scholarly journals Treatment of HeartMate III–LVAD driveline infection by negative pressure wound therapy: Result of our case series

2021 ◽  
pp. 039139882110472
Author(s):  
Mustafa Cikirikcioglu ◽  
Kevin Ponchant ◽  
Nicolas Murith ◽  
Philippe Meyer ◽  
Nurcan Yilmaz ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Good Condition ◽  
Case Series ◽  
Recurrent Infection ◽  
Left Ventricular ◽  
Wound Therapy ◽  
Ventricular Assist ◽  
Invasive Approach ◽  
Driveline Infection

Driveline infection is one of the most frequent complications following left ventricular assist device (LVAD) treatment and there is no consensus for its management. The standard approach to treat foreign-body infection is complete device ablation, which is not always feasible and therefore not an elected method for LVAD driveline infections. Here we share the results from a series of cases successfully treated for driveline infection by negative pressure wound therapy (NPWT) therapy. Between 2016 and 2020, five male patients were hospitalized in our unit with a driveline infection of HeartMate III-LVAD®. Ultrasonography and/or thoraco-abdominal CT confirmed the diagnosis, infection localization, and abscess formation. Following an antibiotic treatment, an urgent surgical abscess drainage and debridement of the infected tissues were performed. At the end of the procedure, NPWT was applied. NPWT re-dressing and debridement of wound was performed every 3–4 days. The wound was closed surgically after obtaining negative culture results and good healing. The patients were discharged in good condition, without signs of infection. Two patients underwent successful heart transplantation after 1 and 13 months. Other patients did not show any residual or recurrent infection during the follow-up within 25 months. Driveline infection following LVAD implantation is a significant complication and a challenging in terms of management for both; the surgical team and the patient. These results from our case series report a successful and less invasive approach by using NPWT for the treatment of LVAD driveline infections.

scholarly journals VeraFlo Negative Pressure Wound Therapy with Household Bleach for Refractory Driveline Infection in a Patient with Left Ventricular Assist Device.

2015 ◽  
Author(s):  
Amr Idris ◽  
Amanda Hart ◽  
Sarah Branam ◽  
Maya Guglin
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Left Ventricular Assist Device ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Left Ventricular ◽  
Drug Resistant ◽  
Wound Therapy ◽  
Assist Device ◽  
Ventricular Assist ◽  
Left Ventricular Assist

Driveline infections and sepsis are amongst the most common causes of morbidity and mortality in a patient with a left ventricular assist device. In this case, we present a patient with a multi drug resistant pseudomonas aeruginosa driveline exit site infection. Initially, it was treated with dual antibiotics, followed by surgical debridement utilizing Dakin’s solution irrigation and standard negative pressure wound therapy. Wound healing was minimal determined by poor granulation appearance, unchanged size from surgical debridement, purulent drainage, and the wound base remained colonized with multi drug resistant pseudomonas aeruginosa. A novel treatment of VeraFlo negative pressure wound therapy in conjunction with indwelling Dakin’s solution into the wound base was introduced. This treatment resulted in improved granulation appearance, decreased drainage, decreasing in wound size, with positive changes noticeable in 7 days. We suggest that the use of VeraFlo negative pressure wound therapy may be used for treatment for cumbersome driveline infections.

scholarly journals New Treatment for Driveline Infection Following Implantation of a Ventricular Assist Device

2020 ◽  
Vol 23 (2) ◽  
pp. E132-E134 ◽  
Author(s):  
Akira Sezai ◽  
Satoshi Unosawa ◽  
Makoto Taoka ◽  
Shunji Osaka ◽  
Yoshiki Kitazumi ◽  
...  
Keyword(s):  
Ventricular Assist Device ◽  
Outpatient Clinic ◽  
Negative Pressure ◽  
Early Treatment ◽  
Negative Pressure Wound Therapy ◽  
Wound Therapy ◽  
Assist Device ◽  
Ventricular Assist ◽  
Driveline Infection ◽  
New Treatment

In patients with an implantable ventricular assist device (VAD), driveline infection (DLI) is a challenging complication. Once DLI occurs, it may lead to pump contamination and/or septicemia, which means that early treatment is essential. We hereby report our initial experiences of a mechanically-powered portable negative pressure wound therapy system (Smart Negative Pressure: SNaPTM) to treat DLI at an outpatient clinic.

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.

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.

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.

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