scholarly journals Management of large chronic venous leg ulcers with negative pressure wound therapy

2017 ◽  
Vol 4 (2) ◽  
pp. 17
Author(s):  
Dominik Andrzej Walczak ◽  
Michał Wojtyniak ◽  
Rajmund Jaguścik ◽  
Joanna Jadwiga Porzeżyńska ◽  
Wojciech Fałek ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Adult Population ◽  
Complete Healing ◽  
Leg Ulcers ◽  
Skin Grafts ◽  
Wound Therapy ◽  
Venous Leg Ulcers ◽  
Venous Ulcers ◽  
The Mean

Introduction: Venous leg ulcers (VLU) occur in 1\% of the adult population and are associated with chronic disability, diminished quality of life and high health-care costs. Treatment is often slow, difficult and recurrence is high because of inappropriate conditions of the wound bed. Patients and Methods: This study involves 14 patients with chronic venous ulcers larger than 100 cm\textsuperscript{2} treated with negative pressure wound therapy (NPWT). Patients underwent a radical debridement of all devitalized tissues and partial stripping of an insufficient great saphenous vein in the first operation. After adequate haemostasis, NPWT kit was applied. Once the wounds were determined to be clean and adequate granulation tissue formation was achieved, split-thickness skin grafts were applied. Dressing impregnated with neutral triglycerides and silver ions was used as a first layer and the black polyurethane NPWT foam was applied over it. The pain assessment was performed for 7 patients using 10 cm visual analog scale (VAS). Results: The mean number of NPWT dressing changes prior to grafting was 5.8. The mean number of NPWT foam changes was 2.8 after skin grafting. We accomplished complete healing of 92\% of applied skin grafts surface. One patient had recurrence of venous ulcers in the follow-up period. Moreover, one patient required regrafting. Conclusions: The application of NPWT provides quick wound-bed preparation and high graft take in venous ulcer treatment.

Treatment of hard-to-heal leg ulcers with hyaluronic acid, sodium alginate and negative pressure wound therapy

2020 ◽  
Vol 29 (7) ◽  
pp. 419-423
Author(s):  
Omer Arda Cetinkaya ◽  
Suleyman Utku Celik ◽  
Can Yahya Boztug ◽  
Hakan Uncu
Keyword(s):  
Hyaluronic Acid ◽  
Lower Extremity ◽  
Negative Pressure ◽  
Conventional Therapy ◽  
Negative Pressure Wound Therapy ◽  
Therapy Group ◽  
Complete Healing ◽  
Leg Ulcers ◽  
Wound Therapy ◽  
Conventional Therapy Group

Objective: Hard-to-heal lower extremity ulcer is a common healthcare problem and can lead to a poor quality of life (QoL). Despite the advances in wound care, conventional therapies, such as necrotic tissue debridement, cleansing, treatment of infection and local treatment with dressing application are still considered the standard of care in patients with hard-to-heal leg ulcers. However, managing hard-to-heal ulcers that do not respond well to these methods has led to new treatment strategies. In this study, the effects of hyaluronic acid (HA) and sodium alginate (SA), combined with negative pressure wound therapy (NPWT), in patients with hard-to-heal leg ulcers are evaluated. Method: Patients with hard-to-heal lower extremity ulcers were treated with HA-SA combined with NPWT (HA-SA-NWPT, n=11), or conventional therapy (n=14), between June 2014 and September 2015. Demographics, comorbidities, time to complete healing and change in wound area were recorded and compared. Results: A total of 25 patients took part. Complete healing was achieved in 63.6% (n=7) of the patients in the HA-SA with NPWT group, compared with 14.3% (n=2) of the patients in the conventional therapy group (p=0.017). The mean decrease in wound size was significantly higher in the HA-SA-NPWT group than in the conventional therapy group (73.8% versus 34.8%, respectively, p=0.029). Despite a shorter healing period in the HA-SA-NPWT group than in the conventional group, no statistically significant difference was found between groups for time to complete healing (37 days versus 55 days, respectively). Conclusion: These results demonstrate that the combination of HA-SA-NPWT is a promising treatment for decreasing the healing time and increasing the success rate by their synergistic effect on wound healing in hard-to-heal lower extremity ulcers. However, further studies with a larger number of patients are needed to confirm the results.

225 Clinical application and efficacy of Negative Pressure Wound Therapy with Instillation and Dwell Time (NPWTi-d): A Systematic Review and Meta-Analysis

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
A Mantelakis
Keyword(s):  
Clinical Application ◽  
Negative Pressure ◽  
Dwell Time ◽  
Negative Pressure Wound Therapy ◽  
Meta Analysis ◽  
Complete Healing ◽  
Current Data ◽  
Wound Therapy ◽  
The Mean ◽  
Mean Time

Abstract Background This study evaluates the current clinical evidence of Negative Pressure Wound Therapy with Instillation and dwell time (NPWTi-d) to establish its clinical application and efficacy. Method MEDLINE, EMBASE, and CENTRAL databases were searched from 1946 to July 2019 for studies reporting clinical outcomes on wounds treated with NPWTi-d. The primary outcome was proportion of wounds with complete healing. The secondary outcomes were mean time for healing, NPWTi-d settings, cost, length of stay and adverse events. Results Thirteen articles were included with a total of 624 wounds in 542 patients involving wounds of various aetiology. The pooled proportion of wound that achieved complete healing was 93.65% (95%CI: 84.02-99.04). Normal saline was the most commonly used instillation solution with the mean dwell time of 14.23 minutes (95%CI: 10.88-17.59) and instillation cycle every 4.17 ± 2.32 hourly. The mean therapy duration was 10.69 days (95%CI: 10.46-10.91) with daily cost of $194.80. The mean hospital stay was 18.1 days (95%CI: 17.20-19.00). There were no severe adverse effects reported. Discussion NPWTi-d is an adjuntive therapy to aid complete healing of the vast majority of wounds. However, the current data is limited by the lack of level 1 evidence.

scholarly journals Full circumference lower extremity degloving injury treated with hydrosurgical debridement and negative-pressure wound therapy with gauze wound filler for fixation of avulsed flap skin grafts

2020 ◽  
Vol 2020 (12) ◽  
Author(s):  
Tae Nagama ◽  
Natsuko Kakudo ◽  
Atsuyuki Kuro ◽  
Yujiro Ozaki ◽  
Yasuko Shirasawa ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Traumatic Injury ◽  
Skin Grafts ◽  
Wound Therapy ◽  
Left Lower Extremity ◽  
Degloving Injury ◽  
Severe Traumatic Injury ◽  
Degloving Injuries

Abstract Degloving, a skin and subcutis avulsion, is a severe traumatic injury sometimes caused by rolling wheels or machines. Although avulsed flaps are often readapted to its original site, most of these tissues become necrotic. Due to the extensive skin and soft tissue deficiency caused by necrosis, treatment becomes difficult. Skin grafts harvested from avulsed flaps may be used to treat degloving injuries, while negative pressure wound therapy (NPWT) is used to secure the grafts. Commonly used porous polyurethane foam wound fillers are difficult to set in circumferential extremity degloving injuries; gauze-based wound fillers are easier to use and cause less pain during dressing changes. We present a case of an extensive, full-circumference left lower-extremity degloving injury, treated using NPWT with gauze-based wound fillers for fixation of skin grafts harvested from avulsed flaps after hydrosurgical debridement. For complex wound geometries, gauze-based wound fillers can be easily applied for skin graft immobilization.

Negative pressure wound therapy using polyvinyl alcohol foam to bolster full-thickness mesh skin grafts in dogs

2017 ◽  
Vol 46 (3) ◽  
pp. 389-395 ◽  
Author(s):  
Matan Or ◽  
Bart Van Goethem ◽  
Adriaan Kitshoff ◽  
Annika Koenraadt ◽  
Ilona Schwarzkopf ◽  
...  
Keyword(s):  
Polyvinyl Alcohol ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Skin Grafts ◽  
Full Thickness ◽  
Wound Therapy

scholarly journals 1431 Stoma Intubation, Isolation and Negative Pressure Wound Therapy for Complex Stoma-Associated Wounds: New Technique and Case Series

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
N Browning ◽  
M Okocha ◽  
M Doe ◽  
A Lyons ◽  
H Sumrien
Keyword(s):  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Enterocutaneous Fistula ◽  
Loop Ileostomy ◽  
Case Series ◽  
Complete Healing ◽  
Wound Therapy ◽  
First Case ◽  
Isolation Device ◽  
Commercial Device

Abstract Background The use of negative pressure wound therapy (NPWT) in colorectal surgery has been demonstrated for treating perineal defects, enterocutaneous fistula and stoma dehiscence. Here we describe a technique for closure of complex stoma-associated wounds using a novel commercial intubation device alongside NPWT to protect the surrounding wound from the stoma effluent. The device has previously described for use with enterocutaneous fistula. We present two cases that have been successfully treated with this technique. Technique and Cases The first case is of 88-year-old women with a retracted loop ileostomy and the second a 48 year-old male with a retracted end colostomy. Both patients underwent significant emergency peristomal debridement and in both cases the commercial device was deployed to intubate the stoma. VAC foam and standard adhesive dressings were used to form a quality seal and the pressure set to 125mmHg. In both cases near complete healing was achieved to the point that standard stoma bags and management could be used. Conclusions This is the first description of the use of an isolation device in complex stoma associated wounds. We have found the Fistula Funnel to be highly effective in this context.

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.

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