The perifascial areolar tissue and negative pressure wound therapy for one‐stage skin grafting on exposed bone and tendon

Abstract Negative pressure wound therapy (NPWT) for treating burns has a variety of therapeutic applications. Here, we present a case of a 53-year-old woman with self-inflicted burn injuries in whom NPWT was applied for three different purposes. The injured sites were the anterior neck, bilateral arms from the wrists upwards to the chest, and back. The left arm was deeply injured, and the elbow joint cavity was opened during treatment. First, NPWT was used for bridge to skin grafting on the entire upper left limb. Second, NPWT was used as a bolster dressing for the autograft after skin grafting was performed on the left arm except the open part of the joint. Third, NPWT over flap was used on the subsequent flap surgical site to address prolonged exudate from the flap margin. The exudate resolved after about a week. Good results were obtained using NPWT during the perioperative period of free flap transplantation for extensive open elbow joint burns. The use of NPWT is an effective option in the treatment of burns.

Download Full-text

Experience with use of improvised negative pressure wound therapy in the management of wounds with exposed bone

Tropical Doctor ◽

10.1177/0049475520962745 ◽

2020 ◽

pp. 004947552096274

Author(s):

Uwakwe C Mba ◽

Wilfred O Okenwa

Keyword(s):

Teaching Hospital ◽

Granulation Tissue ◽

Negative Pressure ◽

Negative Pressure Wound Therapy ◽

Wound Therapy ◽

Significant Challenge ◽

Exposed Bone

Wounds with exposed bone pose a significant challenge in healing. Negative pressure wound therapy has simplified reconstructive options. In economically constrained regions, this has been modified with materials that are affordable. Its effect on such wounds has not been well studied and so case summaries of 15 patients with 17 wounds who were managed with modified negative pressure wound therapy at Ntasiobi Specialist Hospital and ESUT Teaching Hospital between 2015 and 2019 were obtained. The procedure progressed satisfactorily in 88% of patients with granulation tissue covering the bones while the procedure was discontinued in 12%. The modified negative pressure wound therapy achieves similar results as the patented version and is recommended where resources are limited.

Download Full-text

Home based negative pressure wound therapy and moist dressing in the treatment of diabetic foot ulcers

International Surgery Journal ◽

10.18203/2349-2902.isj20195196 ◽

2019 ◽

Vol 6 (12) ◽

pp. 4303

Author(s):

Shiraz Basheer ◽

Naseef Kannanavil ◽

Sunil Rajendran

Keyword(s):

Negative Pressure ◽

Diabetic Foot ◽

Negative Pressure Wound Therapy ◽

Skin Grafting ◽

Foot Ulcers ◽

Diabetic Foot Ulcers ◽

Wound Therapy ◽

Diabetic Ulcer ◽

Home Based ◽

Split Skin Grafting

Background: Negative pressure wound therapy (NPWT) is a non-invasive wound closure system that uses controlled, localized negative pressure to help heal chronic and acute wounds. The objective of the present study was to compare home based NPWT and moist wound dressing in home care setting with respect to wound healing and time taken for healing among diabetic ulcer patients and the comparison of cost involved for the treatment.Methods: A hospital based prospective observational study where all patients were presented to the Department of Surgery at MES Medical College with diabetic ulcer between 1st January 2016 and 30th March 2017 were included in the study; ulcer size and surface area were measured using vernier calipers and Wagner’s grade between the two groups were evaluated at the time of enrollment.Results: Complete ulcer healing by primary intention was achieved in 86.8% in home based NPWT group vs. 44.3% in conventional moist dressing group. Average duration taken for healing in home based NPWT patient was 3.03 months and in moist dressing group was 4.58 months. Split skin grafting was needed in 2 patients in HB-NPWT group vs. 7 in moist dressing group. 9.3 hospital visits in HB-NPWT group vs 136.8 sessions in moist dressing group.Conclusions: The present study states that NPWT is superior to conventional moist dressing for the management of chronic diabetic foot ulcers. Cost is approximately 1/10th of standard NPWT.

Download Full-text

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

Liječnički vjesnik ◽

10.26800/lv-141-5-6-20 ◽

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.

Download Full-text

Negative pressure wound therapy as a „bridge” forthe final reconstruction of tissue defect following adegloving injury of the forearm – a case report

Negative Pressure Wound Therapy Journal ◽

10.18487/npwtj.v6i3.52 ◽

2019 ◽

Vol 6 (3) ◽

pp. 4-7

Author(s):

Izabela Ratnicka ◽

Karolina Kondej ◽

Justyna Jończyk ◽

Magdalena Graczyk ◽

Barbara Chrzanowska ◽

...

Keyword(s):

Negative Pressure ◽

Negative Pressure Wound Therapy ◽

Subcutaneous Tissue ◽

Skin Grafting ◽

Conveyor Belt ◽

Complex Nature ◽

Wound Therapy ◽

Degloving Injury ◽

The Right ◽

Degloving Injuries

Degloving injuries are traumatic avulsions usually resulting in large areas of soft tissue defects. The injury involves separation of skin and subcutaneous tissue from fascia and muscles. The complex nature of these injuries requires a patient-oriented multidisciplinary surgical approach and a wide variety of therapeutic options. Negative pressure wound therapy can be of benefit at every stage of the long-lasting treatment. In this paper, we present a case of a 29-year-old male after an occupational accident with a conveyor belt leading to a degloving injury of the right forearm treated in the Department of Plastic Surgery of the Medical University in Gdańsk. The use of NPWT, hyperbaric oxygen therapy, dermal regeneration templates, skin grafting, and early rehabilitation resulted in an excellent functional and aesthetic outcome.

Download Full-text

Reconstruction of infected and denuded scrotum and penis by combined application of negative pressure wound therapy and split-thickness skin grafting

International Wound Journal ◽

10.1111/j.1742-481x.2012.00997.x ◽

2012 ◽

Vol 10 (4) ◽

pp. 407-410 ◽

Cited By ~ 7

Author(s):

Jing-Chun Zhao ◽

Chun-Jing Xian ◽

Jia-Ao Yu ◽

Kai Shi

Keyword(s):

Negative Pressure ◽

Negative Pressure Wound Therapy ◽

Skin Grafting ◽

Wound Therapy ◽

Combined Application ◽

Thickness Skin ◽

Split Thickness Skin Grafting

Download Full-text

Successful management of complex scalp wounds with exposed calvarial bones by customized Negative pressure wound therapy (NPWT): Case series and review of the literature

Tropical Doctor ◽

10.1177/00494755211043377 ◽

2022 ◽

pp. 004947552110433

Author(s):

Haroon R Zargar ◽

Mir Mohsin ◽

Raheeb A Shah ◽

Mir Yasir ◽

Tanveer A Bhat ◽

...

Keyword(s):

Negative Pressure ◽

Negative Pressure Wound Therapy ◽

Case Series ◽

Major Complication ◽

Wound Treatment ◽

Review Of The Literature ◽

Successful Management ◽

Wound Therapy ◽

Exposed Bone ◽

Animal Bites

Scalp wounds with exposed calvarial bones continue to be a challenge especially when no local flap options are available and no microvascular flaps can be performed. Our prospective study looked at 19 patients (14 males) where customized negative pressure wound treatment was used till the complex scalp wounds, mostly from animal bites, were covered with healthy granulation and grafted. Scalp wounds ranged from 6 × 4 cm to 17 × 11 cm in size whereas the area of exposed bone ranged from 1 × 2 cm to 10 × 10 cm. No major complication was seen, and wounds were rapidly healed.

Download Full-text