scholarly journals Traumatic wound difficult to heal: use of negative pressure therapy: case report

Author(s):  
Edgar Salvador Salas Ochoa ◽  
Edilia Naraleth Arce Sanchez ◽  
Karla Itzel Altamirano Moreno ◽  
Edna Arantza Segura Garcia ◽  
Leslie Alejandra Peña Sustaita ◽  
...  

The skin is one of the largest organs of the anatomy. It is the barrier between the exterior and the first line of defense against aggression. A wound is a loss of continuity of the soft parts of the organism generating an interruption in the structure of the tissue, as a consequence of this loss of continuity, there is a loss of sterility existing inside and infection can occur. Another consequence of discontinuity are possible lesions in adjacent tissues or organs. Trauma results in complex wounds that are difficult to manage due to large skin loss or avulsion of large areas of tissue. Among the factors that can prevent proper healing can be systemic (malnutrition, chemotherapy, steroids) or local (infection, prosthetic material, bone exposure). Among the therapeutic options for complex wounds is negative pressure therapy which generates wound contraction, stabilization of the environment, reduction of edema, removal of exudate and micro-deformations of the surface, increase of angiogenesis, granulation tissue formation and decreased bacterial count. We described a clinical case of traumatic injury at the level of the right pelvic limb in a 70-years-old woman with diabetes and hypertension, in which surgical washing was performed, debridement and use of negative pressure therapy with adequate evolution in a second level public hospital.  

2010 ◽  
Vol 34 (3) ◽  
pp. 161-166 ◽  
Author(s):  
M. Ali Rafique Mirza ◽  
Nauman Ahmad Gill ◽  
Abdul Hameed

2017 ◽  
Vol 44 (1) ◽  
pp. 81-93 ◽  
Author(s):  
RENAN VICTOR KÜMPEL SCHMIDT LIMA ◽  
PEDRO SOLER COLTRO ◽  
JAYME ADRIANO FARINA JÚNIOR

ABSTRACT The objective of this study is to evaluate the effectiveness of negative pressure therapy (NPT) in the treatment of complex wounds, with emphasis on its mechanisms of action and main therapeutic indications. We searched the Pubmed / Medline database for articles published from 1997 to 2016, and selected the most relevant ones. The mechanisms of action of NPT involveboth physical effects, such as increased perfusion, control of edema and exudate, reduction of wound dimensions and bacterial clearance, and biological ones, such as the stimulation of granulation tissue formation, microdeformations and reduction of Inflammatory response. The main indications of NPT are complex wounds, such as pressure ulcers, traumatic wounds, operative wound dehiscences, burns, necrotizing wounds, venous ulcers, diabetic wounds, skin grafts, open abdomen, prevention of complications in closed incisions and in the association with instillation of solutions in infected wounds.


2019 ◽  
Vol 70 (4) ◽  
pp. 1307-1310
Author(s):  
Monica Marilena Tantu ◽  
George Mihail Man ◽  
Alina Paunescu ◽  
Cristina Florentina Plesa ◽  
Camelia Nicolae ◽  
...  

Diabetic foot is a current public health problem and a late consequence of diabetes. Morbidity and mortality are significant, seriously affecting the patient�s quality of life. Treatment of the diabetic foot is a long-lasting, highly resource-consumption process. Using negative pressure therapy leads to shorter hospitalization periods, better functional outcomes, significantly contributes to decreasing the number of amputations and improving patient�s quality of life. 49 year-old patient is hospitalized with necrotizing at right foot and shank, neglected type II diabetes. It is performed amputation of atypical necessity, right leg, transtarsal, open stump. After successive debridements, negative pressure therapy is installed for a period of 24 days. This favors the formation of the granular bed, the remission of the infection, allowing grafting. The graft is partially integrated and plantar reconstruction is performed with sural reversal flap. The local and functional results are satisfactory, with the flap viability and the possibility of moving with support on the right leg, preventing the amputation of the shank. Negative pressure therapy has a multitude of advantages, it is preferable to conventional therapies, and it can have higher costs, but accelerates healing and improves the quality of life of the patient.


2016 ◽  
Vol 3 (2) ◽  
Author(s):  
Bartosz Cybułka ◽  
Jacek Rapeła ◽  
Andrzej Wach

A negative pressure dressing system enables effective dressing of traumatic wounds. Extensive injuries and tissue defects that accompany bone fractures and articular surface injuries require special management. In case of compound fractures, the risk of bone, joint and soft tissue infection significantly increases, so the appropriate healing process of traumatic wound is limited.  Undisturbed healing process of traumatic wound is conditioned only by the proper wound dressing process by the removal of necrotic and ischemic tissues and elimination of the sources of infection and infections themselves. The article shows a case report of a patient with a traumatic subcapital humerus fracture complicated by a haematoma and then by a periarticular abscess. After the incision and drainage of a reservoir of blood and pus, a chronic infected fistula of glenohumeral joint was formed. During a prolonged therapeutic process an aggressive surgical management was implemented, by the removal of the infected bone, what eliminated the actively secreting fistula of glenohumeral joint. Following the appropriate wound preparation, the negative pressure therapy was successfully applied.  In the described case the application of negative pressure dressing system enabled a gradual decrease of total wound depth and surface area and consequently, a restriction of tissue defects.


2012 ◽  
Vol 60 (S 01) ◽  
Author(s):  
S Raab ◽  
T Weimann ◽  
W Sienel ◽  
L Lampl ◽  
M Beyer

2015 ◽  
Vol 77 (5) ◽  
pp. 456-460
Author(s):  
Maiko SAKAMOTO-TOYA ◽  
Sho MIAKE ◽  
Satoko SHIBATA-KIKUCHI ◽  
Masutaka FURUE

2017 ◽  
Vol 68 (11) ◽  
pp. 2687-2690 ◽  
Author(s):  
Bogdan Mihnea Ciuntu ◽  
Stefan Octavian Georgescu ◽  
Ciprian Cirdeiu ◽  
Daniel Timofte ◽  
Doina Azoicai ◽  
...  

The study aims to assess the significance of negative pressure therapy in the treatment of 1 January 2014 - 31 June 2017. The objectives intend to evaluate the healing time required after applying the method and the functional consequences for the patient. A prospective study was conducted on a sample of 31 patients with various tipe of wounds which were monitored their clinical course between September 2014 - February 2017, following negative pressure therapy. There were used vacuum assisted closure devices (VAC � -Hartman) in order to apply negative pressure to the wound, while complying with specified settings in accordance with patients� outcome. Healing was obtained in all cases, to an average hospital stay of 30 days and 12 days of therapy application.The negative result of microbial cultures was obtained after an average of 7.55 days by simultaneous application of negative pressure and antibiotic treatment according to the antibiogram. After basic treatment of the wound, auxiliary methods such as negative pressure contribute to the healing. Evolution was favorable with wound granulation in 95% cases, which allowed surgery under local anesthesia, and defect was covered with skin graft. VAC therapy falls into the last group of treatments by eliminating healing inhibitors. This regenerates the wound in a damp environment and essentially turns an open wound into a closed system.


2017 ◽  
Vol 68 (7) ◽  
pp. 1648-1651
Author(s):  
Bogdan Mihnea Ciuntu ◽  
Ciprian Vasiluta ◽  
Robert Negru ◽  
Roxana Hultoana ◽  
Roxana Ciuntu ◽  
...  

The study aims to assess the significance of negative pressure therapy in the treatment of diabetic foot.The objectives intend to evaluate the healing time required after applying the method and the functional consequences for the patient. A prospective study was conducted on a sample of 37 patients with diabetic foot were monitored their clinical course between September 2014 - April 2017, following negative pressure therapy. There were used vacuum assisted closure devices (VAC � -Hartman) in order to apply negative pressure to the wound, while complying with specified settings (negative pressure, time of use of a kit) in accordance with patients� outcome.There were monitored changes in wound size (planimetric and volumetric measurement), their bacterial load and duration of treatment. Healing was obtained in all cases, to an average hospital stay of 27.3 days and 8 days of therapy application.The negative result of microbial cultures was obtained after an average of 6.45 days by simultaneous application of negative pressure and antibiotic treatment according to the antibiogram. Skin grafts were necessary to close the defect in 4 cases. After basic treatment of the wound, auxiliary methods such as negative pressure contribute to the healing.In patients with diabetic foot who were required surgical intervention, the use of negative pressure therapy yielded a significant benefit in the preservation of the affected limb, after minimal excision.The results we obtained throughout our experience recommend use of NPTW technique as indication for abdominal wall surgery in closing abdominal wall defects, compartment syndrome and surgical site infection after prosthetic mesh.


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