scholarly journals A Case of Extensive Necrotizing Fasciitis with Poor General Condition Treated by Gradual Debridement and Postage Stamp Skin Graft Bolstered with Negative Pressure Wound Therapy at the Bedside

2021 ◽  
Vol 2 (3) ◽  
pp. 59-63
Author(s):  
Shogo Kasai ◽  
Tomoki Kiuchi ◽  
Jun Ihara ◽  
Kazuo Kishi
2018 ◽  
Vol 08 (02) ◽  
pp. 82-86
Author(s):  
Irfan Ilahi ◽  
M. Uzair Ilyas Tahir Kheli ◽  
Ehtesham- ulHaq

Background: Negative-pressure wound therapy (NPWT) or vacuum dressings involve the application of a controlled negative pressure on the wound. Traditionally, STSGs were fixed with bolster technique, where sutures are used to fix pressure dressings over the top of recently placed grafts. Taking it a step further in our study we applied an effective and user friendly filler material (surgical roll gauze) on very large defects. The objective of this study was to assess the clinical efficacy of gauze-based negative pressure wound therapy as an adjunctive therapy to STSG, over complex and very large wounds. Material & Methods: This descriptive study was conducted at Army Burn Center, Combined Military Hospital Kharian and PNS Shifa Hospital Karachi from January 2016 to June 2017. Gauze based VAC system used. Negative pressure was applied at -80 mm Hg. Evaluation was carried out to assess the performance of gauze-based NPWT. Results: Total of 63 patients, 42 males and 21 females, with mean age of 32 years SD+15 were included in the study. The wound size included in the study ranged from 12x10 cm to 88x66 cm. Mean duration of NPWT dressings was 15 days and 313 dressings were employed in total with satisfactory healing achieved in 3 to 4 VAC dressings in most of the cases. Mean duration of hospital stay was 23.92 days at which point graft uptake percentage was in the range of 90% (n=7) to 100% (n=20). Only 3.2% (n=2) cases required partial re-grafting for complete coverage of residual wounds. Conclusion: Gauze-based Negative-pressure wound therapy over split thickness skin graft is a cost-effective addition to the care and management of large and complex wounds


2012 ◽  
Vol 129 (2) ◽  
pp. 399e-401e ◽  
Author(s):  
Tzong Shiun Li ◽  
Mun Yau Choong ◽  
Hsu Fu Wu ◽  
Kao-Chi Chung

2015 ◽  
Vol 51 (1) ◽  
pp. 43-48 ◽  
Author(s):  
Patrick Maguire ◽  
Joseph M. Azagrar ◽  
Allan Carb ◽  
Arnold Lesser

A 5 mo old female Akita and a 1 yr, 5 mo old male German shorthaired pointer were both evaluated for soft-tissue lesions characterized by rapidly expanding edema, erythema, and pain. Ultrasound was utilized to locate and sample fluid accumulations, and β-hemolytic Streptococcus was isolated from the wounds. Development of systemic symptoms including fever, tachycardia, and tachypnea as well as a lack of response to medical management prompted surgical intervention in both cases. During surgical exploration and debridement, disruption of intermuscular tissue planes was appreciated and necrotizing fasciitis (NF) was suspected. Negative-pressure wound therapy systems utilizing 120 mm Hg of continual negative pressure were applied to wounds for 5 and 4 days for the Akita and German shorthaired pointer, respectively. Resolution of infection was achieved and although the lesions were associated with limbs, amputation was avoided. In both cases, the results of histopathology were consistent with NF. NF is recognized as a rapidly progressive infection associated with high rates of morbidity and mortality. Timely use of negative-pressure wound therapy appears to be a viable management tool to accompany surgical debridement, appropriate antibiotics, and analgesics.


2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Michele Maruccia ◽  
Maria G. Onesti ◽  
Valentina Sorvillo ◽  
Antonio Albano ◽  
Luca A. Dessy ◽  
...  

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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