scholarly journals Modified negative-pressure wound therapy for linear blister formation prevention around foam dressings: technical note and case series

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Congming Zhang ◽  
Qian Wang ◽  
Zhimeng Wang ◽  
Qiang Huang ◽  
Chenchen Zhang ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Wound Infection ◽  
Incidence Rate ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Conventional Group ◽  
The Novel ◽  
Intact Skin ◽  
Wound Therapy ◽  
Duration Of Hospital Stay

Abstract Background Linear blisters (LBs) often occur around dressings when negative-pressure wound therapy (NPWT) is used to cover open wounds. Tension blisters may increase the wound infection incidence rate, delay the start of operation, and prolong the duration of hospital stay. Currently, there are no established methods for the prevention of LB formation around dressings, which remains to be a major concern in clinical applications. Therefore, we developed a novel, simple, reproducible, and convenient method for preventing LB formation around NPWT dressings. Method Fifty-three cases of Gustilo type II and III open fractures under NPWT were considered. NPWT was used on every wound after debridement. All patients were divided into a conventional group (27 cases, 33 wounds) and a novel group (26 cases, 27 wounds) based on the difference in the NPWT dressing appearance. A healthy volunteer with intact skin was also included to perform the detailed process of NPWT. LBs occurring on intact skin around the dressings were observed and recorded when the dressing was removed 3 days after the operation. The occurrence of LB formation and wound infection was considered as categorical data and compared between the two groups using a chi-square test. The duration of hospital stay was considered as numerical data and compared between the two groups using two independent t tests. Results The percentage of occurrence of LB formation around dressings in the conventional group was 27.3%, whereas it was merely 3.7% in the novel group (P = 0.037). The infection incidence rate in the conventional group was 30.3%, whereas that in the novel group was 25.9%; however, no statistical difference was observed between the two groups (P = 0.708). The average duration of hospital stay in the conventional group was 14.39 ± 4.55 days, whereas that in the novel group was 11.04 ± 3.47 days (P = 0.003). Conclusion Thus, changing the NPWT dressing appearance can prevent LB formation around dressings, providing an effective method to improve NPWT application. Modified NPWT dressings also shorten the duration of hospital stay, but do not significantly decrease the incidence of wound infection.

Negative pressure wound therapy versus conventional dressing for open fractures in lower extremity trauma

2020 ◽  
Vol 102-B (7) ◽  
pp. 912-917 ◽  
Author(s):  
Muhammad Tahir ◽  
Ejaz A. Chaudhry ◽  
Faridullah K. Zimri ◽  
Nadeem Ahmed ◽  
Saeed A. Shaikh ◽  
...  
Keyword(s):  
Wound Infection ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Mean Difference ◽  
Open Fractures ◽  
Life Assessment ◽  
Wound Therapy ◽  
Significant Difference ◽  
Gauze Dressing ◽  
Secondary Outcomes

Aims It has been generally accepted that open fractures require early skeletal stabilization and soft-tissue reconstruction. Traditionally, a standard gauze dressing was applied to open wounds. There has been a recent shift in this paradigm towards negative pressure wound therapy (NPWT). The aim of this study was to compare the clinical outcomes in patients with open tibial fractures receiving standard dressing versus NPWT. Methods This multicentre randomized controlled trial was approved by the ethical review board of a public sector tertiary care institute. Wounds were graded using Gustilo-Anderson (GA) classification, and patients with GA-II to III-C were included in the study. To be eligible, the patient had to present within 72 hours of the injury. The primary outcome of the study was patient-reported Disability Rating Index (DRI) at 12 months. Secondary outcomes included quality of life assessment using 12-Item Short-Form Health Survey questionnaire (SF-12), wound infection rates at six weeks and nonunion rates at 12 months. Logistic regression analysis and independent-samples t-test were applied for secondary outcomes. Analyses of primary and secondary outcomes were performed using SPSS v. 22.0.1 and p-values of < 0.05 were considered significant. Results A total of 486 patients were randomized between January 2016 and December 2018. Overall 206 (49.04%) patients underwent NPWT, while 214 (50.95%) patients were allocated to the standard dressing group. There was no statistically significant difference in DRI at 12 months between NPWT and standard dressing groups (mean difference 0.5; 95% confidence interval (CI) -0.08 to 1.1; p = 0.581). Regarding SF-12 scores at 12 months follow-up, there was no significant difference at any point from injury until 12 months (mean difference 1.4; 95% CI 0.7 to 1.9; p = 0.781). The 30-day deep infection rate was slightly higher in the standard gauze dressing group. The non-union odds were also comparable (odds ratio (OR) 0.90, 95% CI 0.56 to 1.45; p = 0.685). Conclusion Our study concludes that NPWT therapy does not confer benefit over standard dressing technique for open fractures. The DRI, SF-12 scores, wound infection, and nonunion rates were analogous in both study groups. We suggest surgeons continue to use cheaper and more readily available standard dressings. Cite this article: Bone Joint J 2020;102-B(7):912–917.

scholarly journals A Hybrid Technique to Treat Inguinal Wound Infection after Arterial Surgery with Lateral Femoral Bypass and Intra-Incisional Negative Pressure Wound Therapy

2021 ◽  
Author(s):  
Yi-Fan Wu ◽  
Dong Zhang ◽  
Ai-Xi Yu ◽  
Baiwen Qi ◽  
Chao Jian
Keyword(s):  
Wound Infection ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Hybrid Technique ◽  
Wound Therapy ◽  
Imaging Evaluation ◽  
Clinical Challenge ◽  
Vascular Bypass ◽  
Radical Debridement ◽  
Staged Treatment

Abstract Background: Patients with the inguinal wound infection after arterial surgery remains clinical challenge. Sustaining lymphatic leakage have been shown as a common and potentially serious complication. However, it remains clinical challenge for surgery to deal with this tough problem. Methods: This study describes a hybrid technique of using radical debridement, lateral femoral bypass (LFB) and intra-incisional negative pressure wound therapy (iNPWT) for single-staged treatment of complex inguinal wound infection after arterial surgery (IWI-AS).Results: Between January 2017 and June 2021, 5 IWI-AS cases treated with this new method were identified. Of the patients, 3 were males and 2 were females. The average age was 49.4 years (range, 33 to 77 years). 4 cases suffered emergent operations due to the sudden bleedings. after vascular bypass reconstructions and an average of 2.2 (range:1-3) iNWPT, all cases achieved wound healing at an average duration of 4.6 weeks (range: 3-6weeks). Moreover, all cases showed no bacterial growth and grafts patency as indicated by doppler ultrasound or CT angiography postoperatively. One case did not receive bypass imaging evaluation at postoperative 12 months. Weakness of quadriceps femoris was observed in one case. Conclusion: single-staged therapy of LFB and iNPWT hybridization is a technically handy and effective method for treatment of inguinal wound infection after arterial surgery.

Negative Pressure Wound Therapy in Poststernotomy Deep Sternal Wound Infection

2016 ◽  
pp. 41-73
Author(s):  
Christian Willy ◽  
Catharina Scheuermann-Poley ◽  
Marcus Stichling ◽  
Onnen Grauhan ◽  
André Lieber
Keyword(s):  
Wound Infection ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Deep Sternal Wound Infection ◽  
Sternal Wound Infection ◽  
Wound Therapy

scholarly journals Decreasing complications of pectoralis major muscle flap reconstruction with two modalities of negative pressure wound therapy

2021 ◽  
pp. 145749692110433
Author(s):  
Heidi-Mari Myllykangas ◽  
Jari Halonen ◽  
Annastiina Husso ◽  
Leena T. Berg
Keyword(s):  
Wound Infection ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Pectoralis Major Muscle ◽  
Muscle Flap ◽  
Pectoralis Major ◽  
Deep Sternal Wound Infection ◽  
Sternal Wound Infection ◽  
Wound Therapy ◽  
Pectoralis Major Muscle Flap

Background and objective: Deep sternal wound infection is a feared complication of open-heart surgery. Negative pressure wound therapy has gained an important role in the treatment of deep sternal wound infection. Incisional negative pressure wound therapy has been introduced as a method to prevent wound complications after sternotomy, and lately, after flap reconstructions in the treatment of deep sternal wound infection. We aimed to study if incisional negative pressure wound therapy with PICO™ had similar beneficial effect described earlier with competing commercial devices. Methods: This study included 82 patients treated with pectoralis major muscle flap for deep sternal wound infection during the years 2006–2020. PICO group consisted of 24 patients treated with preoperative negative pressure wound therapy and postoperative incisional negative pressure wound therapy (PICO™). Two control groups included 48 patients with conventional treatment and 10 patients with preoperative negative pressure wound therapy only. Results: In the PICO group, the complication rate declined from 50.0% to 33.30%, major complication rate from 29.2% to 12.5%, and need for an additional flap from 14.6.% to 4.2% when compared to conventional treatment. The length of hospital stay decreased as well. Preoperative negative pressure wound therapy alone was associated with moderate decline in the complication rates. In addition, we described the use of split pectoralis major muscle flap reconstruction in 57 patients. To our knowledge, this is the largest published patient series describing this method in the treatment of deep sternal wound infection. Conclusions: Incisional negative pressure wound therapy with PICO™ seems beneficial after flap reconstruction. Split pectoralis major muscle flap is a versatile reconstruction option suitable to be used as a workhorse in the treatment of deep sternal wound infection.

scholarly journals Efficacy of negative pressure wound therapy in open tibial fractures: a prospective study

2018 ◽  
Vol 4 (2) ◽  
pp. 271
Author(s):  
Umang Shihora ◽  
Bimal Modi
Keyword(s):  
Wound Infection ◽  
Negative Pressure ◽  
Open Fracture ◽  
Negative Pressure Wound Therapy ◽  
Medical Science ◽  
Soft Tissue Coverage ◽  
Wound Therapy ◽  
Wound Debridement ◽  
Group A ◽  
Group B

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Open fracture of tibia is a surgical crisis. This study aims to discover out the efficacy of negative pressure wound therapy in these fractures.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">Present study was performed at department of orthopedics, Gujarat Adani institute of medical science, Bhuj, Kutch, Gujarat. 35 patients with type III open Tibia fractures, managed with wound debridement and external fixation were divided in two groups of 17 and 18 as Group A and Group B</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">The incidence of wound infection was fewer and wound coverage was enhanced in Group A (p≤0.05) when compared to Group B. Wound healed before and hospital reside was not as much of in Group A (p&gt;0.05). </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Early on management with debridement after VAC (vacuum assisted closure) therapy has abridged wound infection rate and instance for soft tissue coverage in patients with open fracture tibia.</span></p>

scholarly journals A Hybrid Technique to Treat Inguinal wound Infection after Arterial Surgery with Lateral Femoral Bypass and Intra-incisional Negative Pressure wound Therapy

2021 ◽  
Author(s):  
Yi-Fan Wu ◽  
Dong Zhang ◽  
Ai-Xi Yu ◽  
Baiwen Qi ◽  
Chao Jian
Keyword(s):  
Wound Infection ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Hybrid Technique ◽  
Wound Therapy ◽  
Imaging Evaluation ◽  
Clinical Challenge ◽  
Vascular Bypass ◽  
Radical Debridement ◽  
Staged Treatment

Abstract Background: Patients with the inguinal wound infection after arterial surgery remains clinical challenge. Sustaining lymphatic leakage have been shown as a common and potentially serious complication. However, it remains clinical challenge for surgery to deal with this tough problem. Methods: This study describes a hybrid technique of using radical debridement, lateral femoral bypass (LFB) and intra-incisional negative pressure wound therapy (iNPWT) for single-staged treatment of complex inguinal wound infection after arterial surgery (IWI-AS).Results: Between January 2017 and June 2021, 5 IWI-AS cases treated with this new method were identified. Of the patients, 3 were males and 2 were females. The average age was 49.4 years (range, 33 to 77 years). 4 cases suffered emergent operations due to the sudden bleedings. after vascular bypass reconstructions and an average of 2.2 (range:1-3) iNWPT, all cases achieved wound healing at an average duration of 4.6 weeks (range: 3-6weeks). Moreover, all cases showed no bacterial growth and grafts patency as indicated by doppler ultrasound or CT angiography postoperatively. One case did not receive bypass imaging evaluation at postoperative 12 months. Weakness of quadriceps femoris was observed in one case. Conclusion: single-staged therapy of LFB and iNPWT hybridization is a technically handy and effective method for treatment of inguinal wound infection after arterial surgery.

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