scholarly journals The efficacy of negative pressure wound therapy in treating sacroiliac joint tuberculosis with a chronic sinus tract: a case series

Author(s):  
Xiaobo Luo ◽  
Xiangyu Tang ◽  
Yuanzheng Ma ◽  
Yonggang Zhang ◽  
Shuzhi Fang
2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S195-S195
Author(s):  
Nicole M Kopari ◽  
Yazen Qumsiyeh

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.


2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
N Browning ◽  
M Okocha ◽  
M Doe ◽  
A Lyons ◽  
H Sumrien

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.


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 ◽  
...  

2019 ◽  
Vol 7 (2) ◽  
pp. e000751
Author(s):  
Sofia Garcia-Pertierra ◽  
Nuria Vizcaino Reves ◽  
Araceli Calvo Aguado

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.


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.


Author(s):  
JiaJun Tang ◽  
Guilu Tao ◽  
Yingkai Liu ◽  
Xian Ma ◽  
Yakupu Aobuliaximu ◽  
...  

The sinus tract of the ischial tuberosity is often caused by pressure injury. It has the characteristics of difficult treatment and high cost, which increases the anxiety of patients and reduces the quality of life of patients. This case report is to describe an effective method to treat sinus wound at the ischial tuberosity. A 53-year-old male suffered pressure ulcer with sinus wound at the left ischial tuberosity due to inadequate walking and sedentary activity. On the basis of pressure relief and immobilization, the patient was treated with CO2 laser debridement and negative pressure wound therapy under endoscope support 3 times, the deep of the sinus wound was completely closed, and then the residual superficial wound was treated by skin grafting. Follow-up of 1 year after healing showed no recurrence of wound.


2019 ◽  
Vol 28 (Sup9) ◽  
pp. S28-S37 ◽  
Author(s):  
Rose Raizman

Objective: Knowledge of wound bioburden can guide selection of therapies, for example, the use of negative pressure wound therapy (NPWT) devices with instillation in a heavily contaminated wound. Wound and periwound bacteria can be visualised in real-time using a novel, non-contact, handheld fluorescence imaging device that emits a safe violet light. This device was used to monitor bacterial burden in patients undergoing NPWT. Methods: Diverse wounds undergoing NPWT were imaged for bacterial (red or cyan) fluorescence as part of routine wound assessments. Results: We assessed 11 wounds undergoing NPWT. Bacterial fluorescence was detected under sealed, optically-transparent (routine) adhesive before dressing changes, on foam dressings, within the wound bed, and on periwound tissues. Bacterial visualisation in real-time helped to guide: (1) bioburden-based, personalised treatment regimens, (2) clinician selection of NPWT, with or without instillation of wound cleansers, and (3) the extent and location of wound cleaning during dressing changes. The ability to visualise bacteria before removal of dressings led to expedited dressing changes when heavy bioburden was detected and postponement of dressing changes for 24 hours when red fluorescence was not observed, avoiding unnecessary disturbance of the wound bed. Conclusion: Fluorescence imaging of bacteria prompted and helped guide the timing of dressing changes, the extent of wound cleaning, and selection of the appropriate and most cost-effective NPWT (standard versus instillation). These results highlight the capability of bacterial fluorescence imaging to provide invaluable real-time information on a wound's bioburden, contributing to clinician treatment decisions in cases where bacterial contamination could impede wound healing.


2019 ◽  
Vol 28 (4) ◽  
pp. 240-244
Author(s):  
Fatma Nihal Durmus Kocaaslan ◽  
Melekber Cavus Ozkan ◽  
Zeynep Akdeniz ◽  
Bulent Sacak ◽  
Bulent Erol ◽  
...  

2017 ◽  
Vol 25 (2) ◽  
pp. 85-88 ◽  
Author(s):  
Camilo Partezani Helito ◽  
Daniel Kamura Bueno ◽  
Pedro Nogueira Giglio ◽  
Marcelo Batista Bonadio ◽  
José Ricardo Pécora ◽  
...  

ABSTRACT Objective: To present an experience with negative-pressure wound therapy (NPWT) in the treatment of surgical wounds in patients treated for infections after total knee arthroplasty (TKA) with or without dehiscence and prophylaxis in wounds considered at risk of healing problems. Methods: We prospectively evaluated patients with TKA infection with or without surgical wound dehiscence and patients with risk factors for infection or surgical wound complications treated with Pico(r) device for NPWT in addition to standard treatment of infection or dehiscence in our institution. We considered as an initial favorable outcome the resolution of the infectious process and the closure of the surgical wound dehiscences in the treated cases and the good progression of the wound without complicating events in the prophylactic cases. Results: We evaluated 10 patients who used Pico(r) in our service. All patients had a favorable outcome according to established criteria. No complications were identified regarding the use of the NPWT device. The mean follow-up of the patients after the use of the device was 10.5 months. Conclusion: The NPWT can be safely used in wound infections and complications following TKA with promising results. Long-term randomized prospective studies should be conducted to prove its effectiveness. Level of Evidence IV, Case Series.


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