) decreased after surgery. Potassium and pH showed no significant changes in the first three postoperative days, whereas total protein showed an undulant and partially significant course. Conclusion: We were able to quantify cellular metabolites by analyzing the rinsing fluid of NPWTi. We propose the analysis of this material as a novel and potentially promising tool to monitor wound status without removal of the dressing. The establishment of reference values might help to improve the NPWTi therapy.


2014 ◽  
Vol 1 (1) ◽  
Author(s):  
Vivano Conference

During a two-day conference international speakers presented their experiences with negative pressure wound therapy in chronic wounds but also in cases of third- and fourth-degree burns, in complex surgical interventions of the abdominal region, in open fractures as well as in thoracic and cardiac surgery. The this year’s conference focused on questions whether negative pressure wound therapy (NPWT) resulted in wound healing more often and more quickly than standard wound therapy, for which indications can NPWT be used and how should the cost-benefit ratio be evaluated.


Author(s):  
I.M. Zazirnyi ◽  
D.D. Kravchenko ◽  
A. Andreev

Summary. Negative pressure wound therapy (NPWT), in its most used Vacuum Assisted Closure (VAC) variant, consists in applying subatmospheric pressure to a wound that is sealed off by a specially designed dressing and connected by a tube to a suction pump and drainage collection system. Skin defects are extremely common in orthopedic and trauma surgery. VAC is valuable across a range of indications. Proven effects include an increase in blood flow, stimulation of angiogenesis, and a decrease in wound surface area. VAC can be used to treat post-traumatic and surgical wounds, burns, and chronic wounds such as pressure sores and ulcers. The lower frequency of dressing changes with VAC lightens the staff workload. The public health services of Australia, Belgium, Canada, New Zealand, the United States, Germany, and France have issued good practice guidelines for the use of VAC in specific and limited indications. VAC has benefited from the introduction of several technological improvements such as silicone interfaces, foam dressings with various densities and pore sizes, and irrigation systems. The result of using this method is greater adaptability to each specific situation. Nevertheless, VAC is not appropriate in every case and cannot replace a necessary surgical procedure. The aim of this study is to review the principles, practical modalities, and indications of VAC.


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