Successful management of complex scalp wounds with exposed calvarial bones by customized Negative pressure wound therapy (NPWT): Case series and review of the literature

2022 ◽  
pp. 004947552110433
Author(s):  
Haroon R Zargar ◽  
Mir Mohsin ◽  
Raheeb A Shah ◽  
Mir Yasir ◽  
Tanveer A Bhat ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Case Series ◽  
Major Complication ◽  
Wound Treatment ◽  
Review Of The Literature ◽  
Successful Management ◽  
Wound Therapy ◽  
Exposed Bone ◽  
Animal Bites

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.

NEGATIVE PRESSURE WOUND THERAPY IN WARTIME WOUNDS - CASE SERIES AND REVIEW OF THE LITERATURE

2018 ◽  
Vol 4 (3) ◽  
pp. 138
Author(s):  
Georgi Popivanov ◽  
Ivan Inkov ◽  
Georgi Kovachev ◽  
Kirien Kjossev ◽  
Anthony Philipov ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Case Series ◽  
Review Of The Literature ◽  
Wound Therapy

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.

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.

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
Keyword(s):  
Teaching Hospital ◽  
Granulation Tissue ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Wound Therapy ◽  
Significant Challenge ◽  
Exposed Bone

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.

scholarly journals 1431 Stoma Intubation, Isolation and Negative Pressure Wound Therapy for Complex Stoma-Associated Wounds: New Technique and Case Series

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
N Browning ◽  
M Okocha ◽  
M Doe ◽  
A Lyons ◽  
H Sumrien
Keyword(s):  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Enterocutaneous Fistula ◽  
Loop Ileostomy ◽  
Case Series ◽  
Complete Healing ◽  
Wound Therapy ◽  
First Case ◽  
Isolation Device ◽  
Commercial Device

Abstract Background The use of negative pressure wound therapy (NPWT) in colorectal surgery has been demonstrated for treating perineal defects, enterocutaneous fistula and stoma dehiscence. Here we describe a technique for closure of complex stoma-associated wounds using a novel commercial intubation device alongside NPWT to protect the surrounding wound from the stoma effluent. The device has previously described for use with enterocutaneous fistula. We present two cases that have been successfully treated with this technique. Technique and Cases The first case is of 88-year-old women with a retracted loop ileostomy and the second a 48 year-old male with a retracted end colostomy. Both patients underwent significant emergency peristomal debridement and in both cases the commercial device was deployed to intubate the stoma. VAC foam and standard adhesive dressings were used to form a quality seal and the pressure set to 125mmHg. In both cases near complete healing was achieved to the point that standard stoma bags and management could be used. Conclusions This is the first description of the use of an isolation device in complex stoma associated wounds. We have found the Fistula Funnel to be highly effective in this context.

scholarly journals Negative pressure wound therapy for massive subcutaneous emphysema: a systematic review and case series

2021 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
Nicky Janssen ◽  
Iris E. W. G. Laven ◽  
Jean H. T. Daemen ◽  
Karel W. E. Hulsewé ◽  
Yvonne L. J. Vissers ◽  
...  
Keyword(s):  
Systematic Review ◽  
Subcutaneous Emphysema ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Case Series ◽  
Wound Therapy

Negative-pressure wound therapy for high-risk surgical incision wounds using an ultra-portable device: 11 cases

2019 ◽  
Vol 7 (2) ◽  
pp. e000751
Author(s):  
Sofia Garcia-Pertierra ◽  
Nuria Vizcaino Reves ◽  
Araceli Calvo Aguado
Keyword(s):  
High Risk ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Healing Process ◽  
Case Series ◽  
Portable Device ◽  
Wound Therapy ◽  
Surgical Incision ◽  
Early Ambulation ◽  
Healing Wounds

Negative-pressure wound therapy (NPWT) involves the application of subatmospheric pressure to a wound to help in the healing process. The objective of this case series was to evaluate the clinical experience using ultra-portable NPWT devices on high-risk closed incisions after surgical management of complex non-healing wounds. Data were available for eight dogs and three cats. Wound aetiologies varied from traumatic, neoplastic and foreign body. Application and maintenance of the portable device were technically easy in most cases, finding some difficulties when applied to curved body surfaces. All patients’ outcome was highly rewarding. This case series suggests that portable NPWT helps in achieving full recovery, increases comfort allowing early ambulation and feeding, and reduces hospitalisation time. Their reduced size is suitable for smaller animals, enhancing their therapeutic use in veterinary medicine.

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