Treatment of hard-to-heal leg ulcers with hyaluronic acid, sodium alginate and negative pressure wound therapy

2020 ◽  
Vol 29 (7) ◽  
pp. 419-423
Author(s):  
Omer Arda Cetinkaya ◽  
Suleyman Utku Celik ◽  
Can Yahya Boztug ◽  
Hakan Uncu
Keyword(s):  
Hyaluronic Acid ◽  
Lower Extremity ◽  
Negative Pressure ◽  
Conventional Therapy ◽  
Negative Pressure Wound Therapy ◽  
Therapy Group ◽  
Complete Healing ◽  
Leg Ulcers ◽  
Wound Therapy ◽  
Conventional Therapy Group

Objective: Hard-to-heal lower extremity ulcer is a common healthcare problem and can lead to a poor quality of life (QoL). Despite the advances in wound care, conventional therapies, such as necrotic tissue debridement, cleansing, treatment of infection and local treatment with dressing application are still considered the standard of care in patients with hard-to-heal leg ulcers. However, managing hard-to-heal ulcers that do not respond well to these methods has led to new treatment strategies. In this study, the effects of hyaluronic acid (HA) and sodium alginate (SA), combined with negative pressure wound therapy (NPWT), in patients with hard-to-heal leg ulcers are evaluated. Method: Patients with hard-to-heal lower extremity ulcers were treated with HA-SA combined with NPWT (HA-SA-NWPT, n=11), or conventional therapy (n=14), between June 2014 and September 2015. Demographics, comorbidities, time to complete healing and change in wound area were recorded and compared. Results: A total of 25 patients took part. Complete healing was achieved in 63.6% (n=7) of the patients in the HA-SA with NPWT group, compared with 14.3% (n=2) of the patients in the conventional therapy group (p=0.017). The mean decrease in wound size was significantly higher in the HA-SA-NPWT group than in the conventional therapy group (73.8% versus 34.8%, respectively, p=0.029). Despite a shorter healing period in the HA-SA-NPWT group than in the conventional group, no statistically significant difference was found between groups for time to complete healing (37 days versus 55 days, respectively). Conclusion: These results demonstrate that the combination of HA-SA-NPWT is a promising treatment for decreasing the healing time and increasing the success rate by their synergistic effect on wound healing in hard-to-heal lower extremity ulcers. However, further studies with a larger number of patients are needed to confirm the results.

scholarly journals Management of large chronic venous leg ulcers with negative pressure wound therapy

2017 ◽  
Vol 4 (2) ◽  
pp. 17
Author(s):  
Dominik Andrzej Walczak ◽  
Michał Wojtyniak ◽  
Rajmund Jaguścik ◽  
Joanna Jadwiga Porzeżyńska ◽  
Wojciech Fałek ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Adult Population ◽  
Complete Healing ◽  
Leg Ulcers ◽  
Skin Grafts ◽  
Wound Therapy ◽  
Venous Leg Ulcers ◽  
Venous Ulcers ◽  
The Mean

Introduction: Venous leg ulcers (VLU) occur in 1\% of the adult population and are associated with chronic disability, diminished quality of life and high health-care costs. Treatment is often slow, difficult and recurrence is high because of inappropriate conditions of the wound bed. Patients and Methods: This study involves 14 patients with chronic venous ulcers larger than 100 cm\textsuperscript{2} treated with negative pressure wound therapy (NPWT). Patients underwent a radical debridement of all devitalized tissues and partial stripping of an insufficient great saphenous vein in the first operation. After adequate haemostasis, NPWT kit was applied. Once the wounds were determined to be clean and adequate granulation tissue formation was achieved, split-thickness skin grafts were applied. Dressing impregnated with neutral triglycerides and silver ions was used as a first layer and the black polyurethane NPWT foam was applied over it. The pain assessment was performed for 7 patients using 10 cm visual analog scale (VAS). Results: The mean number of NPWT dressing changes prior to grafting was 5.8. The mean number of NPWT foam changes was 2.8 after skin grafting. We accomplished complete healing of 92\% of applied skin grafts surface. One patient had recurrence of venous ulcers in the follow-up period. Moreover, one patient required regrafting. Conclusions: The application of NPWT provides quick wound-bed preparation and high graft take in venous ulcer treatment.

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.

Incisional Negative Pressure Wound Therapy After High-Risk Lower Extremity Fractures

2012 ◽  
Vol 26 (1) ◽  
pp. 37-42 ◽  
Author(s):  
James P Stannard ◽  
David A Volgas ◽  
Gerald McGwin ◽  
Rena L Stewart ◽  
William Obremskey ◽  
...  
Keyword(s):  
High Risk ◽  
Lower Extremity ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Wound Therapy

scholarly journals 1431 Stoma Intubation, Isolation and Negative Pressure Wound Therapy for Complex Stoma-Associated Wounds: New Technique and Case Series

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
N Browning ◽  
M Okocha ◽  
M Doe ◽  
A Lyons ◽  
H Sumrien
Keyword(s):  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Enterocutaneous Fistula ◽  
Loop Ileostomy ◽  
Case Series ◽  
Complete Healing ◽  
Wound Therapy ◽  
First Case ◽  
Isolation Device ◽  
Commercial Device

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.

scholarly journals Negative Pressure Wound Therapy (NPWT) in open wound management: A study of 16 Cases in Orthopaedic Department of Faridpur Medical College Hospital

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 ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Granulation Tissue ◽  
Negative Pressure ◽  
Open Fracture ◽  
Negative Pressure Wound Therapy ◽  
Soft Tissue Defect ◽  
Healing Time ◽  
Wound Management ◽  
Wound Therapy ◽  
College Hospital

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

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