scholarly journals Applying NPWT to bleeding open wounds after forefoot amputation in diabetic foot patients - a case report

2018 ◽  
Vol 5 (4) ◽  
pp. 5-8
Author(s):  
Jacek Białecki ◽  
Przemysław Pyda ◽  
Anna Kołodziejska ◽  
Anna Rybak ◽  
Sebastian Sowier
Keyword(s):  
Negative Pressure ◽  
Diabetic Foot ◽  
Pressure Range ◽  
Packing Material ◽  
Surgical Wound ◽  
Bone Resection ◽  
Optimum Pressure ◽  
Forefoot Amputation ◽  
Pressure Dressing ◽  
High Negative Pressure

NPWT is increasingly used in patients with diabetic foot. The protocol for performing NPWT is subject to debate. Main concerns regard the type of suction to use (continuous, intermittent, or variable), the wound-packing material, or the exact pressure to apply. Typically, an optimum pressure range of –80 to –125 mmHg is indicated. Following bone resection in diabetic foot patients, the surgical wound is left open, which often entails bleeding from the resection site. In these cases, the start of NPWT was typically delayed by 24–48 hours – during that time a pressure dressing was applied – and NPWT was only started once bleeding had ceased. In order to initiate NPWT as soon as possible, we decided to start it at a higher negative pressure than usual, i.e. –180 mmHg, expecting that this would stop the bleeding. Only then would we reduce the negative pressure. This paper presents the course of NPWT with high negative pressure values after an amputation in 2 diabetic foot patients. In both cases, our assumptions were confirmed. The patients did not bleed, the drained volume did not exceed 30 ml (which seems clinically insignificant) in the first 40 minutes of treatment. Later, with negative pressure at –120 mmHg, no bleeding into the dressing was observed. Following the treatment (which lasted for 9 days), the wounds granulated normally, with no signs of inflammation. Applying VAC dressing using high negative pressure values to bleeding wounds immediately after surgery may stop the bleeding, enabling immediate initiation of NPWT.

Negative Pressure Therapy in the Surgical Treatment of Diabetic Foot

2017 ◽  
Vol 68 (7) ◽  
pp. 1648-1651
Author(s):  
Bogdan Mihnea Ciuntu ◽  
Ciprian Vasiluta ◽  
Robert Negru ◽  
Roxana Hultoana ◽  
Roxana Ciuntu ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Negative Pressure ◽  
Diabetic Foot ◽  
Bacterial Load ◽  
Abdominal Wall Defects ◽  
Negative Pressure Therapy ◽  
Simultaneous Application ◽  
Average Hospital ◽  
Pressure Therapy ◽  
Days Of Therapy

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.

Prophylactic Negative Pressure Dressing Use in Closed Laparotomy Wounds Following Abdominal Operations

2017 ◽  
Vol 265 (6) ◽  
pp. 1082-1086 ◽  
Author(s):  
Donal Peter O’Leary ◽  
Colin Peirce ◽  
Breffini Anglim ◽  
Michael Burton ◽  
Elizabeth Concannon ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Abdominal Operations ◽  
Pressure Dressing

Autologous fat grafting combined with negative pressure wound therapy in severe diabetic foot ulcer: a case study

2021 ◽  
Vol 30 (Sup4) ◽  
pp. S38-S40
Author(s):  
Zheng Biyao ◽  
Xu Gang ◽  
Jiang Hai ◽  
Duan Chenwang ◽  
Liu Xuan
Keyword(s):  
Negative Pressure ◽  
Diabetic Foot ◽  
Negative Pressure Wound Therapy ◽  
Foot Ulcer ◽  
Fat Grafting ◽  
Autologous Fat Grafting ◽  
Wound Therapy ◽  
Autologous Fat ◽  
Split Thickness Skin Grafting

Objective: Hard-to-heal wounds are a surgical challenge, and diabetic foot ulcers (DFUs) are one of the most common and severe varieties. Previous studies have shown that autologous fat grafting (AFG) and negative pressure wound therapy (NPWT) have the potential to promote wound healing. This case study describes how these two methods together helped in the healing of a serious DFU. Case history: A 65-year-old female patient had a severe DFU on her right foot, with a 30-year history of disease and renal failure. By the time symptoms were evident, regular dressing changes and antibiotic treatment were inadequate. She received surgical debridement, AFG and NPWT. Finally, as the granulation tissue covered the full wound bed, the wound was closed by split-thickness skin grafting. One month later, the DFU was fully healed with no recurrences. Conclusion: The application of AFG or components of adipose tissue to treat hard-to-heal wounds has been researched at both the molecular level and in clinic. In this case, we have proved the curative effect of jointly using AFG and NPWT.

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