Autologous fat grafting combined with negative pressure wound therapy in severe diabetic foot ulcer: a case study

2021 ◽  
Vol 30 (Sup4) ◽  
pp. S38-S40
Author(s):  
Zheng Biyao ◽  
Xu Gang ◽  
Jiang Hai ◽  
Duan Chenwang ◽  
Liu Xuan
Keyword(s):  
Negative Pressure ◽  
Diabetic Foot ◽  
Negative Pressure Wound Therapy ◽  
Foot Ulcer ◽  
Fat Grafting ◽  
Autologous Fat Grafting ◽  
Wound Therapy ◽  
Autologous Fat ◽  
Split Thickness Skin Grafting

Objective: Hard-to-heal wounds are a surgical challenge, and diabetic foot ulcers (DFUs) are one of the most common and severe varieties. Previous studies have shown that autologous fat grafting (AFG) and negative pressure wound therapy (NPWT) have the potential to promote wound healing. This case study describes how these two methods together helped in the healing of a serious DFU. Case history: A 65-year-old female patient had a severe DFU on her right foot, with a 30-year history of disease and renal failure. By the time symptoms were evident, regular dressing changes and antibiotic treatment were inadequate. She received surgical debridement, AFG and NPWT. Finally, as the granulation tissue covered the full wound bed, the wound was closed by split-thickness skin grafting. One month later, the DFU was fully healed with no recurrences. Conclusion: The application of AFG or components of adipose tissue to treat hard-to-heal wounds has been researched at both the molecular level and in clinic. In this case, we have proved the curative effect of jointly using AFG and NPWT.

Efficacy of negative pressure wound therapy for the treatment of diabetic foot ulcer/gangrene

2013 ◽  
Vol 5 (2) ◽  
pp. 112-116
Author(s):  
Kazuki Ikura ◽  
Takamichi Shinjyo ◽  
Yuka Kato ◽  
Yasuko Uchigata
Keyword(s):  
Negative Pressure ◽  
Diabetic Foot ◽  
Negative Pressure Wound Therapy ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Wound Therapy

Application of irrigation and negative pressure wound therapy (INPWT) to treat diabetic foot gangrene: a case report

WCET Journal ◽  
2019 ◽  
Vol 39 (3) ◽  
pp. 20-25
Author(s):  
Ai-hua Chen ◽  
Huiling Liu ◽  
Chunmei Zhang ◽  
Ping Zou
Keyword(s):  
Blood Pressure ◽  
Case Report ◽  
Blood Sugar ◽  
Negative Pressure ◽  
Diabetic Foot ◽  
Negative Pressure Wound Therapy ◽  
Treatment Process ◽  
Wound Therapy ◽  
Spread Of Infection

This case study summarises the treatment of a patient with diabetic foot gangrene. By undergoing irrigation and negative pressure wound therapy (INPWT) with moist dressing, foot amputation was avoided. The treatment process included: the comprehensive assessment of systemic and local condition; choosing suitable debridement such as sharp surgical debridement; preventing the spread of infection; applying INPWT to reduce endotoxin absorption; and active treatments of primary disease such as controlling blood sugar and blood pressure, and improving microcirculation and nutrition. After 2 months of vigorous INPWT, the patient’s wound bed improved. After the application of a moist dressing, the wound closed and healed successfully at 3 months.

scholarly journals Effects of Negative Pressure Wound Therapy on Levels of Angiopoetin-2 and Other Selected Circulating Signaling Molecules in Patients with Diabetic Foot Ulcer

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Jerzy Hohendorff ◽  
Anna Drozdz ◽  
Sebastian Borys ◽  
Agnieszka H. Ludwig-Slomczynska ◽  
Beata Kiec-Wilk ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Diabetic Foot ◽  
Negative Pressure Wound Therapy ◽  
Foot Ulcer ◽  
Annexin V ◽  
Diabetic Foot Ulcer ◽  
Entire Group ◽  
Wound Therapy ◽  
Accelerate Wound Healing ◽  
Premature Deaths

Background and Aims. Diabetic foot ulcers (DFUs) are linked to amputations and premature deaths. Negative pressure wound therapy (NPWT) has been used for DFUs. The mechanism of NPWT’s action may be associated with its influence on circulating molecules. We assessed NPWT’s effect on the plasma levels of angiopoietin-2 (Ang2), a key regulator of angiogenesis, and its microvesicular receptors (Tie2) as well as the microvesicles (MVs) themselves in DFU patients. Materials and Methods. We included 69 patients with type 2 diabetes mellitus (T2DM) and neuropathic, noninfected DFUs—49 were treated with NPWT and 20 were treated with standard therapy (ST). Assigning patients to the NPWT group was not random but based on DFU characteristics, especially wound area. Ang2 was measured by ELISA in the entire group, while in a subgroup of 19 individuals on NPWT and 10 on ST, flow cytometry was used to measure Tie2+ and the corresponding isotype control (Iso+) and annexin V (AnnV+) as well as total MVs. Measurements were performed at the beginning and after 8±1 days of therapy. Results. Treatment groups were similar for basic characteristics but differed by their median DFU areas (10.3 (4.2-18.9) vs. 1.3 (0.9-3.4) cm2, p=0.0001). At day 0, no difference was observed in Ang2 levels, total MVs, MV Tie+, and MV AnnV+ between the groups. Ang2 decreased after 8 days in the NPWT group, unlike in the ST group (3.54 (2.40-5.40) vs. 3.32 (2.33-4.61), p=0.02, and 3.19±1.11 vs. 3.19±1.29 ng/mL, p=0.98, respectively). No other parameters were identified that may have been influenced by the NPWT treatment. Conclusion. NPWT in T2DM patients with neuropathic, noninfected DFU seems to lead to reduction of the Ang2 level. Influencing the level of Ang2 may constitute one of NPWT-related mechanisms to accelerate wound healing.

scholarly journals EFFICACY OF NEGATIVE PRESSURE WOUND THERAPY IN EARLY DIABETIC FOOT ULCER MANAGEMENT IN COMPARISON WITH ADVANCED MOIST WOUND THERAPY

2021 ◽  
Vol 71 (6) ◽  
pp. 2087-90
Author(s):  
Naveed Ahmed Sheen ◽  
Ali Murtaza Samar ◽  
Muhammad Ibrar Butt ◽  
Zeeshan Ayub ◽  
Faisal Nadeem
Keyword(s):  
Negative Pressure ◽  
Diabetic Foot ◽  
Negative Pressure Wound Therapy ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Healing Time ◽  
Military Hospital ◽  
Wound Therapy ◽  
Ulcer Size ◽  
Surgical Department

Objective: To compare negative pressure wound therapy with advanced moist wound therapy in managing early diabetic foot ulcer. Study Design: Quasi-experimental study. Place and Duration of Study: Surgical Department, Combined Military Hospital Rawalpindi, from Jul 2016 to Jun 2018. Methodology: A total of 100 patients of diabetic foot ulcer were randomly allocated into two equal groups for the treatment with negative pressure wound therapy (NPWT) and advanced moist wound therapy (AMWT). Ulcers were reassessed after 4 weeks for presence of granulation tissue covering entire ulcer base and reduction of 3 cm in largest diameter of ulcer. Results: Mean age of the study participants was 57.08 ± 9.99 years. 33 patients had Wagner grade-I ulcer, while remaining had Wagner grade-II ulcer. Mean ulcer size at presentation was 6.46 ± 1.71 cm. Both study groups were comparable in terms of mean age (p=0.968), wound size at presentation (p=1.000), age (p=0.695), gender (p=1.000) and Wagner ulcer grade (p=0.288). Mean ulcer size was found smaller with negative pressure wound therapy (3.46cm, p=0.061) at follow-up visits. Reduction in ulcer size ≥3cm was achieved frequently with negative pressure wound therapy technique (72.0% vs. 38.0%; p>0.01). Mean healing time was 4.11 ± 1.65 weeks which was lower with negative pressure wound therapy (3.66 weeks vs. 4.56 weeks; p>0.05). Treatment efficacy (healing in ≤4 weeks and ≥3cm reduction in ulcer) was significantly higher with negative pressurewound therapy (72.0% vs. 38.0%; p<0.01) as well. Conclusion: This study demonstrates superiority of negative pressure wound therapy over advanced moist...............

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