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

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.

scholarly journals Role of customised negative-pressure wound therapy in the integration of split-thickness skin grafts: A randomised control study

2017 ◽  
Vol 50 (01) ◽  
pp. 043-049 ◽  
Author(s):  
Mir Mohsin ◽  
Haroon Rashid Zargar ◽  
Adil Hafeez Wani ◽  
Mohammad Inam Zaroo ◽  
Peerzada Umar Farooq Baba ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Financial Burden ◽  
Wound Therapy ◽  
Graft Take ◽  
Thickness Skin ◽  
Custom Made ◽  
Split Thickness Skin Grafting ◽  
Control Study

ABSTRACT Background: Split-thickness skin grafting (STSG) is a time-tested technique in wound cover, but many factors lead to suboptimal graft take. Role of custom-made negative-pressure wound therapy (NPWT) is compared with conventional dress in the integration of STSG and its cost is compared with widely used commercially available NPWT. Materials and Methods: This is a parallel group randomised control study. Block randomisation of 100 patients into one of the two groups (NPWT vs. non-NPWT; 50 patients each) was done. Graft take/loss, length of hospital stay post-grafting, need for regrafting and cost of custom-made negative pressure wound therapy (NPWT) dressings as compared to widely used commercially available NPWT were assessed. Results: Mean graft take in the NPWT group was 99.74% ± 0.73% compared to 88.52% ± 9.47% in the non-NPWT group (P = 0.004). None of the patients in the NPWT group required second coverage procedure as opposed to six cases in the non-NPWT group (P = 0.035). All the patients in the NPWT group were discharged within 4–9 days from the day of grafting. No major complication was encountered with the use of custom-made NPWT. Custom-made NPWT dressings were found to be 22 times cheaper than the widely used commercially available NPWT. Conclusions: Custom-made NPWT is a safe, simple and effective technique in the integration of STSG as compared to the conventional dressings. We have been able to reduce the financial burden on the patients as well as the hospital significantly while achieving results at par with other studies which have used commercially available NPWT.

scholarly journals Matching Biological Mesh and Negative Pressure Wound Therapy in Reconstructing an Open Abdomen Defect

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Fabio Caviggioli ◽  
Francesco Maria Klinger ◽  
Andrea Lisa ◽  
Luca Maione ◽  
Davide Forcellini ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Skin Graft ◽  
Granulation Tissue ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Rectal Adenocarcinoma ◽  
Biological Mesh ◽  
Split Thickness Skin Graft ◽  
Wound Therapy ◽  
Thickness Skin

Reconstruction of open abdominal defects is a clinical problem which general and plastic surgeons have to address in cooperation. We report the case of a 66-year-old man who presented an abdominal dehiscence after multiple laparotomies for a sigmoid-rectal adenocarcinoma that infiltrated into the abdominal wall, subsequently complicated by peritonitis and enteric fistula. A cutaneous dehiscence and an incontinent abdominal wall resulted after the last surgery. The abdominal wall was reconstructed using a biological porcine cross-linked mesh Permacol (Covidien Inc., Norwalk, CT). Negative Pressure Wound Therapy (NPWT), instead, was used on the mesh in order to reduce wound dimensions, promote granulation tissue formation, and obtain secondary closure of cutaneous dehiscence which was finally achieved with a split-thickness skin graft. Biological mesh behaved like a scaffold for the granulation tissue that was stimulated by the negative pressure. The biological mesh was rapidly integrated in the abdominal wall restoring abdominal wall continence, while the small dehiscence, still present in the central area, was subsequently covered with a split-thickness skin graft. The combination of these different procedures led us to solve this complicated case obtaining complete wound closure after less than 2 months.

Dermal Regeneration Template and Staged Skin Grafting for Extirpative Scalp Wound Reconstruction: A 14-Year Experience

2021 ◽  
pp. 019459982098658
Author(s):  
Jacob C. Maus ◽  
Kshipra Hemal ◽  
Mija Khan ◽  
Bennett W. Calder ◽  
Malcolm W. Marks ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Academic Medical Center ◽  
Case Series ◽  
Skin Grafting ◽  
Wound Therapy ◽  
Scalp Defects ◽  
Split Thickness Skin Grafting ◽  
Dermal Regeneration Template ◽  
Dermal Regeneration

Objective Dermal regeneration template and staged split-thickness skin grafting may mitigate the need for flap coverage of postoncologic scalp defects. This technique has been studied previously in small case series. We examine the effect of risk factors, surgical technique, irradiation, and dressing modalities on reconstructive outcomes in a highly comorbid patient cohort. Study Design Retrospective review. Setting Academic medical center. Methods Full- and partial-thickness extirpative scalp wounds reconstructed with dermal regeneration template and staged skin grafting were reviewed over a 14-year period. Stage 1 consisted of template application following burr craniectomy in cases lacking periosteum. Stage 2 consisted of skin grafting. Negative pressure wound therapy (NPWT) was variably used to support adherence. Results In total, 102 patients were analyzed (average age 74, mean follow-up 18 months). Eighty-one percent were American Society of Anesthesiologists class 3 or 4. Defect size averaged 56 cm2. Average skin graft take was 94.5% in full-thickness wounds. Seven patients failed this method. Preoperative scalp irradiation was associated with major complication and delayed graft healing. Comorbidities, wound size, and burring were not associated with complication. Patients were more likely to heal with NPWT compared to bolster (hazard ratio, 1.67; 95% CI 1.01-2.77; P = .046). Time between stages was 6.6 days shorter when NPWT was applied ( P < .001). Conclusion Dermal template and staged skin grafting is a reliable option for postcancer scalp reconstruction in poor flap candidates. Radiotherapy is associated with adverse outcomes. Negative pressure wound therapy simplifies postoperative wound care regimens and may accelerate healing.

scholarly journals A Novel Autologous Micrografts Technology in Combination with Negative Pressure Wound Therapy (NPWT) for Quick Granulation Tissue Formation in Chronic/Refractory Ulcer

Healthcare ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 513
Author(s):  
Satoshi Takagi ◽  
Takuto Oyama ◽  
Shiro Jimi ◽  
Arman Saparov ◽  
Hiroyuki Ohjimi
Keyword(s):  
Combination Therapy ◽  
Granulation Tissue ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Ulcer Patient ◽  
Skin Grafting ◽  
Tissue Formation ◽  
Wound Therapy ◽  
Granulation Tissue Formation ◽  
Wide Range

Negative pressure wound therapy (NPWT) has been commonly used over the years for a wide range of chronic/refractory lesions. Alternatively, autologous micrografting technology is recently becoming a powerful modality for initiating wound healing. The case presented is of a patient with a lower leg ulcer that had responded poorly to NPWT alone for three weeks. Consequently, the patient was put on a combination therapy of NPWT and micrografting. After injection of a dermal tissue micrografts suspension into the entire wound bed, NPWT was performed successively for two weeks, resulting in fresh granulation tissue formation. Thereafter, the autologous skin graft was taken well. This case study indicates that for a chronic/refractory ulcer patient with poor NPWT outcome, combination therapy using micrografting treatment and NPWT could rapidly initiate and enhance granulation tissue formation, creating a favorable bedding for subsequent skin grafting.

Cost-efficacy of skin grafting techniques using negative pressure wound therapy and tissue-engineered skin for burns

2021 ◽  
Author(s):  
Muhammad Hanif Nadhif ◽  
Muhammad Satrio Utomo ◽  
Muhammad Farel Ferian ◽  
Farhan H. Taufikulhakim ◽  
Nadine H. P. Soerojo ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Skin Grafting ◽  
Wound Therapy ◽  
Cost Efficacy

Combination of Three Different Negative Pressure Wound Therapy Applications and Free Flap for Open Elbow Joint Injury With Extensive Burns

2021 ◽  
Author(s):  
Junya Oshima ◽  
Kaoru Sasaki ◽  
Yukiko Aihara ◽  
Masahiro Sasaki ◽  
Yoichiro Shibuya ◽  
...  
Keyword(s):  
Free Flap ◽  
Negative Pressure ◽  
Elbow Joint ◽  
Negative Pressure Wound Therapy ◽  
Skin Grafting ◽  
Perioperative Period ◽  
Wound Therapy ◽  
Joint Injury ◽  
Left Limb ◽  
Effective Option

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.

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