scholarly journals Charcot foot (neuropathic arthropathy) in diabetes as a "special needs foot". Case report of an efficient negative pressure wound therapy use.

2018 ◽  
Vol 5 (1) ◽  
Author(s):  
Bartosz Cybułka
Keyword(s):  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Multiple Organ ◽  
Autonomic Nerves ◽  
Charcot Foot ◽  
Orthopedic Treatment ◽  
Neuropathic Arthropathy ◽  
Optimal Care ◽  
Irreversible Damage ◽  
Patients With Diabetes

Diabetes is the most common endocrine disorder of carbohydrate metabolism. If left untreated, or improperly treated for many years, diabetes leads to multiple organ complications. One of the serious consequences of the disease is damage to the peripheral and autonomic nerves known as diabetic neuropathy. The most advanced form of neuropathy, leading to damage to the structures of the forefoot, midfoot and hindfoot, is the so called Charcot foot, or neuropathic osteoarthropathy. Irreversible damage to the structures of the foot affects between 0,1% and 7.5% of patients with diabetes. The optimal care for that form of foot damage is still a subject to debate. Available methods of caring for Charcot foot include invasive orthopedic treatment and conservative treatment. The use of negative pressure woudn therapy may be an effective, as well as transitional, way of managing Charcot foot.  

The role of angiopoetic factors in wound healing among patients with diabetes treated with negative-pressure wound therapy

Leczenie Ran ◽  
2015 ◽  
Vol 11 (4) ◽  
pp. 171-178
Author(s):  
Beata Mrozikiewicz-Rakowska ◽  
Joanna Kania ◽  
Ewelina Bucior ◽  
Adriana Nowak ◽  
Tomasz Grzela ◽  
...  
Keyword(s):  
Wound Healing ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Wound Therapy ◽  
Patients With Diabetes

scholarly journals Negative-pressure wound therapy in the management of diabetic Charcot foot and ankle wounds

2013 ◽  
Vol 4 (1) ◽  
pp. 20878 ◽  
Author(s):  
Crystal L. Ramanujam ◽  
John J. Stapleton ◽  
Thomas Zgonis
Keyword(s):  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Foot And Ankle ◽  
Charcot Foot ◽  
Wound Therapy

scholarly journals Extensive post-covid mucormycosis salvaged by old fashioned negative pressure wound therapy

2021 ◽  
Vol 8 (9) ◽  
pp. 2856
Author(s):  
R. Sanjay ◽  
Farukh Khan ◽  
Shalu Gupta ◽  
Rahul Chikkarangappa ◽  
Komal Choudhary
Keyword(s):  
Chest Wall ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Fungal Growth ◽  
Anterior Chest Wall ◽  
Wound Therapy ◽  
Patients With Diabetes ◽  
Muscle Fascia ◽  
Cutaneous Mucormycosis ◽  
Thorough Debridement

Mucormycosis represents a group of life threatenening infections caused by fungi of the order Mucorales. Mucorales are ubiquitous environmental fungi that grow well in moist and damp conditions. They can invade arteries to cause thrombosis and infarction. These fungi cause infection primarily in patients with diabetes, neutropenia, elevated levels of free iron and those who are on glucocorticoid therapy, which supports fungal growth in serum and tissues. Recently the incidence of mucormycosis was found to have increased in patients previously infected with coronavirus (COVID-19). Here we presented a 52 year old lady who was previously infected by coronavirus, was administered glucocorticoids as a part of empirical treatment for COVID-19 pnemonitis. She recovered uneventfully within a few days, but, around a month later presented with erythematous papule over the anterior chest wall. The papule developed into a large fungating ulcer over a period of 10 days. KOH mount and culture confirmed it to be mucormycosis. Cutaneous mucormycosis can be highly invasive, penetrating into muscle, fascia and even bone. These are molds that grow well in moist and damp conditions. But depriving them of moisture and oxygen can help control their spread. This could be achieved by thorough debridement and applying negative pressure to the wound. The results achieved are remarkable and satisfactory.

Single-use negative pressure wound therapy reduces costs in closed surgical incisions: UK and US economic evaluation

2021 ◽  
Vol 30 (Sup5) ◽  
pp. S23-S31
Author(s):  
Leo M Nherera ◽  
Chris Saunders ◽  
Sanjay Verma ◽  
Paul Trueman ◽  
Francis Fatoye
Keyword(s):  
Sensitivity Analysis ◽  
Negative Pressure ◽  
Standard Care ◽  
Negative Pressure Wound Therapy ◽  
Decision Analytic Model ◽  
Wound Therapy ◽  
Surgical Incisions ◽  
Patients With Diabetes ◽  
Single Use ◽  
The Uk

Objective: Single-use negative pressure wound therapy (sNPWT) following closed surgical incisions has a demonstrable effect in reducing surgical site complications (SSC). However, there is little health economic evidence to support its widespread use. We sought to evaluate the cost-effectiveness of sNPWT compared with standard care in reducing SSCs following closed surgical incisions. Method: A decision analytic model was developed to explore the total costs and health outcomes associated with the use of the interventions in patients following vascular, colorectal, cardiothoracic, orthopaedic, C-section and breast surgery from the UK National Health Service (NHS) and US payer perspective over a 12-week time horizon. We modelled complications avoided (surgical site infection (SSI) and dehiscence) using data from a recently published meta-analysis. Cost data were sourced from published literature, NHS reference costs and Centers for Medicare and Medicaid Services. We conducted subgroup analysis of patients with diabetes, an American Society of Anesthesiologists (ASA) score ≥3 and body mass index (BMI) ≥30kg/m2. A sensitivity analysis was also conducted. Results: sNPWT resulted in better clinical outcomes and overall savings of £105 per patient from the UK perspective and $637 per patient from the US perspective. There were more savings when higher-risk patients with diabetes, or a BMI ≥30kg/m2 or an ASA≥3 were considered. We conducted both one-way and probabilistic sensitivity analysis, and the results suggested that this conclusion is robust. Conclusion: Our findings suggest that the use of sNPWT following closed surgical incisions saves cost when compared with standard care because of reduced incidence of SSC. Patients at higher risk should be targeted first as they benefit more from sNPWT. This analysis is underpinned by strong and robust clinical evidence from both randomised and observational studies.

scholarly journals Effectiveness of negative pressure wound therapy in the management of chronic diabetic ulcers: a prospective study

2017 ◽  
Vol 4 (4) ◽  
pp. 1313 ◽  
Author(s):  
Dhruv Sharma ◽  
Biplav Singh ◽  
K. S. Jaswal ◽  
Vishal Thakur ◽  
Vibhor Nanda ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Diabetic Patients ◽  
Wound Therapy ◽  
Diabetic Ulcers ◽  
Silicone Catheter ◽  
Patients With Diabetes ◽  
The Moment ◽  
A Prospective Study ◽  
Dressing Change

Background: Chronic ulcers in patients with diabetes are complex and treatment is often difficult. At the moment, negative pressure wound therapy (NPWT) is widely used for the treatment of several types of wounds. Nevertheless, the clinical evidence to support the application of this dressing in chronic diabetic ulcers is scarce. The aim of this study was to evaluate the efficacy of NPWT to treat chronic diabetic ulcers.Methods: Prospective time bound comparative study. Diabetic patients aged 18 years or older with an ulcer were assigned to treatment with NPWT. Primary efficacy end point was time in reaching complete ulcer closure. A size of sample of 15 patients was used. NPWT was prepared with a polyurethane foam dressing, a Silicone catheter, a transparent adhesive drape and continuous negative pressure of 125 mm Hg. The wound was treated for cycles of 5 days and evaluated at every dressing change. Descriptive and analytical statistics were used.Results: There were 15 patients, with a mean age of 54.4 years (73.3% men). The average time to complete ulcer closure was (41.2 [8.5] days).Conclusions: NPWT is an effective modality of treatment of chronic diabetic ulcers with early appearance of granulation tissue and faster rates of overall complete wound closure.

Prevention of poststernotomy wound infections in obese patients by negative pressure wound therapy

2013 ◽  
Vol 61 (S 01) ◽  
Author(s):  
O Grauhan ◽  
A Navasardyan ◽  
M Hofmann ◽  
P Müller ◽  
J Stein ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Obese Patients ◽  
Wound Infections ◽  
Wound Therapy

Experience of negative pressure wound therapy over sternal wound healing: A retrospective review

WCET Journal ◽  
2019 ◽  
Vol 39 (2) ◽  
pp. 9-18
Author(s):  
Wai Sze Ho ◽  
Wai Kuen Lee ◽  
Ka Kay Chan ◽  
Choi Ching Fong
Keyword(s):  
Wound Healing ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Assessment Tool ◽  
Wound Care ◽  
Wound Therapy ◽  
Treatment Pathways ◽  
Wound Assessment ◽  
One Year

Objectives The aim of this study was to retrospectively review the effectiveness of negative pressure wound therapy (NPWT) in sternal wound healing with the use of the validated Bates-Jensen Wound Assessment Tool (BWAT), and explore the role of NPWT over sternal wounds and future treatment pathways. Methods Data was gathered from patients' medical records and the institution's database clinical management system. Seventeen subjects, who had undergone cardiothoracic surgeries and subsequently consulted the wound care team in one year were reviewed. Fourteen of them were included in the analysis. Healing improvement of each sternal wound under continuous NPWT and continuous conventional dressings was studied. In total, 23 continuous NPWT and 13 conventional dressing episodes were analysed with the BWAT. Results Among conventional dressing episodes, sternal wound improvement was 2.5–3% over 10 days to 3.5 weeks, whereas 4–5% sternal healing was achieved in 5 days to 2 weeks with sternal wire presence. Better healing at 11% in 1 week by conventional dressing was attained after sternal wire removal. In NPWT episodes, 8–29%, 13–24%, and 15–46% of healing was observed in 2 weeks, 3.5 to 5 weeks and 6 to 7 weeks, respectively. Only 39% wound healing was acquired at the 13th week of NPWT in one subject. With sternal wire present, 6%–29% wound healing progress was achieved by NPWT in 1–4 weeks, and 16–23% wound improvement in 2 to 4.5 weeks by NWPT after further surgical debridement. After sternal wire removal, 6–34% sternal wound healing occurred by continuous NPWT for 1–2 weeks, and maximum healing at 46% after 2.5 weeks of NPWT were observed. Conclusions Better wound healing was achieved in the NPWT group in comparison to conventional dressings alone. However, suboptimal sternal wound healing by NPWT alone was observed. Removal of sternal wire may improve the effectiveness of NPWT. Successful tertiary closure after NPWT among subjects supports the important bridging role of NPWT in sternal wound healing. Factors causing stagnant sternal wound healing by NPWT alone are discussed.

The effects and use of negative pressure wound therapy – a set of case reports

2020 ◽  
Vol 99 (4) ◽  
pp. 183-188
Keyword(s):  
Wound Healing ◽  
High Risk ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Chronic Wounds ◽  
Wide Spectrum ◽  
Case Reports ◽  
Modern Medicine ◽  
Wound Therapy ◽  
Basic Set

Modern medicine offers a wide spectrum of wound healing resources for acute or chronic wounds. Negative pressure wound therapy (NPWT) is a very effective method, allowing complicated defects and wounds to heal. The basic set is usually provided with various special accessories to facilitate the use and support safe application of NPWT to high-risk tissue. Selected case reports are presented herein to document the special use and combinations of materials in negative pressure wound therapy.

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