Experience with use of improvised negative pressure wound therapy in the management of wounds with exposed bone

2020 ◽  
pp. 004947552096274
Author(s):  
Uwakwe C Mba ◽  
Wilfred O Okenwa

Wounds with exposed bone pose a significant challenge in healing. Negative pressure wound therapy has simplified reconstructive options. In economically constrained regions, this has been modified with materials that are affordable. Its effect on such wounds has not been well studied and so case summaries of 15 patients with 17 wounds who were managed with modified negative pressure wound therapy at Ntasiobi Specialist Hospital and ESUT Teaching Hospital between 2015 and 2019 were obtained. The procedure progressed satisfactorily in 88% of patients with granulation tissue covering the bones while the procedure was discontinued in 12%. The modified negative pressure wound therapy achieves similar results as the patented version and is recommended where resources are limited.

2019 ◽  
Vol 13 (1) ◽  
pp. 008
Author(s):  
Amreen Faruq ◽  
HM Sabbir Raihan ◽  
Muhtarima Haque

Background and objectives: Mesh infection following hernia repair has previously often resulted in removal of mesh. The aim of this study was to evaluate if negative pressure wound therapy (NPWT) can be used to treat such complications and preserve the mesh. Materials and method: A prospective study was carried in the Department of Surgery, BIRDEM General Hospital from January 2017 to January 2019. Patients with deep wound infection and exposed infected mesh after hernioplasty were included in the study. Patients’ demographics, existing comorbidities and outcome were recorded. All patients were treated with NPWT till the wound was covered with healthy granulation tissue and closed. Results: NPWT was used to treat 7 patients with mesh infection following hernia repair. There was 2 male and 5 female cases and age ranged from 38-58 years. With NPWT the mesh in 6 patients (86%) out of 7 could be completely salvaged and wound closed with secondary suturing. However, in 1 patient although the mesh covered with granulation tissue by NPWT and wound was closed; but it had to be partly removed later on due to development of chronic discharging sinus 20 days after stitch removal. Conclusion: The study demonstrated that NPWT was a useful technique for the treatment and preservation of infected mesh after hernia repair. IMC J Med Sci 2019; 13(1): 008


2019 ◽  
Vol 141 (5-6) ◽  
pp. 146-149

Two cases which involved a massive avulsion injury of the lower extremities are presented. In both cases the treatment consisted of sequential debridement during the initial period after which negative pressure wound therapy was applied for a period of three to four weeks in order to enable the formation of a solid layer of granulation tissue and a clinically clean wound. Subsequently, INTEGRA® DRTwas fixed to the wound bed with negative pressure wound therapy. During the next three weeks INTEGRA® DRT „integrated“ which enabled split-thickness skin grafting with 0.2 mm thick grafts. In both cases the final outcome was functionally and cosmetically satisfying with near normal contours of the lower extremity restored. Negative pressure wound therapy for a period of three to four weeks enables control of the colonisation of the wound bed and a formation of a solid layer of granulation tissue. The application of INTEGRA® DRT enables formation of the neodermis which provides elasticity and better contours of the reconstructed tissue. A downside of this type of treatment is the price as well as the duration of therapy of about eight weeks.


2013 ◽  
Vol 7 (2) ◽  
pp. 63-66
Author(s):  
Nusrat Shaheed ◽  
A S M Jahangir Chowdhury ◽  
Anadi Ranjan Mondal ◽  
Amal Chandra Paul ◽  
Md Shahin Akhter ◽  
...  

Wound management is a major concern in open fracture cases. Negative Pressure Wound Therapy (NPWT) is an  advanced method for managing open wounds. It is a topical treatment using sub-atmospheric pressure to increase  blood flow, remove bacteria and increase growth of granulation tissue in the wound. The study was performed to  evaluate the results of NPWT in patients with open fracture in lower extremity. Using Aquarium pump as an NPWT  device, 16 patients were prospectly treated for open fractures in their inferior extremity. Mean patients' age range was  21 to 60 yrs. The patients under study either had suffered from trauma, fall or had post operative wound infection.  Many of them had wounds with underlying tendon or bone exposure. Necrotic tissues were debrided before applying  NPWT. Dressings were changed every 3rd or 4th day and treatments were continued for 07 to 28 days. Exposed  tendons and bones were successfully covered with healthy granulation tissue in all cases, depth of the wounds  reduced as well as surface areas. In 12 cases coverage of granulation tissue were achieved and further managed by  skin grafting, 4 cases with wound infections were closed with secondary suture. No significant complications were  noted regarding the treatment. NPWT was found to facilitate the rapid formation of healthy granulation tissue on  open wounds in lower extremity and thus to shorten healing time and minimize secondary soft tissue defect coverage  procedures. DOI: http://dx.doi.org/10.3329/fmcj.v7i2.13500 Faridpur Med. Coll. J. 2012;7(2):63-66


2022 ◽  
pp. 004947552110433
Author(s):  
Haroon R Zargar ◽  
Mir Mohsin ◽  
Raheeb A Shah ◽  
Mir Yasir ◽  
Tanveer A Bhat ◽  
...  

Scalp wounds with exposed calvarial bones continue to be a challenge especially when no local flap options are available and no microvascular flaps can be performed. Our prospective study looked at 19 patients (14 males) where customized negative pressure wound treatment was used till the complex scalp wounds, mostly from animal bites, were covered with healthy granulation and grafted. Scalp wounds ranged from 6 × 4 cm to 17 × 11 cm in size whereas the area of exposed bone ranged from 1 × 2 cm to 10 × 10 cm. No major complication was seen, and wounds were rapidly healed.


2018 ◽  
Vol 65 (1.2) ◽  
pp. 96-102
Author(s):  
Yoshiro Abe ◽  
Ichiro Hashimoto ◽  
Soushi Ishida ◽  
Kazuhide Mineda ◽  
Sho Yoshimoto

2009 ◽  
Vol 75 (11) ◽  
pp. 1128-1131
Author(s):  
S. Lindsey Wong ◽  
Andrew J. Defranzo ◽  
Michael J. Morykwas ◽  
Louis C. Argenta

Brown recluse spider (Loxosceles sp) bites continue to be a significant challenge to manage clinically. Sequelae from these lesions range from chronic necrotic ulcers that persist for months to an acute life-threatening course of sepsis. Negative pressure wound therapy using vacuum-assisted closure (VAC) has been described for use in both acute and chronic wounds. We present a novel application for the use of this therapy in a retrospective review of eight clinical cases treated with the VAC.


2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Fabio Caviggioli ◽  
Francesco Maria Klinger ◽  
Andrea Lisa ◽  
Luca Maione ◽  
Davide Forcellini ◽  
...  

Reconstruction of open abdominal defects is a clinical problem which general and plastic surgeons have to address in cooperation. We report the case of a 66-year-old man who presented an abdominal dehiscence after multiple laparotomies for a sigmoid-rectal adenocarcinoma that infiltrated into the abdominal wall, subsequently complicated by peritonitis and enteric fistula. A cutaneous dehiscence and an incontinent abdominal wall resulted after the last surgery. The abdominal wall was reconstructed using a biological porcine cross-linked mesh Permacol (Covidien Inc., Norwalk, CT). Negative Pressure Wound Therapy (NPWT), instead, was used on the mesh in order to reduce wound dimensions, promote granulation tissue formation, and obtain secondary closure of cutaneous dehiscence which was finally achieved with a split-thickness skin graft. Biological mesh behaved like a scaffold for the granulation tissue that was stimulated by the negative pressure. The biological mesh was rapidly integrated in the abdominal wall restoring abdominal wall continence, while the small dehiscence, still present in the central area, was subsequently covered with a split-thickness skin graft. The combination of these different procedures led us to solve this complicated case obtaining complete wound closure after less than 2 months.


Sign in / Sign up

Export Citation Format

Share Document