scholarly journals Negative Pressure Wound Therapy: A Pilot Study

2021 ◽  
Author(s):  
Devesh Kumar ◽  
Sachin Upadhyay ◽  
Hashmukh Shantilal Varma ◽  
Darwin Kumar Thakur
Keyword(s):  
Wound Healing ◽  
Pilot Study ◽  
Granulation Tissue ◽  
Negative Pressure Wound Therapy ◽  
Skin Grafting ◽  
P Value ◽  
Wound Therapy ◽  
Impaired Wound Healing ◽  
Split Skin Grafting ◽  
Split Skin

Introduction: Impaired wound healing has a significant socio- economic impact. The introduction of Vacuum Assisted Closure (VAC) has been one of the major breakthroughs in the management of nonhealing wounds owing to its property of granulation tissue formation via effects related to local sub atmospheric pressure and fluid drainage. Aim: To study the efficacy of Negative Pressure Wound Therapy (NPWT) in wound healing. Materials and Methods: A pilot study was performed on 50 patients out of which 41 were males 82% and 9 were females (18%) with chronic non healing wounds of different aetiologies between the age of 15-70 years. Eligible patients were treated with NPWT at two days interval for an average of two dressings. Patients were evaluated after two dressings for appearance of granulation tissue, reduction in wound size and decrease of bacterial load in the wound. Paired t-test and Chi-square tests were used. The p<0.05 was considered significant. Results: The use of NPWT in different types of open wounds, pressure sores, postoperative wounds resulted in reduction of wound size (p-value=0.001), infection rate (p-value=0.001) within a week after two dressings to finally be closed with split skin grafting or secondary suturing. Conclusion: NPWT dressing is a safe, reliable intervention for patients with chronic wounds associated with impaired wound healing, particularly with wounds larger in surface area which requires closure by split skin grafting or musculocutaneous flaps.

scholarly journals Salvage of a mangled limb with Matriderm® augmented split-skin grafting and maggot biodebridement

2021 ◽  
Author(s):  
Maximilian Lempert ◽  
Hans-Christoph Pape ◽  
Gerrolt Jukema
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Negative Pressure Wound Therapy ◽  
Treatment Options ◽  
Skin Grafting ◽  
Soft Tissue Injuries ◽  
Wound Therapy ◽  
Split Skin Grafting ◽  
Split Skin ◽  
Severe Soft Tissue

We present a case of a young woman with a mangled leg, that could be salvaged with a combination of negative pressure wound therapy, Matriderm® augmented split-skin grafting, and maggot biodebridement. The aim of this case report is to outline alternative treatment options in severe soft tissue injuries.

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

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.

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.

COLLAGEN DRESSING VERSUS CONVENTIONAL DRESSINGS IN BURN AND CHRONIC WOUNDS: A COMPARATIVE STUDY

2021 ◽  
pp. 43-45
Author(s):  
Sujeet Kumar Bharti ◽  
Kirti Priya
Keyword(s):  
Granulation Tissue ◽  
Chronic Wounds ◽  
Skin Grafting ◽  
Conventional Group ◽  
Wound Surface ◽  
Early Conclusion ◽  
Patients Satisfaction ◽  
Collagen Group ◽  
Split Skin Grafting ◽  
Split Skin

Objective: Biological dressings are water-resistant to bacteria, and generate the most physiological interfacebetween the wound surface and the environment. Collagen dressings have other superiority over conventional dressings in terms of ease of application and being natural, non-immunogenic, non-pyrogenic, hypoallergenic, and pain-free. Materials And Methods: The data of 120 patients with chronic wounds of diverse aetiologies and with signify age 43.7 years were accumulated and analyzed. The patients had been treated with collagen or other conventional dressing substance. The patients were split into two groups; 'Collagen group' and 'Conventional group', For the cause of comparison. 60 patients wereincluded in both groups. For assessment the wound characteristics in size, edge, oor, granulation tissue, and wound swab were recorded. With starting treatment, appearance of granulation tissue, completeness of healing, require for skin grafting, and patients' satisfaction was noted in both groups. Results: Sixty percentage of the 'collagen group' wounds and only forty-two percentage of the 'conventionalgroup' wounds were sterile (P=0.04) within two weeks of treatment. Healthy granulation tissue seemed earlier over collagen-dressed woundsthan over conventionally treated wounds (P=0.04). After eight weeks, (87%) of 'collagen group' wounds and (80%) of 'conventional group' wounds were >75% healed (P=0.21). In the 'collagen group' eight patients and twelvein the 'conventional group' required partial split-skin grafting (P=0.05). Collagen-treated patients enjoyed early. Conclusion: No remarkable better results were found in terms of complete of healing of burn andchronic wounds between collagen dressing and conventional dressing. Collagen dressing, however, mayavoid the require of skin grafting, and provides additional benet of patients' comfort.

Arginine Metabolites in Wound Fluids From Pressure Ulcers: A Pilot Study

2008 ◽  
Vol 10 (2) ◽  
pp. 87-92 ◽  
Author(s):  
Beverly Childress ◽  
Joyce K. Stechmiller ◽  
Gregory S. Schultz
Keyword(s):  
Nitric Oxide ◽  
Wound Healing ◽  
Pilot Study ◽  
Negative Pressure Wound Therapy ◽  
Chronic Wounds ◽  
Pressure Ulcers ◽  
Stage Iii ◽  
Wound Therapy ◽  
Before And After ◽  
Oxide Synthase

Compelling evidence suggests that nitric oxide (NO•), a metabolite of arginine, plays an important role in wound healing. Arginine is a semi-essential amino acid that is metabolized by nitric oxide synthase and arginase. One model for wound-healing regulation suggests the importance of strict reciprocal control of these enzymes in wounds. The purpose of this pilot study was to investigate arginine metabolism in wound fluids from patients with Stage III or IV pressure ulcers receiving negative pressure wound therapy (NPWT). Wound fluids were collected from 8 patients, aged 31—79 years, before and after initiation of NPWT on Days 1, 3, and 7. Wound fluids were analyzed for nitrates/nitrites (NOx), arginine, citrulline, proline, and ornithine. There were no significant differences between NOx, arginine, citrulline, proline, and ornithine concentrations before and after initiation of NPWT among the various timepoints. However, we observed a downward trend of NO•levels from baseline to Day 7 of NPWT treatment. Furthermore, we detected a decrease in arginine levels over the study period, suggesting that the iNOS/citrulline pathway predominated during the first 72 hr of treatment, and the arginase/ ornithine pathway dominated thereafter. Arginine and its metabolites are detectable in wound fluids from patients with Stage III or IV pressure ulcers on NPWT. Further studies on chronic wounds are warranted to correlate wound-healing outcomes with arginine metabolites at the cellular and molecular level over a longer period of time.

scholarly journals The effect of closed-incision negative pressure wound therapy on clinical and ultrasonographic seroma formation and wound healing following forequarter amputation in large dogs - a randomized pilot trial

2020 ◽  
Vol 89 (4) ◽  
pp. 198-207
Author(s):  
N. Vallarino ◽  
N. Devriendt ◽  
A. Koenraadt ◽  
M. Or ◽  
E. Stock ◽  
...  
Keyword(s):  
Wound Healing ◽  
Pilot Study ◽  
Negative Pressure ◽  
Scoring System ◽  
Negative Pressure Wound Therapy ◽  
Pilot Trial ◽  
Seroma Formation ◽  
Control Group ◽  
Wound Therapy ◽  
Forequarter Amputation

This pilot study aimed at evaluating whether closed-incision negative pressure wound therapy (ciNPWT) has an effect on seroma formation and wound healing following forequarter amputation in dogs above 20 kg. Twelve client-owned dogs weighing more than 20 kg, presented for forequarter amputation, were randomly assigned after surgery into two groups (six ciNPWT and six controls with soft-padded bandage, both bandages applied for three days). A clinical and ultrasonographic control (newly developed scoring system) was performed at bandage removal (three days postoperatively) and ten days, postoperatively. A postoperative seroma was present in 4/6 dogs in the ciNPWT group and in 5/6 dogs in the control group. There were no apparent differences in the ultrasonographic scores or subcutis measurements at three versus ten days, postoperatively. The results of this pilot trial do not support expansion to a larger-scale study evaluating ciNPWT after forequarter amputation in dogs.

Benefits of negative pressure wound therapy with instillation in the treatment of hard-to-heal wounds: a case series

2020 ◽  
Vol 29 (4) ◽  
pp. 248-253 ◽  
Author(s):  
Valérie Latouche ◽  
Hervé Devillers
Keyword(s):  
Wound Healing ◽  
Negative Pressure ◽  
Dwell Time ◽  
Negative Pressure Wound Therapy ◽  
Early Stage ◽  
Case Series ◽  
Wound Therapy ◽  
Impaired Wound Healing ◽  
The Mean ◽  
Mean Cost

Objective: Impaired wound healing can lead to hard-to-heal wounds, which impact on patients, clinicians and healthcare systems. Negative pressure wound therapy with instillation and dwell time (NPWTi-d) was developed to manage wounds through early-stage cleansing. This study describes the use of NPWTi-d to help manage hard-to-heal wounds in patients with risk factors for impaired wound healing. Method: In this case series, patients were treated between October 2015 and March 2018 at a community hospital in western France. Normal saline solution was instilled into wounds with a dwell time of 10 minutes, followed by the application of negative pressure at −75 mmHg to −125 mmHg for 2–3 hours. If needed, patients were given appropriate oral or intravenous antibiotic treatment in conjunction with NPWTi-d and subsequent wound therapies. Results: A total of 15 patients participated in the study. Mean age was 81±13 years, and 12 (80%) patients were malnourished with blood albumin levels of 30.1±5.7g/l, and 12 (80%) patients were given antibiotic therapy. The mean duration of NPWTi-d was 19.4±20.8 days, with a mean number of dressing changes of 6.6±6.8; the duration of NPWTi-d and the number of dressing changes for pressure ulcers was three times that of the other wound types. The mean cost of NPWTi-d in this study was €1643.40±€1709.13. Overall, NPWTi-d provided early-stage wound cleansing and helped achieve adequate granulation tissue formation and progression to the next phase of wound healing. Conclusion: In these cases, NPWTi-d was a beneficial and effective method of treating hard-to-heal wounds that were resistant to traditional treatments, yielding favourable clinical outcomes.

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