scholarly journals The effectiveness of negative-pressure wound therapy for wound healing after stoma reversal: a randomised control study (SR-PICO study)

Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Sohyun Kim ◽  
Sung Il Kang
Keyword(s):  
Wound Healing ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Intervention Group ◽  
Wound Dressings ◽  
Controlled Study ◽  
Control Group ◽  
Wound Therapy ◽  
Stoma Reversal ◽  
Healing Period

Abstract Background Although the wound-healing period for purse-string closure (PSC) after stoma reversal is longer than that required for the primary closure method, the rate of wound infection is reduced. The application of negative-pressure wound therapy (NPWT) can reduce the healing period for many types of wounds. Herein, we describe a planned trial to test the hypothesis that NPWT can reduce the healing period for PSC after stoma reversal. Methods/design Patients undergoing stoma reversal will be recruited and allocated into intervention and control groups, with 1:1 randomisation. Patients in the control group will receive standard postsurgical wound care; patients in the intervention group will receive NPWT using the PICO™ system. The target sample size will be 38 patients, as this will provide 80% power at the 5% level of significance to detect a 7-day reduction in the wound-healing period in the intervention group compared to that in the control group. The primary endpoint will be the duration to wound healing, defined as the time to nearly complete epithelisation of the wound, without any discharge or surgical site infection (SSI). Secondary endpoints will be the SSI rate, length of postoperative hospital stay, number of wound dressings and visits to the hospital for wound dressing after discharge, total cost of wound dressings, and patient and observer scar assessment scale scores. Discussion The results of this planned randomised controlled study will clarify the role of NPWT in patients undergoing stoma reversal and strengthen the rationale for choosing a dressing technique. Trial registration Clinical Research Information Service (CRIS), KCT0004063. Registered on 6 June 2019.

scholarly journals A Prospective Randomized Study: The Usefulness and Efficacy of Negative Pressure Wound Therapy with Lipidocolloid Polyester Mesh Compared to Traditional Negative Pressure Wound Therapy for Treatment of Pressure Ulcers

Pharmaceutics ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 813
Author(s):  
Wooyeol Baek ◽  
Nara Lee ◽  
Eun Jin Han ◽  
Tai Suk Roh ◽  
Won Jai Lee
Keyword(s):  
Wound Healing ◽  
Pressure Ulcer ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Randomized Study ◽  
Contact Layer ◽  
Control Group ◽  
Wound Therapy ◽  
Group 2 ◽  
Group 1

To improve healing of pressure ulcer wounds, it is important to optimize the conditions of the area surrounding the wound. Negative pressure wound therapy (NPWT) promotes wound healing, however, the removal of NPWT can cause pain or focal bleeding, delaying wound healing or causing infection. In this study, we reviewed the efficacy of the lipidocolloid non-adherent dressing (Urgotul®) as a wound contact layer. A total of 38 patients from the same facility who applied NPWT from April 2016 to October 2019 were included and divided into two groups; NPWT with the lipidocolloid non-adherent dressing (group 1, experimental group, 19 patients) and NPWT only (group 2, control group, 19 patients). The condition of the wound was examined prior to NPWT application, at one week, and again at three weeks after application. No significant differences were found between groups for general characteristics, bacterial culture or photo analysis. However, when comparing groups based on the time of examination, there was a significant reduction of the wound size in group 1 (p = 0.001) but not in group 2 (p = 0.082). Therefore, the current study finds that using the lipidocolloid non-adherent dressing as a wound contact layer in NPWT stimulates healing by shrinking the size of the pressure ulcer wound.

The Effect of Cold Water on Pain Evaluation During Negative Pressure Wound Therapy Dressing Changes: A Prospective, Randomized Controlled Study

2020 ◽  
pp. 153473462095017
Author(s):  
Suphot Chattinnakorn ◽  
Poonpissamai Suwajo ◽  
Jiraroch Meevassana ◽  
Kasama Nilprapha ◽  
Pornthep Pungrasmi ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Room Temperature ◽  
Negative Pressure Wound Therapy ◽  
Cold Water ◽  
Controlled Study ◽  
Control Group ◽  
Sterile Water ◽  
Wound Therapy ◽  
Randomized Controlled ◽  
Dressing Change

Negative pressure wound therapy (NPWT) is a technique using vacuum dressing to promote wound healing in complicated wound. However, for many patients, the application and removal of the NPWT is source of procedural pain. The authors hypothesized that administering cold sterile water into the NPWT sponge would decrease pain during dressing changes. A prospective randomized controlled study was conducted on 27 patients who were undergoing 81 NPWT wound dressing changes (n = 81) at a single institution between October 2016 and September 2017. Each patient had 3 NPWT dressing changes. Cold sterile water (5.74 °C), room temperature sterile water (26.89 °C), and nothing were randomized and administered in the NPWT tubing into the sponge 10 minutes before changing the dressing in each and every procedure. Pain scores were assessed using a 0 to 10 numeric pain scale. Patients administered with cold water reported less pain than those administered with room temperature sterile water during the dressing change (4 vs 5.67; P < .003), and much less pain than those with nothing instilled before dressing change (4 vs 6.59; P < .001). There is no statistically significant difference in pain score between using the room temperature sterile water group and the control group that instilled nothing (5.67 vs 6.59; P = .065). This study has shown that cold water administered through the suction tubing before the dressing change had a better reduction in pain score than using room temperature sterile water and the control group.

Preliminary Outcome of Treatment of Postoperative Primarily Closed Sternotomy Wounds Treated Using Negative Pressure Wound Therapy

2015 ◽  
Vol 86 (10) ◽  
Author(s):  
Anna Witt-Majchrzak ◽  
Piotr Żelazny ◽  
Jadwiga Snarska
Keyword(s):  
Wound Healing ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Therapy Group ◽  
Artery Bypass ◽  
Surgical Techniques ◽  
Group Versus ◽  
Control Group ◽  
Wound Therapy ◽  
Number Of Patients

AbstractHospital infections, and in particular infections of the surgical site are a common problem of the procedural departments. Due to continuous progress of surgical techniques and patient population getting older with multiple co-morbidities, multidirectional actions need to be taken to avoid these infections or, if they do occur, achieve optimal treatment outcomes. Vacuum wound therapy is one of the directions that has been developed over the recent years.evaluate wound healing in patients after an off-pump coronary artery bypass grafting procedure, using the internal mammary artery, treated with negative pressure wound therapy system.This prospective, open label study evaluated healing of postoperative sternotomy wounds after their primary closure with negative pressure wound therapy, using continuous negative pressure of -80 mmHg in 40 patients and 40 patients in a control group in whom conventional dressings were applied in the postoperative period.The number of patients in whom primary wound healing occurred without complications was significantly higher in the negative pressure wound therapy group versus the control group (xNegative pressure wound therapy after primary wound closure reduces the risk of superficial infections in the population with multiple risk factors of complications in the sternotomy wound healing.

scholarly journals Modification of Breast Pump as a Negative Pressure Wound Therapy for Accelerating Wound Healing of Diabetic Ulcer

Jurnal NERS ◽  
2015 ◽  
Vol 10 (1) ◽  
pp. 104 ◽  
Author(s):  
Yunita Sari ◽  
Iwan Purnawan ◽  
Hartono Hartono
Keyword(s):  
Wound Healing ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Control Group ◽  
Necrotic Tissue ◽  
Wound Therapy ◽  
Diabetic Ulcer ◽  
Pressure Therapy ◽  
Breast Pump ◽  
Experimental Group

Introduction: Negative Pressure Wound Therapy (NPWT) is considered as the best treatment for accelerating wound healing, including diabetic ulcer. However, this device is still not available in Indonesia. Therefore, the purpose of this study were to make NPWT by using modifi cation of breast pump, and to elucidate the effect of this device on acceleration of wound healing in diabetic ulcer. Method: NPWT was made by using digital breast pump. Wounds were divided into two groups; wound-treated by NPWT (experimental group) and wound-untreated by NPWT (control). The negative pressure used for this study was 85 mmHg. Rats were sacrifi ced on day 7, and wound samples and surrounding skin were stained with Hematoxylin and Eosyn. Infl ammation, intensity of necrotic tissue, and wound closure were observed. Result: The device could deliver a negative pressure at a range of 85–140 mmHg. Wound size in the experimental group was smaller than in control group. Infl ammation was also less in the experimental group than control group. Discussion: The modifi cation of breast pump could be used as a negative pressure therapy for wounds, and has effect on reducing infl ammation and necrotic tissue. Further study is needed to elucidate the effect of this device on human subject.Keywords: diabetic wound, breast pump, negative pressure, wound healing

scholarly journals The effect of closed-incision negative pressure wound therapy on clinical and ultrasonographic seroma formation and wound healing following forequarter amputation in large dogs - a randomized pilot trial

2020 ◽  
Vol 89 (4) ◽  
pp. 198-207
Author(s):  
N. Vallarino ◽  
N. Devriendt ◽  
A. Koenraadt ◽  
M. Or ◽  
E. Stock ◽  
...  
Keyword(s):  
Wound Healing ◽  
Pilot Study ◽  
Negative Pressure ◽  
Scoring System ◽  
Negative Pressure Wound Therapy ◽  
Pilot Trial ◽  
Seroma Formation ◽  
Control Group ◽  
Wound Therapy ◽  
Forequarter Amputation

This pilot study aimed at evaluating whether closed-incision negative pressure wound therapy (ciNPWT) has an effect on seroma formation and wound healing following forequarter amputation in dogs above 20 kg. Twelve client-owned dogs weighing more than 20 kg, presented for forequarter amputation, were randomly assigned after surgery into two groups (six ciNPWT and six controls with soft-padded bandage, both bandages applied for three days). A clinical and ultrasonographic control (newly developed scoring system) was performed at bandage removal (three days postoperatively) and ten days, postoperatively. A postoperative seroma was present in 4/6 dogs in the ciNPWT group and in 5/6 dogs in the control group. There were no apparent differences in the ultrasonographic scores or subcutis measurements at three versus ten days, postoperatively. The results of this pilot trial do not support expansion to a larger-scale study evaluating ciNPWT after forequarter amputation in dogs.

scholarly journals The Utility of Disposable Negative Pressure Wound Therapy (PICO) in Wound Healing of Latissimus Dorsi Musculocutaneous Flap Donor Sites

2020 ◽  
Vol 16 (1) ◽  
pp. 21-25
Author(s):  
Jeoung Hyun Nam ◽  
Eun Soo Park ◽  
Seok Hwan Kim
Keyword(s):  
Wound Healing ◽  
Negative Pressure ◽  
Latissimus Dorsi ◽  
Negative Pressure Wound Therapy ◽  
Musculocutaneous Flap ◽  
Wound Complications ◽  
Control Group ◽  
Dressing Method ◽  
Wound Therapy ◽  
Latissimus Dorsi Musculocutaneous Flap

Background: Among treatments aiming to solve surgical wound complications, negative pressure wound therapy (NPWT) is considered an innovative method. NPWT can promote wound healing, protect the wound from infection and reduce the tension on suture sites. At the same time, the large machine required in the therapy led to some inconvenience. The PICO system has recently been developed as a simple pocket-sized NPWT device. By comparing the time required for healing of the wound, incidence of wound complications, duration of hospital stays, and dressing costs, we attempted to confirm the utility of PICO for managing latissimus dorsi musculocutaneous flap donor sites.Methods: PICO was used on nine donor sites of patients who had undergone breast reconstruction using latissimus dorsi musculocutaneous flaps. PICO was applied immediately after operation and removed on the 9th day. In the control group, daily conventional dressings were administered commensurate with the condition of the wounds. We defined the wound healing time to the point when no more dressing was needed. For the costs of dressing, only costs incurred on the donor sites were included.Results: Wound healing was proven to be faster in the PICO group (P=0.035) versus the control group, and no complications were observed in the PICO group. Also, the cost of PICO was lower compared to the costs incurred by the conventional dressing method (P<0.001).Conclusion: We suggest that PICO can reduce wound complications on areas where anatomical movement could lead to tension, while also reducing dressing costs.

Closed Incisional Negative Pressure Wound Therapy (ciNPWT) in Oncological Orthopedic Surgery: Preliminary Report

2021 ◽  
Author(s):  
Livia Gabriele ◽  
Gabriele Gariffo ◽  
Stefano Grossi ◽  
Edoardo Ipponi ◽  
Rodolfo Capanna ◽  
...  
Keyword(s):  
Wound Healing ◽  
Length Of Stay ◽  
Orthopedic Surgery ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Surgical Excision ◽  
Control Group ◽  
Wound Therapy ◽  
Wound Site ◽  
Post Surgery

This report presents the authors’ experience with surgical wound-healing using a negative-pressure wound therapy (NPWT) device in a population of oncological orthopedic patients. Two groups of 26 oncological patients each underwent surgical excision. After surgery, the control group received standard dressings and the closed incisional NPWT (ciNPWT) group was treated with a ciNPWT system on the sutured wound area for 14 days. As a primary endpoint, the percentage of post-surgery wound-site complications using ciNPWT devices was compared to that with standard patch dressings. Overall, 30.7% of the control group and 7.7% of the ciNPWT group manifested wound-site complications within 2 weeks after surgery. As a secondary endpoint, final wound healing was compared between the groups: delayed wound healing was observed in 4 (15.4%) patients in the control group and in none (0%) of those in the ciNPWT group. Finally, the length of stay (LOS) was 6.3 days in the control group and 5.1 days in the ciNPWT group. These results suggest that the ciNPWT device could be beneficial in minimizing the incidence of short-term surgical-site complications and decreasing length of stay in high-risk patients, such as those undergoing oncological orthopedic surgery.

Use of incisional vacuum-assisted closure in the prevention of postoperative infection in high-risk patients who underwent spine surgery: a proof-of-concept study

2019 ◽  
Vol 31 (3) ◽  
pp. 430-439 ◽  
Author(s):  
Bailey A. Dyck ◽  
Christopher S. Bailey ◽  
Chris Steyn ◽  
Julia Petrakis ◽  
Jennifer C. Urquhart ◽  
...  
Keyword(s):  
High Risk ◽  
Diagnostic Criteria ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Wound Dressings ◽  
Control Group ◽  
Proof Of Concept ◽  
Risk Of Infection ◽  
Vacuum Assisted Closure ◽  
Wound Therapy

OBJECTIVEThis proof-of-concept study was conducted to determine whether negative-pressure wound therapy, through the use of incisional vacuum-assisted closure (VAC), is associated with a reduction in surgical site infections (SSIs) when compared to standard wound dressings in patients undergoing open posterior spinal fusion who have a high risk of infection.METHODSA total of 64 patients were examined; 21 patients received incisional VAC application (VAC group) versus 43 diagnosis-matched patients who received standard wound dressings (control group). Patients in the VAC group were prospectively enrolled in a consecutive series between March 2013 and March 2014 if they met the following diagnostic criteria for high risk of infection: posterior open surgery across the cervicothoracic junction; thoracic kyphosis due to metastatic disease; high-energy trauma; or multilevel revision reconstructive surgery. Patients in the VAC group also met one or more comorbidity criteria, including body mass index ≥ 35 or < 18.5, diabetes, previous radiation at surgical site, chemotherapy, steroid use, bedridden state, large traumatic soft-tissue disruption, or immunocompromised state. Consecutive patients in the control group were retrospectively selected from the previous year by the same high-risk infection diagnostic criteria as the VAC group. All surgeries were conducted by the same surgeon at a single site. The primary outcome was SSI. All patients had 1 year of follow-up after their surgery. Baseline demographics, intraoperative parameters, and postoperative wound infection rates were compared between groups.RESULTSPatient demographics including underlying comorbidities were similar, with the exception that VAC-treated patients were malnourished (p = 0.020). VAC-treated patients underwent longer surgeries (p < 0.001) and required more postoperative ICU admissions (p = 0.039). The median length of hospital stay was not different between groups. In total, 9 control patients (21%) developed an SSI, versus 2 VAC-treated patients (10%).CONCLUSIONSPatients in this cohort were selected to have an increased risk of infection; accordingly, the rate of SSI was high. However, negative-pressure wound therapy through VAC application to the postoperative incision resulted in a 50% reduction in SSI. No adverse effects were noted secondary to VAC application. The preliminary data confirm the authors’ proof of concept and strongly support the need for a prospective randomized trial.

scholarly journals Reducing Surgical Site Infection with Negative-Pressure Wound Therapy After Open Abdominal Surgery: A Prospective Randomized Controlled Study

2016 ◽  
Vol 106 (3) ◽  
pp. 189-195 ◽  
Author(s):  
P.-Y. Li ◽  
D. Yang ◽  
D. Liu ◽  
S.-J. Sun ◽  
L.-Y. Zhang
Keyword(s):  
Abdominal Surgery ◽  
Surgical Site Infection ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Controlled Study ◽  
Control Group ◽  
Site Infection ◽  
Wound Therapy ◽  
Infection Incidence ◽  
Surgical Site Infection Incidence

Background and Aims: Surgical site infection, in particular superficial incision infection, is a common type of complication following abdominal surgery. Negative-pressure wound therapy has been confirmed to reduce the incidence of surgical site infection in various surgeries, but there are few prospective randomized studies into its application to abdominal surgery. Material and Methods: A prospective randomized controlled study was conducted in which patients with abdominal surgery and open surgery were randomly divided into a negative-pressure wound therapy experimental group and a gauze-covering control group. Information about demographic data, type of surgery, surgical sites, incision treatment outcomes, surgical site infection factors, and follow-up was recorded. Results: From May 2015 to December 2015, 71 patients were enrolled in this study, including 33 in the experimental group and 38 in the control group. There were 10 cases of incision complications, all superficial infections, with an incidence of 14.1%. The surgical site infection incidence was statistically different between the experimental and control groups (3.0% vs 23.7%, p = 0.031). Multivariate logistic regression analysis showed that incision length ⩾20 cm increased the surgical site infection incidence (odds ratio value of 15.576, p = 0.004) and that the application of negative-pressure wound therapy reduced the surgical site infection incidence (odds ratio value of 0.073, p = 0.029). Conclusion: Negative-pressure wound therapy can reduce the incidence of surgical site infection in open abdominal surgery.

Experience of negative pressure wound therapy over sternal wound healing: A retrospective review

WCET Journal ◽  
2019 ◽  
Vol 39 (2) ◽  
pp. 9-18
Author(s):  
Wai Sze Ho ◽  
Wai Kuen Lee ◽  
Ka Kay Chan ◽  
Choi Ching Fong
Keyword(s):  
Wound Healing ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Assessment Tool ◽  
Wound Care ◽  
Wound Therapy ◽  
Treatment Pathways ◽  
Wound Assessment ◽  
One Year

Objectives The aim of this study was to retrospectively review the effectiveness of negative pressure wound therapy (NPWT) in sternal wound healing with the use of the validated Bates-Jensen Wound Assessment Tool (BWAT), and explore the role of NPWT over sternal wounds and future treatment pathways. Methods Data was gathered from patients' medical records and the institution's database clinical management system. Seventeen subjects, who had undergone cardiothoracic surgeries and subsequently consulted the wound care team in one year were reviewed. Fourteen of them were included in the analysis. Healing improvement of each sternal wound under continuous NPWT and continuous conventional dressings was studied. In total, 23 continuous NPWT and 13 conventional dressing episodes were analysed with the BWAT. Results Among conventional dressing episodes, sternal wound improvement was 2.5–3% over 10 days to 3.5 weeks, whereas 4–5% sternal healing was achieved in 5 days to 2 weeks with sternal wire presence. Better healing at 11% in 1 week by conventional dressing was attained after sternal wire removal. In NPWT episodes, 8–29%, 13–24%, and 15–46% of healing was observed in 2 weeks, 3.5 to 5 weeks and 6 to 7 weeks, respectively. Only 39% wound healing was acquired at the 13th week of NPWT in one subject. With sternal wire present, 6%–29% wound healing progress was achieved by NPWT in 1–4 weeks, and 16–23% wound improvement in 2 to 4.5 weeks by NWPT after further surgical debridement. After sternal wire removal, 6–34% sternal wound healing occurred by continuous NPWT for 1–2 weeks, and maximum healing at 46% after 2.5 weeks of NPWT were observed. Conclusions Better wound healing was achieved in the NPWT group in comparison to conventional dressings alone. However, suboptimal sternal wound healing by NPWT alone was observed. Removal of sternal wire may improve the effectiveness of NPWT. Successful tertiary closure after NPWT among subjects supports the important bridging role of NPWT in sternal wound healing. Factors causing stagnant sternal wound healing by NPWT alone are discussed.

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