scholarly journals Clinical outcome of Maggot Debridement Therapy followed by Negative Pressure Wound Therapy for chronic hand wound with Multi-Drug Resistant Organism infection: Two cases and review of the literature

2021 ◽  
Vol 29 (3) ◽  
pp. 230949902110673
Author(s):  
Zi Hao Phang ◽  
Saw Sian Khoo ◽  
Jayaletchumi Gunasagaran ◽  
Tunku Sara Tunku Ahmad

The advancement in science and research has led to development of medical maggots which feed exclusively on dead tissue. Medical maggots have three important functions namely debridement, disinfection, and stimulation of wound healing. The modern use of medical maggots now goes by the term “Maggot Debridement Therapy” (MDT) for use in wound management. MDT is still used infrequently due to the effectiveness of surgical debridement and antibiotics for treatment of wound infection. Lately, there was emergence of Multi-Drug Resistant Organism (MDRO) likely due to inappropriate antibiotics usage. Maggot secretions have been shown to be effective in inhibiting some MDRO, for example, Methicillin-resistant Staphylococcus aureus, thus making MDT an attractive option for wounds with MDRO. We report two patients with multiple medical comorbidities, diagnosed with serious MDRO Diabetic Hand Infections treated with three cycles of MDT followed by Negative Pressure Wound Therapy.

Redox Biology ◽  
2019 ◽  
Vol 20 ◽  
pp. 307-320 ◽  
Author(s):  
Gregory Lucien Bellot ◽  
Xiaoke Dong ◽  
Amitabha Lahiri ◽  
Sandeep Jacob Sebastin ◽  
Ines Batinic-Haberle ◽  
...  

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Diaa Othman

This is a paper reviewing the National Health Service (NHS) agenda in relation to the use of Negative Pressure Wound Therapy (NPWT) in chronic wound management and assesses the evidence behind it, its cost effectiveness and the outcome it has on patients’ satisfaction and life style. Multiple studies over the last 10 years looking at clinical efficacy of NPWT with its cost effectiveness and the implementation of this service in the UK were reviewed. NPWT has showed a reasonable body of evidence to support its usage in chronic wounds with potential positive outcomes on finance and patients’ satisfaction. However, the NHS system shows significant variations in the availability and implementation of this useful tool, depending on care providers and resources availabilities. The paper concluded that the NPWT can be a useful source of cutting down costs of chronic wound managements and saving money by its effect on expediting wound healing, which can address a part of the financial crises facing the NHS, however, has to be considered according to specific case needs. There should also be a national standard for the availability and indication of this tool to assure equal opportunities for different patients in different areas in the country.


2015 ◽  
Author(s):  
Amr Idris ◽  
Amanda Hart ◽  
Sarah Branam ◽  
Maya Guglin

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.


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


BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yoshinori Yane ◽  
Jin-ichi Hida ◽  
Yusuke Makutani ◽  
Hokuto Ushijima ◽  
Yasumasa Yoshioka ◽  
...  

Abstract Background Temporary stomas have been widely used to avoid the risk of complications such as anastomotic leakage after colorectal resection. Stoma closure is relatively easy; however, postoperative surgical site infection (SSI) may be a problem. Various methods have been used to reduce the incidence of SSI. We aimed to evaluate a new technique for stoma wound closure. Methods We enrolled patients who underwent stoma closure at our hospital between September 2019 and May 2020. We selected patients who lived far from our hospital and had difficulty visiting the hospital regularly and who agreed to undergo this surgical technique. We used negative pressure wound therapy with instillation and dwelling (NPWTi-d) and delayed primary closure for these patients. Results Four patients underwent NPWTi-d and delayed primary closure without the occurrence of SSI. The median postoperative hospital stay was 9 days (range: 7–14 days), and the median number of days to confirmation of epithelialization was 11.5 days (range: 10–16 days). Conclusion The combined use of NPWTi-d and delayed primary closure for the stoma wound was very effective. This method may be a valuable new technique for wound management after stoma closure.


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