scholarly journals Bronchial fistula closure with negative pressure wound therapy: a feasible and cost-effective treatment

2016 ◽  
Vol 43 (4) ◽  
pp. 292-294 ◽  
Author(s):  
RODRIGO BARBOZA NUNES ◽  
BRUNO FRANCISCO MÜLLER NETO ◽  
FEDERICO ENRIQUE GARCIA CIPRIANO ◽  
PEDRO SOLER COLTRO ◽  
JAYME ADRIANO FARINA JÚNIOR
Keyword(s):  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Cost Effective ◽  
Surgical Approaches ◽  
Negative Pressure Therapy ◽  
Wound Therapy ◽  
Cost Of Treatment ◽  
Pressure Therapy ◽  
Bronchial Fistula ◽  
Cost Effective Treatment

ABSTRACT Treatment of bronchial fistula (BF) after pulmonary lobectomy is a challenge. Often, patients require long hospital stay, have recurrent empyema and pneumonia, are susceptible to sepsis, often need broad-spectrum antibiotics, as well as various surgical approaches. With the advent and growing evidence of the benefits of negative pressure therapy (NPT), its use in some patients with BF has been reported with encouraging results concerning its feasibility and cost-effectiveness. The aim of this study was to demonstrate the application of NPT as a resource for BF treatment and comparatively analyze the overall cost of treatment.

Negative Pressure Wound Therapy for Prevention and Treatment of Purulent Septic Complications in Traumatology and Orthopedics

2013 ◽  
Vol 20 (2) ◽  
pp. 3-11
Author(s):  
V. N Obolenskiy ◽  
A. A Ermolov ◽  
D. V Sychyev ◽  
A. Y Semenistyi ◽  
G. V Rodoman ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Surgical Intervention ◽  
Negative Pressure Therapy ◽  
Wound Therapy ◽  
Cost Of Treatment ◽  
Septic Complications ◽  
Pressure Therapy ◽  
Total Arthroplasty ◽  
The Cost

Negative pressure therapy is one of the newest methods used in the wounds treatment. It enables to accelerate and optimize the process of wound healing and hence to reduce the cost of treatment. Negative pressure stimulates proliferation of granulation tissue, provides continuous evacuation of exudate and effectively cleans wound surface. Treatment results for 251 patients with purulent septic complications after surgical intervention are presented. One hundred two patients had open fractures of extremity bones, 51 patients underwent total arthroplasty of large joints and 48 patients — scoliosis endocorrection.

scholarly journals Negative pressure therapy for management of patients with enterocutaneous fistulas

2020 ◽  
pp. 90-92
Author(s):  
A. E. Demko ◽  
I. M. Batyrshin ◽  
J. S. Ostroumova ◽  
D. S. Sklizkov ◽  
D. V. Fomin
Keyword(s):  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Negative Pressure Therapy ◽  
Wound Therapy ◽  
Comparable Group ◽  
Pressure Therapy ◽  
Saint Petersburg ◽  
Early Closure ◽  
Surgical Tactics ◽  
Intestinal Fistulas

Objective: To assess the benefits of negative pressure wound therapy (NPWT) in complex therapy of patients with enterocuta‑ neous fistulas.Methods: From 2014 to 2019 in Saint Petersburg I.I. Dzhanelidze Research Institute of Emergency Medicine, 24 patients were managed with vacuum assisted techniques. For comparison, a comparable group of 23 observations (control) was formed retrospectively based on an analysis of medical records.Results: When using NPWT, the terms of wound cleansing and the formation of a laparostomy were reduced, and conditions were created for its early closure. With a small laparostomy, the use of NPWT contributed to self-epithelialization of the wound around the fistula.Conclusions: The use of NPWT more than halves the time of formation of a laparostomy, shortens the time for cleansing the wound and creates the conditions for its closure. Surgical tactics using NPWT can more than three times reduce the number of local complications in patients with unformed intestinal fistulas and less often change the combination of antibacterial drugs. 

scholarly journals A simple and low- cost technique for Closed Incision Negative-Pressure Therapy

2017 ◽  
Vol 4 (1) ◽  
pp. 12
Author(s):  
Dominik Andrzej Walczak ◽  
Michał Wojtyniak ◽  
Piotr Wojciech Trzeciak ◽  
Dariusz Pawełczak ◽  
Zbigniew Pasieka
Keyword(s):  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Low Cost ◽  
Antibiotic Usage ◽  
Preventive Strategy ◽  
Site Infection ◽  
Surgical Wound ◽  
Negative Pressure Therapy ◽  
Wound Therapy ◽  
Pressure Therapy

Surgical site infection (SSI) makes patient care more expensive by prolonging antibiotic usage and hospital stay. Negative pressure wound therapy (NPWT) has been recently reported as a preventive strategy to avoid SSI. We present a simple and low-cost vacuum dressing that may improve surgical wound healing and prevent high-risk wounds from complications.

scholarly journals Intrauterine negative-pressure therapy (IU-NPT) to treat peritonitis after caesarean section

2020 ◽  
Vol 5 (1-2) ◽  
pp. 67-73
Author(s):  
Chris-Henrik Wulfert ◽  
Christian Theodor Müller ◽  
Ahmed Farouk Abdel-Kawi ◽  
Wolfgang Schulze ◽  
Henning Schmidt-Seithe ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Abdominal Cavity ◽  
Total Duration ◽  
Uterine Cavity ◽  
Negative Pressure Therapy ◽  
Wound Therapy ◽  
Pressure Therapy ◽  
Septic Focus

AbstractObjectivesWe describe the first application of intrauterine negative-pressure therapy (IU-NPT) for an early rupture of a uterine suture after a third caesarean section with consecutive peritonitis and sepsis. Because all four quadrants were affected by peritonitis, a laparotomy was performed on the 15th day after caesarean section. Abdominal negative-pressure wound therapy (A-NPWT) of the open abdomen was initiated. During the planned relaparotomy, a suture defect of the anterior uterine wall was identified and sutured. In the second relaparotomy, the suture appeared once more insufficient.Case presentationFor subsequent IU-NPT, we used an open-pore film drainage (OFD) consisting of a drainage tube wrapped in the double-layered film. The OFD was inserted into the uterine cavity via the uterine defect and IU-NPT was established together with A-NPT. With the next relaparotomy, local inflammation and peritonitis had been resolved completely. IU-NPT was continued transvaginally, the uterine defect was sutured, and the abdomen was closed. Vaginal IU-NPT was also discontinued after another eight days.ConclusionsBy using IU-NPT, local infection control of the septic focus was achieved. The infectious uterine secretions were completely evacuated and no longer discharged into the abdominal cavity. As a result of the applied suction, the uterine cavity collapsed around the inlaid OFD. The total duration of IU-NPT was 11 days. The uterine defect was completely closed, and a hysterectomy was avoided. The patient was discharged four days after the end of IU-NPT. IU-NPT follows the same principles as those described for endoscopic negative-pressure wound therapy of the gastrointestinal tract.

scholarly journals Efficacy Of Gauze-based Negative Pressure Wound Therapy After Split-thickness Skin Graft In The Care Of Large Wounds

2018 ◽  
Vol 08 (02) ◽  
pp. 82-86
Author(s):  
Irfan Ilahi ◽  
M. Uzair Ilyas Tahir Kheli ◽  
Ehtesham- ulHaq
Keyword(s):  
Skin Graft ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Cost Effective ◽  
Military Hospital ◽  
Split Thickness Skin Graft ◽  
Wound Therapy ◽  
Thickness Skin ◽  
User Friendly ◽  
Over The Top

Background: Negative-pressure wound therapy (NPWT) or vacuum dressings involve the application of a controlled negative pressure on the wound. Traditionally, STSGs were fixed with bolster technique, where sutures are used to fix pressure dressings over the top of recently placed grafts. Taking it a step further in our study we applied an effective and user friendly filler material (surgical roll gauze) on very large defects. The objective of this study was to assess the clinical efficacy of gauze-based negative pressure wound therapy as an adjunctive therapy to STSG, over complex and very large wounds. Material & Methods: This descriptive study was conducted at Army Burn Center, Combined Military Hospital Kharian and PNS Shifa Hospital Karachi from January 2016 to June 2017. Gauze based VAC system used. Negative pressure was applied at -80 mm Hg. Evaluation was carried out to assess the performance of gauze-based NPWT. Results: Total of 63 patients, 42 males and 21 females, with mean age of 32 years SD+15 were included in the study. The wound size included in the study ranged from 12x10 cm to 88x66 cm. Mean duration of NPWT dressings was 15 days and 313 dressings were employed in total with satisfactory healing achieved in 3 to 4 VAC dressings in most of the cases. Mean duration of hospital stay was 23.92 days at which point graft uptake percentage was in the range of 90% (n=7) to 100% (n=20). Only 3.2% (n=2) cases required partial re-grafting for complete coverage of residual wounds. Conclusion: Gauze-based Negative-pressure wound therapy over split thickness skin graft is a cost-effective addition to the care and management of large and complex wounds

scholarly journals Successful Use of Negative Pressure Wound Therapy for Abdominal Wall Necrosis Caused by a Perforated Ascending Colon Using the ABThera System

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Kouki Imaoka ◽  
Takuya Yano ◽  
Yasuhiro Choda ◽  
Ko Oshita ◽  
Yuma Tani ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Open Abdomen ◽  
Anterolateral Thigh Flap ◽  
Temporary Abdominal Closure ◽  
Ascending Colon ◽  
Wound Therapy ◽  
Pressure Therapy ◽  
New Device

Background. The practice of leaving the abdomen open after an emergency laparotomy has gained increasing popularity recently. Negative pressure wound therapy (NPWT) is known as an effective technique in the management of an open abdomen (OA). A new device, the ABThera™ Open Abdomen Negative Pressure Therapy System (KCI USA, San Antonio, TX, USA), was specifically designed to achieve a temporary abdominal closure (TAC) in the management of an OA. This study was aimed at presenting a successful experience of treating a case of abdominal wall necrosis caused by a perforated ascending colon using the ABThera System. Case Presentation. A 66-year-old man was admitted to our hospital with complaints of severe pain in the abdomen. On admission, abdominal contrast-enhanced computed tomography (CT) showed fluid collection, an air pocket in the subcutaneous fat layer of the abdominal wall, and edematous changes in the adipose tissue in the peritoneum and abdominal wall. Based on a diagnosis of peritonitis resulting from a perforated ascending colon, emergency surgery was performed. A right hemicolectomy, ileostomy construction, and debridement of the necrotic tissues were performed. However, necrotizing fasciitis rapidly spread; therefore, more necrotic tissue was debrided in a second operation. The abdominal wall defect was left open, and the ABThera System was used in the management of the OA; this device promoted wound healing. A reduction was observed in the size of the open wound with visible granulation tissue. The defect was finally covered with a mesh split-thickness skin graft and anterolateral thigh flap. Conclusions. In the management of a case of a massive wound with infection, it can be of great benefit to treat the wound with NPWT initially to decrease its size. The ABThera System could facilitate early and safe management of an OA by surgeons.

scholarly journals An Alternative Treatment Strategy for Complicated Chronic Wounds: Negative Pressure Therapy over Mesh Skin Graft

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Michele Maruccia ◽  
Maria G. Onesti ◽  
Valentina Sorvillo ◽  
Antonio Albano ◽  
Luca A. Dessy ◽  
...  
Keyword(s):  
Skin Graft ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Tissue Growth ◽  
Real Problem ◽  
Skin Defect ◽  
Skin Grafts ◽  
Wound Therapy ◽  
Pressure Therapy ◽  
Mesh Skin Graft

Extensive skin defect represents a real problem and major challenge in plastic and reconstructive surgery. On one hand, skin grafts offer a practical method to deal with skin defects despite their unsuitability for several complicated wounds. On the other hand, negative pressure wound therapy (NPWT), applied before skin grafting, promotes granulation tissue growth. The aim of the study is to evaluate the improvement in wound healing given by the merger of these two different approaches. We treated 23 patients for large wounds of multiple factors. Of these, 15 were treated with the application of V.A.C.® Therapy (KCI Medical S.r.l., Milan, Italy), in combination with skin grafts after a prior unsuccessful treatment of 4 weeks with mesh skin grafts and dressings. Another 8 were treated with only mesh skin graft. Pain reduction and wound area reduction were found statistically significant (p<0.0009,p<0.0001). Infection was resolved in almost all patients. According to our study, the use of the negative pressure wound therapy over mesh skin grafts is significantly effective especially in wounds resistant to conventional therapies, thereby improving the rate of skin graft take.

Fluorescence imaging guided dressing change frequency during negative pressure wound therapy: a case series

2019 ◽  
Vol 28 (Sup9) ◽  
pp. S28-S37 ◽  
Author(s):  
Rose Raizman
Keyword(s):  
Real Time ◽  
Fluorescence Imaging ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Case Series ◽  
Cost Effective ◽  
Wound Therapy ◽  
Imaging Device ◽  
Treatment Regimens ◽  
Selection Of

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.

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