Reconstruction of an Octogenarian Major Pretibial Degloving Injury Utilizing Negative Pressure Wound Therapy and Subsequently Combining Fenestrated-Type Artificial Dermis Without Skin Grafting

2021 ◽  
pp. 153473462098325
Author(s):  
Wei-Chung Hung ◽  
Maria Chicco ◽  
Tony Chieh-Ting Huang ◽  
Hsu-Tang Cheng
Keyword(s):  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Combined Therapy ◽  
Skin Grafting ◽  
Soft Tissue Coverage ◽  
Wound Therapy ◽  
Secondary Intention ◽  
Artificial Dermis ◽  
Degloving Injury ◽  
Degloving Injuries

Major pretibial degloving injuries are complex wounds, which can be challenging to treat. Despite recent advances in reconstructive options, most of these injuries still require a prolonged healing period and may result in amputation. Few reports have been published on the management of these complex traumatic injuries. In this article, we present a case of an octogenarian, frail patient with a major pretibial degloving injury. Treatment included serial surgical debridements in combination with negative pressure wound therapy aimed at salvaging the avulsed tissue. Subsequently, a fenestrated-type artificial dermis and negative pressure wound therapy were used as combined therapy so as to obtain adequate soft tissue coverage. The patient made an unremarkable recovery and was discharged on day 22 after injury. The wound healed by secondary intention without need for skin grafting.

scholarly journals Negative pressure wound therapy as a „bridge” forthe final reconstruction of tissue defect following adegloving injury of the forearm – a case report

2019 ◽  
Vol 6 (3) ◽  
pp. 4-7
Author(s):  
Izabela Ratnicka ◽  
Karolina Kondej ◽  
Justyna Jończyk ◽  
Magdalena Graczyk ◽  
Barbara Chrzanowska ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Subcutaneous Tissue ◽  
Skin Grafting ◽  
Conveyor Belt ◽  
Complex Nature ◽  
Wound Therapy ◽  
Degloving Injury ◽  
The Right ◽  
Degloving Injuries

Degloving injuries are traumatic avulsions usually resulting in large areas of soft tissue defects. The injury involves separation of skin and subcutaneous tissue from fascia and muscles. The complex nature of these injuries requires a patient-oriented multidisciplinary surgical approach and a wide variety of therapeutic options. Negative pressure wound therapy can be of benefit at every stage of the long-lasting treatment. In this paper, we present a case of a 29-year-old male after an occupational accident with a conveyor belt leading to a degloving injury of the right forearm treated in the Department of Plastic Surgery of the Medical University in Gdańsk. The use of NPWT, hyperbaric oxygen therapy, dermal regeneration templates, skin grafting, and early rehabilitation resulted in an excellent functional and aesthetic outcome.

scholarly journals Full circumference lower extremity degloving injury treated with hydrosurgical debridement and negative-pressure wound therapy with gauze wound filler for fixation of avulsed flap skin grafts

2020 ◽  
Vol 2020 (12) ◽  
Author(s):  
Tae Nagama ◽  
Natsuko Kakudo ◽  
Atsuyuki Kuro ◽  
Yujiro Ozaki ◽  
Yasuko Shirasawa ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Traumatic Injury ◽  
Skin Grafts ◽  
Wound Therapy ◽  
Left Lower Extremity ◽  
Degloving Injury ◽  
Severe Traumatic Injury ◽  
Degloving Injuries

Abstract Degloving, a skin and subcutis avulsion, is a severe traumatic injury sometimes caused by rolling wheels or machines. Although avulsed flaps are often readapted to its original site, most of these tissues become necrotic. Due to the extensive skin and soft tissue deficiency caused by necrosis, treatment becomes difficult. Skin grafts harvested from avulsed flaps may be used to treat degloving injuries, while negative pressure wound therapy (NPWT) is used to secure the grafts. Commonly used porous polyurethane foam wound fillers are difficult to set in circumferential extremity degloving injuries; gauze-based wound fillers are easier to use and cause less pain during dressing changes. We present a case of an extensive, full-circumference left lower-extremity degloving injury, treated using NPWT with gauze-based wound fillers for fixation of skin grafts harvested from avulsed flaps after hydrosurgical debridement. For complex wound geometries, gauze-based wound fillers can be easily applied for skin graft immobilization.

Cost-efficacy of skin grafting techniques using negative pressure wound therapy and tissue-engineered skin for burns

2021 ◽  
Author(s):  
Muhammad Hanif Nadhif ◽  
Muhammad Satrio Utomo ◽  
Muhammad Farel Ferian ◽  
Farhan H. Taufikulhakim ◽  
Nadine H. P. Soerojo ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Skin Grafting ◽  
Wound Therapy ◽  
Cost Efficacy

Combination of Three Different Negative Pressure Wound Therapy Applications and Free Flap for Open Elbow Joint Injury With Extensive Burns

2021 ◽  
Author(s):  
Junya Oshima ◽  
Kaoru Sasaki ◽  
Yukiko Aihara ◽  
Masahiro Sasaki ◽  
Yoichiro Shibuya ◽  
...  
Keyword(s):  
Free Flap ◽  
Negative Pressure ◽  
Elbow Joint ◽  
Negative Pressure Wound Therapy ◽  
Skin Grafting ◽  
Perioperative Period ◽  
Wound Therapy ◽  
Joint Injury ◽  
Left Limb ◽  
Effective Option

Abstract Negative pressure wound therapy (NPWT) for treating burns has a variety of therapeutic applications. Here, we present a case of a 53-year-old woman with self-inflicted burn injuries in whom NPWT was applied for three different purposes. The injured sites were the anterior neck, bilateral arms from the wrists upwards to the chest, and back. The left arm was deeply injured, and the elbow joint cavity was opened during treatment. First, NPWT was used for bridge to skin grafting on the entire upper left limb. Second, NPWT was used as a bolster dressing for the autograft after skin grafting was performed on the left arm except the open part of the joint. Third, NPWT over flap was used on the subsequent flap surgical site to address prolonged exudate from the flap margin. The exudate resolved after about a week. Good results were obtained using NPWT during the perioperative period of free flap transplantation for extensive open elbow joint burns. The use of NPWT is an effective option in the treatment of burns.

Negative-Pressure Wound Therapy and External Fixation for Infection and Hematoma After Hallux Abducto Valgus Surgery

2007 ◽  
Vol 97 (5) ◽  
pp. 410-414 ◽  
Author(s):  
Edward Ferdinando ◽  
Laura Guerin ◽  
Aluko O. Jervis ◽  
Henrietta Obidigbo
Keyword(s):  
Soft Tissue ◽  
External Fixation ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Early Recognition ◽  
Metatarsophalangeal Joint ◽  
Postoperative Phase ◽  
Soft Tissue Coverage ◽  
Wound Therapy ◽  
First Metatarsophalangeal Joint

Hematoma refers to the collection or extravasation of blood, usually clotted, in a closed tissue space. It is caused by leakage from local vessels damaged by blunt trauma, local injury, or surgical dissection. In the postoperative phase, a hematoma often results in edema, pain, wound dehiscence, infection, and scarring of the surgical wound. We describe a 44-year-old woman who developed severe complications, including hematoma, abscess, failure of internal fixation, and loss of soft-tissue structures, after hallux abducto valgus surgery. Hospitalization was required for infection control, soft-tissue coverage through negative-pressure wound therapy, and first metatarsophalangeal joint stabilization through external fixation. Early recognition of the signs of infection and hematoma can help decrease the incidence of postoperative complications. (J Am Podiatr Med Assoc 97(5): 410–414, 2007)

scholarly journals Home based negative pressure wound therapy and moist dressing in the treatment of diabetic foot ulcers

2019 ◽  
Vol 6 (12) ◽  
pp. 4303
Author(s):  
Shiraz Basheer ◽  
Naseef Kannanavil ◽  
Sunil Rajendran
Keyword(s):  
Negative Pressure ◽  
Diabetic Foot ◽  
Negative Pressure Wound Therapy ◽  
Skin Grafting ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Wound Therapy ◽  
Diabetic Ulcer ◽  
Home Based ◽  
Split Skin Grafting

Background: Negative pressure wound therapy (NPWT) is a non-invasive wound closure system that uses controlled, localized negative pressure to help heal chronic and acute wounds. The objective of the present study was to compare home based NPWT and moist wound dressing in home care setting with respect to wound healing and time taken for healing among diabetic ulcer patients and the comparison of cost involved for the treatment.Methods: A hospital based prospective observational study where all patients were presented to the Department of Surgery at MES Medical College with diabetic ulcer between 1st January 2016 and 30th March 2017 were included in the study; ulcer size and surface area were measured using vernier calipers and Wagner’s grade between the two groups were evaluated at the time of enrollment.Results: Complete ulcer healing by primary intention was achieved in 86.8% in home based NPWT group vs. 44.3% in conventional moist dressing group. Average duration taken for healing in home based NPWT patient was 3.03 months and in moist dressing group was 4.58 months. Split skin grafting was needed in 2 patients in HB-NPWT group vs. 7 in moist dressing group. 9.3 hospital visits in HB-NPWT group vs 136.8 sessions in moist dressing group.Conclusions: The present study states that NPWT is superior to conventional moist dressing for the management of chronic diabetic foot ulcers. Cost is approximately 1/10th of standard NPWT.

scholarly journals NEGATIVE PRESSURE WOUND THERAPY AND INTEGRA® DRT FOR AVULSION INJURIES OF THE LOWER EXTREMITIES – PRESENTATION OF TWO CASES AND LITERATURE REVIEW

2019 ◽  
Vol 141 (5-6) ◽  
pp. 146-149
Keyword(s):  
Granulation Tissue ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Initial Period ◽  
Lower Extremities ◽  
Skin Grafting ◽  
Solid Layer ◽  
Wound Therapy ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting

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.

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