scholarly journals “Traumatic fistula of glenohumeral joint with concurrent osteomyelitis and infection of periarticular tissues. The use of negative pressure therapy as one of the elements of treatment of chronic traumatic wound.”

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.

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.  


2014 ◽  
Vol 1 (2) ◽  
pp. 38-43
Author(s):  
Abdelmoughit Echchaoui ◽  
Malika Benyachou ◽  
Jawad Hafidi ◽  
Imane Elaissaoui ◽  
Hasna Zaouri ◽  
...  

Introduction : The topical negative pressure therapy (TNP) is a non-invasive method to treat chronic and acute wounds locally, using a continuous or intermittent negative pressure. The objective of this study is to present the first experience of this type of treatment used in clinical cases in our department. By presenting these cases, we highlight indication and efficiency of this new technique applied in relatively complicated situations, at the same time it also allows a significant improvement in treating injuries and chronic wounds. Materials and methods : In this study, we present the recent experience of the Department of Reconstructive and Plastic Surgery of the University Hospital Center of Avicenne in Rabat. This therapy was used for the first time this year (in 2014), in three young patients who presented with chronic wounds associated with local and general factors that are unfavorable for the healing process. Results : In all three of our cases we obtained highly satisfactory clinical results. TNP allows wounds to bud in a shorter time, as well as a fast healing by second intention due to controlled wound healing or split-skin graft without using flaps. This enables to decrease the margin of error, the time and the number of dressing replacements, and to reduce the length of hospital stay. Conclusion : This is an expensive and specific equipment. However, the cost-benefit ratio analysis shows that it is an essential method that should be part of our therapeutic strategies.


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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