scholarly journals Results of negative pressure wound therapy in compound grade 3 tibial fractures

2018 ◽  
Vol 4 (3) ◽  
pp. 428
Author(s):  
Atul Kantilal Patil ◽  
Ansari Muqtadeer Abdul Aziz ◽  
Rahul Devale
Keyword(s):  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Skin Grafting ◽  
Control Group ◽  
Study Group ◽  
Wound Therapy ◽  
Long Term Follow Up ◽  
Flap Cover

<p class="abstract"><strong>Background:</strong> Open fractures constitute major chunk of orthopaedic trauma in a busy tertiary hospital and involve lot of morbidity, efforts, cost and time. Negative pressure wound therapy (NPWT) is a relatively new treatment that has proven beneficial in various types of complex wounds. The purpose of our study is to see the utility of NPWT in compound type III tibial fractures and its impact on the outcome of the patients.</p><p class="abstract"><strong>Methods:</strong> 30 patients were included in the study with a mean age of 40.27 years ranging from 13 years to 62 years. There were 26 male patients and 4 female patients with 22 right sided fractures and 8 left sided fractures. The patients were then distributed into VAC/NPWT (study) group and control group using table of random numbers. Each group had 15 patients each. Scoring was carried out at before the first debridement.<strong></strong></p><p class="abstract"><strong>Results:</strong> In the study NPWT group it was estimated that 5 patients may need amputation or but of these only 1 (20%) patient went on to have amputation of the involved limb while the rest (80%) could be salvaged. In the control group, 1 patient was predicted to need amputation which indeed resulted in amputation. Of the 7 predicted to need flap cover in study group, 4 (57.1%) eventually needed flap cover while the 3 (42.9%) were covered with skin grafting. Contrary in the control group all the 8 patients predicted to need flap cover, all ended up having the same. In the control group, of the 6 patients who were prognosticated to needed skin grafting, 2 (33.3%) worsened and needed flap cover while in the rest 4 (66.7%) skin grafting sufficed.</p><p class="abstract"><strong>Conclusions:</strong> NPWT resulted in healthy granulation of the wound. The study undertaken was a prospective randomised control trial. However, the main drawbacks were the sample size and the inability to have long term follow up. More studies with larger sample size and a long term follow up are necessary to substantiate the findings of the study.</p>

scholarly journals Long-term follow-up of negative pressure wound therapy with instillation: a limb salvage procedure?

2014 ◽  
Vol 13 (5) ◽  
pp. 768-773 ◽  
Author(s):  
Daniele Bollero ◽  
Kiran Degano ◽  
Ezio N Gangemi ◽  
Domenico Aloj ◽  
Valeria Malvasio ◽  
...  
Keyword(s):  
Limb Salvage ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Salvage Procedure ◽  
Wound Therapy ◽  
Limb Salvage Procedure ◽  
Long Term Follow Up

Delayed closure of open abdomen in septic patients treated with negative pressure wound therapy and dynamic fascial suture: the long-term follow-up study

2017 ◽  
Vol 31 (11) ◽  
pp. 4717-4724 ◽  
Author(s):  
Anna Theresa Hofmann ◽  
Simone Gruber-Blum ◽  
Michael Lechner ◽  
Alexander Petter-Puchner ◽  
Karl Glaser ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Open Abdomen ◽  
Wound Therapy ◽  
Follow Up Study ◽  
Long Term Follow Up ◽  
Delayed Closure

scholarly journals Closed incision negative pressure wound therapy versus conventional dressings following soft-tissue sarcoma excision: a prospective, randomized controlled trial

2021 ◽  
Vol 2 (12) ◽  
pp. 1049-1056
Author(s):  
David W. Shields ◽  
Nima Razii ◽  
James Doonan ◽  
Ashish Mahendra ◽  
Sanjay Gupta
Keyword(s):  
Randomized Controlled Trial ◽  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Controlled Trial ◽  
Control Group ◽  
Wound Therapy ◽  
Randomized Controlled

Aims The primary objective of this study was to compare the postoperative infection rate between negative pressure wound therapy (NPWT) and conventional dressings for closed incisions following soft-tissue sarcoma (STS) surgery. Secondary objectives were to compare rates of adverse wound events and functional scores. Methods In this prospective, single-centre, randomized controlled trial (RCT), patients were randomized to either NPWT or conventional sterile occlusive dressings. A total of 17 patients, with a mean age of 54 years (21 to 81), were successfully recruited and none were lost to follow-up. Wound reviews were undertaken to identify any surgical site infection (SSI) or adverse wound events within 30 days. The Toronto Extremity Salvage Score (TESS) and Musculoskeletal Tumor Society (MSTS) score were recorded as patient-reported outcome measures (PROMs). Results There were two out of seven patients in the control group (28.6%), and two out of ten patients in the intervention group (20%) who were diagnosed with a SSI (p > 0.999), while one additional adverse wound event was identified in the control group (p = 0.593). No significant differences in PROMs were identified between the groups at either 30 days (TESS, p = 0.987; MSTS, p = 0.951) or six-month (TESS, p = 0.400) follow-up. However, neoadjuvant radiotherapy was significantly associated with a SSI within 30 days of surgery, across all patients (p = 0.029). The mean preoperative modified Glasgow Prognostic Score (mGPS) was also significantly higher among patients who developed a postoperative adverse wound event (p = 0.028), including a SSI (p = 0.008), across both groups. Conclusion This is the first RCT comparing NPWT with conventional dressings following musculoskeletal tumour surgery. Postoperative wound complications are common in this group of patients and we observed an overall SSI rate of 23.5%. We propose proceeding to a multicentre trial, which will help more clearly define the role of closed incision NPWT in STS surgery. Cite this article: Bone Jt Open 2021;2(12):1049–1056.

scholarly journals Delayed Closure of Open Abdomen in Septic Patients Treated With Negative Pressure Vacuum Therapy and Dynamic Sutures: A 10-Years Follow-Up on Long-Term Complications

2021 ◽  
Vol 7 ◽  
Author(s):  
Anna Theresa Hofmann ◽  
Christopher May ◽  
Karl Glaser ◽  
René H. Fortelny
Keyword(s):  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Open Abdomen ◽  
Fascial Closure ◽  
Wound Therapy ◽  
Surgical Interventions ◽  
Incisional Hernias ◽  
Operating Field

Introduction: Patients with open abdomen after surgical interventions associated with the complication of secondary peritonitis are successfully treated with negative pressure wound therapy. The use of dynamic fascial sutures reduces fascial lateralization and increases successful delayed fascial closure after open abdomen treatment.Methods: In 2017 we published the follow-up results of 38 survivors out of 87 open abdomen patients treated with negative pressure wound therapy and dynamic fascial sutures between 2007 and 2012. In our current study we present the 10-years follow-up results regarding long-term complications with the focus on incisional hernias and pain. Since 2017 seven more patients have died, hence 31 patients were included in the current study. The patients were asked to answer questions about specific long-term complications of OA treatment including pain, the presence of incisional hernias and subsequent surgical interventions. Demographic data and data regarding fascial closure after open abdomen treatment were collected. All results were analyzed quantitatively. The follow-up period was 8–13 years.Results: The median age was 69 (30–90) years, and 15 (48.4%) were females. Twenty-four patients (77.4%) responded to the questionnaire: Three patients (12.5%) suffered from pain in the original operating field, all three at rest but not during exercise. None of the patients required analgesic treatment. Eleven patients (45.8%) were found to have incisional hernias. Five out of 11 hernias (45.5%) were treated by surgery and did not declare any pain in the operating field. Among the patients with incisional hernias lower MPI (Mannheimer Peritonitis Index) at the time of primary surgery but more reoperations and treatment days were found. The technique of fascial closure was heterogenic and no differences in the occurrence of incisional hernia could be detected.Conclusion: The incidence of incisional hernias after open abdomen treatment is still high, but are associated with little pain in the original operating field. Further studies are required to investigate methods for fascial closure techniques after OA treatment.

scholarly journals Role and effectiveness of complex and supervised rehabilitation on overall and hand function in systemic sclerosis patients—one-year follow-up study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Michał Waszczykowski ◽  
Bożena Dziankowska-Bartkowiak ◽  
Michał Podgórski ◽  
Jarosław Fabiś ◽  
Arleta Waszczykowska
Keyword(s):  
Systemic Sclerosis ◽  
Hand Function ◽  
Exercise Program ◽  
Rehabilitation Program ◽  
Long Term Results ◽  
Home Exercise ◽  
Control Group ◽  
Study Group

AbstractThe aim of this study was to estimate the long-term results of complex and supervised rehabilitation of the hands in systemic sclerosis (SSc) patients. Fifty-one patients were enrolled in this study: 27 patients (study group) were treated with a 4-week complex, supervised rehabilitation protocol. The control group of 24 patients was prescribed a home exercise program alone. Both groups were evaluated at baseline and after 1-, 3-, 6-, and 12-months of follow-up with the Disability of the Arm, Shoulder and Hand Questionnaire (DAHS) as the primary outcome, pain (VAS—visual analog scale), Cochin Hand Function Scale (CHFS), Health Assessment Questionnaire Disability Index (HAQ-DI), Scleroderma-HAQ (SHAQ), range of motion (d-FTP—delta finger to palm, Kapandji finger opposition test) and hand grip and pinch as the secondary outcomes. Only the study group showed significant improvements in the DASH, VAS, CHFS and SHAQ after 1, 3 and 6 months of follow-up (P = 0.0001). Additionally, moderate correlations between the DASH, CHFS and SHAQ (R = 0.7203; R = 0.6788; P = 0.0001) were found. Complex, supervised rehabilitation improves hand and overall function in SSc patients up to 6 months after the treatment but not in the long term. The regular repetition of this rehabilitation program should be recommended every 3–6 months to maintain better hand and overall function.

Cost-efficacy of skin grafting techniques using negative pressure wound therapy and tissue-engineered skin for burns

2021 ◽  
Author(s):  
Muhammad Hanif Nadhif ◽  
Muhammad Satrio Utomo ◽  
Muhammad Farel Ferian ◽  
Farhan H. Taufikulhakim ◽  
Nadine H. P. Soerojo ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Skin Grafting ◽  
Wound Therapy ◽  
Cost Efficacy

scholarly journals Long-Term Follow-Up After Maxillary Sinus Balloon Sinuplasty and ESS

2021 ◽  
pp. 014556132098603
Author(s):  
Anni Koskinen ◽  
Marie Lundberg ◽  
Markus Lilja ◽  
Jyri Myller ◽  
Matti Penttilä ◽  
...  
Keyword(s):  
Maxillary Sinus ◽  
Revision Surgery ◽  
University Hospital ◽  
Sinus Surgery ◽  
Control Group ◽  
University Hospitals ◽  
Balloon Sinuplasty ◽  
Long Term Follow Up

Objectives: The aim of this controlled follow-up study was to compare the need for revision surgery, long-term efficacy, and satisfaction in chronic rhinosinusitis patients who had undergone maxillary sinus operation with either balloon sinuplasty or traditional endoscopic sinus surgery (ESS) technique. Methods: Thirty-nine ESS patients and 36 balloon patients of our previously described cohort, who had been primarily operated in 2008 to 2010, were contacted by phone. Symptoms, satisfaction, and need for revision surgery were asked. In addition, we collected data of patients who had undergone primary maxillary sinus balloon sinuplasty in the Helsinki University Hospital during the years 2005 to 2019. As a control group, we collected data of patients who had undergone primary maxillary sinus ESS at 3 Finnish University Hospitals, and 1 Central Hospital in years 2005, 2008, and 2011. Results: Altogether, 77 balloon patients and 82 ESS patients were included. The mean follow-up time was 5.3 years in balloon group and 9.8 years in ESS group. Revision surgery was performed on 17 balloon patients and 6 ESS patients. In the survival analysis, the balloon sinuplasty associated significantly with a higher risk of revision surgery compared to ESS. According to the phone interviews, 82% of ESS patients and 75% of balloon patients were very satisfied with the primary operation. Conclusion: Although the patient groups expressed equal satisfaction and change in symptoms after the operations, the need for revision surgery was higher after balloon sinuplasty than after ESS. This should be emphasized when counselling patients regarding surgical options.

Combination of Three Different Negative Pressure Wound Therapy Applications and Free Flap for Open Elbow Joint Injury With Extensive Burns

2021 ◽  
Author(s):  
Junya Oshima ◽  
Kaoru Sasaki ◽  
Yukiko Aihara ◽  
Masahiro Sasaki ◽  
Yoichiro Shibuya ◽  
...  
Keyword(s):  
Free Flap ◽  
Negative Pressure ◽  
Elbow Joint ◽  
Negative Pressure Wound Therapy ◽  
Skin Grafting ◽  
Perioperative Period ◽  
Wound Therapy ◽  
Joint Injury ◽  
Left Limb ◽  
Effective Option

Abstract Negative pressure wound therapy (NPWT) for treating burns has a variety of therapeutic applications. Here, we present a case of a 53-year-old woman with self-inflicted burn injuries in whom NPWT was applied for three different purposes. The injured sites were the anterior neck, bilateral arms from the wrists upwards to the chest, and back. The left arm was deeply injured, and the elbow joint cavity was opened during treatment. First, NPWT was used for bridge to skin grafting on the entire upper left limb. Second, NPWT was used as a bolster dressing for the autograft after skin grafting was performed on the left arm except the open part of the joint. Third, NPWT over flap was used on the subsequent flap surgical site to address prolonged exudate from the flap margin. The exudate resolved after about a week. Good results were obtained using NPWT during the perioperative period of free flap transplantation for extensive open elbow joint burns. The use of NPWT is an effective option in the treatment of burns.

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