scholarly journals Treatment of Acute Compartment Syndrome Sequela of the Leg: A Case Report Demonstrating Negative Pressure Wound Therapy with Instillation and Dwell Utilizing a Novel Dressing and Serial Automated Suction Blister Epidermal Harvesting and Grafting

Cureus ◽  
2018 ◽  
Author(s):  
Ralph J Napolitano
Author(s):  
Jaroslaw P. Miszczuk ◽  
Maria Błońska-Staniec ◽  
Anna Michalska ◽  
Bartosz Stemplewski

Background and Objectives: Acute compartment syndrome (ACS) is an emergency condition of the lower limb in which prophylactic fasciotomy is required to prevent complications. A negative pressure wound therapy (NPWT) used to the treatment of fasciotomy wounds provide beneficial clinical results. This study aimed to exchange the authors’ experience of using the NPWT installation system on the lower limb wounds after fasciotomy in ACS. Materials and Methods: This is a retrospective study enrolled consecutive patients with ACS, who underwent fasciotomy and was treated with the NPWT installation system at Department of Vascular Surgery, Provincial Hospital in Kielce from April 2016 to July 2017. Results: The study enrolled 15 patients with a diagnosis of ACS (87% men, mean age 65 years old). An open four-compartment fasciotomy (87%) or two-compartment fasciotomy (13%) was performed. The NPWT was applied on the first day after fasciotomy in 87% of patients. Therapy was initiated by the negative pressure of 125 mm Hg, which maintained at this level until the therapy was finalized. In 80% of patients, the vacuum-assisted wound closure (VAC) dressing changes were performed every 3 days. The first approximation of fasciotomy wounds margins occurred on the 4th day after surgery among 67% of individuals. The average time of using VAC on fasciotomy wounds was 9 days. The average time to definitive closure edges of fasciotomy wounds was 12 days. The average time of hospital stay was 17 days. Conclusions: Our experience indicates the legitimacy of using NPWT in wound treatment after fasciotomy in ACS. The NPWT enables faster primary closure of wounds, reduces edema, as well as decreases hospitalization time.


Author(s):  
Michael J. Gigliotti ◽  
Neel Patel ◽  
Caroline McLaughlin ◽  
Alexis Rothermel ◽  
Cathy Henry ◽  
...  

2020 ◽  
Author(s):  
Pete Allen ◽  
Jackson Pugh ◽  
Alexander Blau

ABSTRACT The incidence of compartment syndrome of the lumbar paraspinal muscles is exceedingly rare. Approximately 24 hours following a high-intensity kettlebell swing workout, a 33-year-old Sailor presented to the medical department on board a forward deployed Wasp-class amphibious assault ship with increasing discomfort in his middle and lower back, and evidence of rhabdomyolysis. Discomfort quickly turned to unrelenting pain coupled with dorsal paresthesias and rigidity in the paraspinal muscles. He was taken emergently to the operating room, where his paraspinal muscles were released via fasciotomy. As a result of limited resources aboard the deployed ship, a negative pressure wound dressing was fashioned using the supplies available aboard the ship. Following 3 days of the negative pressure wound therapy, muscle bulging decreased substantially, and the skin was closed. After 4 weeks of physical therapy, he returned to full duty.


2020 ◽  
Vol 13 (6) ◽  
pp. 1331-1337
Author(s):  
Yosuke Namba ◽  
Yasuhiro Matsugu ◽  
Masaru Furukawa ◽  
Maiko Namba ◽  
Tamito Sasaki ◽  
...  

2019 ◽  
Vol 12 (9) ◽  
pp. e231197
Author(s):  
Victoria Elizabeth McKinnon ◽  
Jouseph Barkho ◽  
Mark H McRae

Exposure of a renal transplant through the abdominal wall is a rare event. A search of the literature reveals only six documented cases which used skin autograft for coverage, with none reported since 1981, and none which used negative-pressure wound therapy (NPWT) to prepare the recipient bed. This case report demonstrates that NPWT followed by split thickness skin graft is a reconstructive option which is feasible in patients who are at high risk for surgical complications in prolonged flap surgery.


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