scholarly journals Improvement of Therapy Outcomes after Negative Pressure Wound Therapy in a Patient with Acne inversa.

2014 ◽  
Vol 1 (1) ◽  
Author(s):  
Wojciech Francuzik ◽  
Tomasz Banasiewicz ◽  
Zygmunt Adamski
Keyword(s):  
Negative Pressure ◽  
Negative Impact ◽  
Life Quality ◽  
Skin Grafting ◽  
Surgical Excision ◽  
Visual Assessment ◽  
Acne Inversa ◽  
Pressure Therapy ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting

Treatment of acne inversa (also known as hidradenitis suppurativa) is complicated and chronic. This debilitating, inflammatory disease of the follicular sacks affects mostly young adults and has a strong negative impact on their quality of life. We present a case of a 28 year old woman with a history of acneinversa of Hurley grade 2 for 6 years. Patient underwent surgical excision of the skin of the left inguinum followed by negative pressure therapy dressings for 2 and a half weeks (5 dressing changes). This allowed a full closure of the wound after 12 weeks and formation of a well accepted scar. Patient’s paindecreased from 4.5 to 1.5 according to visual assessment scale. We also noted a 28 point decrease in disease severity score according to Sartorius scale and a 19 point decrease in Dermatology Life Quality Index. Two years prior admission patient had undergone surgical treatment of her right inguinum with split thickness skin grafting, which healed for 26 weeks and yielded less satisfactory results. Comparison photographs of both treatment results are presented.

Coverage of Exposed Bones and Joints in Critically Ill Patients: Lower Extremity Salvage with Topical Negative Pressure Therapy

2008 ◽  
Vol 12 (5) ◽  
pp. 223-229 ◽  
Author(s):  
Raymund E. Horch ◽  
Adrian Dragu ◽  
Werner Lang ◽  
Paul Banwell ◽  
Mareike Leffler ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Negative Pressure ◽  
Critically Ill Patients ◽  
Skin Grafting ◽  
Negative Pressure Therapy ◽  
Pressure Therapy ◽  
Topical Negative Pressure ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting ◽  
Extremity Amputation

Background: Soft tissue defects of the limb with exposure of tendons and bones in critically ill patients usually lead to extremity amputation. A potential treatment with topical negative pressure may allow split-thickness skin grafting to the bone, which leads to limb salvage. Materials and Methods: We report on 21 multimorbid patients, 46 to 80 years of age, with severe lower limb soft tissue loss and infection with exposed bone following débridement with critical limb ischemia. Attempts to salvage the extremities were undertaken with repeated surgical débridement followed by vacuum-assisted closure therapy and subsequent split-thickness skin grafting procedures. Results: Infection control and limb salvage were achieved in all cases with multiple débridements, topical negative pressure therapy, and skin grafts. In all patients, the exposure of tendons and bones was reversible by this strategy without a free flap transfer. Discussion: The patients described in this study were severely compromised by systemic and vascular disorders, so extremity amputation had been considered owing to the overall condition and the exposure of tendons and bones. Since it was possible to salvage the affected limbs with this straightforward and simple procedure, this type of treatment should be considered as a last attempt to prevent amputation.

scholarly journals NEGATIVE PRESSURE WOUND THERAPY AND INTEGRA® DRT FOR AVULSION INJURIES OF THE LOWER EXTREMITIES – PRESENTATION OF TWO CASES AND LITERATURE REVIEW

2019 ◽  
Vol 141 (5-6) ◽  
pp. 146-149
Keyword(s):  
Granulation Tissue ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Initial Period ◽  
Lower Extremities ◽  
Skin Grafting ◽  
Solid Layer ◽  
Wound Therapy ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting

Two cases which involved a massive avulsion injury of the lower extremities are presented. In both cases the treatment consisted of sequential debridement during the initial period after which negative pressure wound therapy was applied for a period of three to four weeks in order to enable the formation of a solid layer of granulation tissue and a clinically clean wound. Subsequently, INTEGRA® DRTwas fixed to the wound bed with negative pressure wound therapy. During the next three weeks INTEGRA® DRT „integrated“ which enabled split-thickness skin grafting with 0.2 mm thick grafts. In both cases the final outcome was functionally and cosmetically satisfying with near normal contours of the lower extremity restored. Negative pressure wound therapy for a period of three to four weeks enables control of the colonisation of the wound bed and a formation of a solid layer of granulation tissue. The application of INTEGRA® DRT enables formation of the neodermis which provides elasticity and better contours of the reconstructed tissue. A downside of this type of treatment is the price as well as the duration of therapy of about eight weeks.

scholarly journals Negative Pressure Dressings over Free Muscle Flaps with Immediate Split-Thickness Skin Grafting: A 9-Year Experience

2020 ◽  
Vol 05 (01) ◽  
pp. e27-e31
Author(s):  
Pallavi A. Kumbla ◽  
Steven L. Henry ◽  
Carter J. Boyd ◽  
Patrick K. Kelley ◽  
Ashley Q. Thorburn ◽  
...  
Keyword(s):  
Skin Graft ◽  
Negative Pressure ◽  
Skin Grafting ◽  
Flap Necrosis ◽  
Muscle Flaps ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting ◽  
Muscle Necrosis ◽  
Negative Pressure Dressings ◽  
Pressure Dressing

Abstract Background Negative pressure wound therapy has allowed for significant advances in the treatment of wounds. This occurs through a process of angiogenesis, microdeformation, macrodeformation, and decrease in exudate and bacterial load. It is routinely used as a bolster in the management of skin grafts. However, its role as a dressing over free muscle flaps has not gained widespread acceptance due to the fear of flap compromise. Methods A retrospective review of 97 patients over 9 years was performed. All patients underwent free muscle flap coverage of various wounds with immediate split-thickness skin grafting. A negative pressure dressing was applied, with windows made in the foam sponge to enable Doppler monitoring as well as visual inspection of the flap. Complications including flap failure, skin graft loss, hematoma, distal flap necrosis, negative pressure dressing failure, partial muscle necrosis, and mild flap congestion were assessed. Results Flap loss occurred at a rate of 8.2% (eight flaps). Four of these flaps were lost due to patient factors not attributable to the dressing. In the remaining four flaps (4.1% of the series), it is conceivable that the negative pressure dressing was a contributing factor. However, this failure rate is comparable to flap loss rates in studies where negative pressure dressings were not used. The rates of skin graft failure, hematoma, distal flap necrosis, inability to maintain seal, partial muscle necrosis, and mild flap congestion were also acceptable and similar to studies where negative pressure dressings were not used. Conclusion Negative pressure dressings over free muscle flaps with immediate split-thickness skin grafts are effective and safe to use while allowing for postoperative flap monitoring and skin graft protection.

Increased Cost of Negative Pressure Dressings Is Not Justified for Split-Thickness Skin Grafting of Low-Risk Wounds

2015 ◽  
Vol 29 (7) ◽  
pp. 301-306 ◽  
Author(s):  
Laurence B. Kempton ◽  
Timothy B. Larson ◽  
Harvey E. Montijo ◽  
Rachel B. Seymour ◽  
Stanely B. Getz ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Skin Grafting ◽  
Low Risk ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting ◽  
Negative Pressure Dressings
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