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Negative pressure therapy

Hasan M Al-Dorzi, Abdulaziz S Aldawood, Raymond Khan, Salim Baharoon, John D Alchin, Amal A Matroud, Sameera M Al Johany, Hanan H Balkhy, Yaseen M Arabi
BACKGROUND: Middle East respiratory syndrome coronavirus (MERS-CoV) has caused several hospital outbreaks, including a major outbreak at King Abdulaziz Medical City, a 940-bed tertiary-care hospital in Riyadh, Saudi Arabia (August-September 2015). To learn from our experience, we described the critical care response to the outbreak. METHODS: This observational study was conducted at the Intensive Care Department which covered 5 ICUs with 60 single-bedded rooms. We described qualitatively and, as applicable, quantitatively the response of intensive care services to the outbreak...
December 2016: Annals of Intensive Care
Zsolt Sziklavari, Michael Ried, Florian Zeman, Christian Grosser, Tamas Szöke, Reiner Neu, Rudolf Schemm, Hans-Stefan Hofmann
BACKGROUND: This retrospective study analyzed the effectiveness of intrathoracic negative pressure therapy for debilitated patients with empyema and compared the short-term and long-term outcomes of three different intrapleural vacuum-assisted closure (VAC) techniques. METHODS: We investigated 43 consecutive (pre)septic patients with poor general condition (Karnofsky index ≤ 50 %) and multimorbidity (≥ 3 organ diseases) or immunosuppression, who had been treated for primary, postoperative, or recurrent pleural empyema with VAC in combination with open window thoracostomy (OWT-VAC) with minimally invasive technique (Mini-VAC), and instillation (Mini-VAC-Instill)...
October 21, 2016: Journal of Cardiothoracic Surgery
Vincenzo Vindigni, Carlotta Scarpa, Erica Dalla Venezia, Franco Bassetto
INTRODUCTION: Fournier's gangrene is a rare disease that affects the genital, abdominal, and perineal regions and leads to death if not treated promptly. CASE REPORT: A 42-year-old, obese woman presented to the authors' department affected by Fournier's gangrene. In order to treat her abdominal and genital regions, the authors performed a surgical debridement followed by combined therapy with antibiotics and topical negative pressure wound therapy (NPWT) with instillation plus saline solution...
October 2016: Wounds: a Compendium of Clinical Research and Practice
Ian Chik, Enda G Kelly, Razman Jarmin, Farrah-Hani Imran
INTRODUCTION: Negative pressure wound therapy is a widely used method of wound dressing with various commercially available brands. The authors created the Hanikoda Method (HM) for effective wound bed preparation or definite wound closure. METHODS: In this case series, the authors discuss 8 different wound cases that presented to their Plastics Unit from January 2014 to June 2015. Patients with traumatic or infected wounds were selected for treatment with the HM...
October 2016: Wounds: a Compendium of Clinical Research and Practice
Norbert Nemeth, Katalin Peto, Adam Deak, Viktoria Sogor, Gabor Varga, Bence Tanczos, Klaudia Balog, Adrienn Csiszko, Zoltan Godo, Zsolt Szentkereszty
BACKGROUND: Abdominal compartment syndrome (ACS) is a life-threatening condition, of which pathomechanism hasn't been completely clarified, yet. Furthermore, surgical therapy still needs optimization. OBJECTIVE: We aimed to investigate microcirculatory and micro-rheological alterations in ACS, using various temporary abdominal closure methods, including three settings of vacuum-assisted closure technique (negative pressure wound therapy, NPWT). METHODS: On anesthetized pigs, by intraabdominally placed and filled-up silicone bags, intraabdominal pressure at 30 mmHg was maintained for 3 hours, and afterwards, decompressive laparotomy happened...
October 20, 2016: Clinical Hemorheology and Microcirculation
Johannes Schalamon, Thomas Petnehazy, Herwig Ainoedhofer, Christoph Castellani, Holger Till, Georg Singer
BACKGROUND: In an experimental study the performance of different closed abdominal drainage systems was tested. METHODS: A vacuum bottle designed for Redon Drainage, a flexible plastic bulb designed for Jackson-Pratt drains and a V.A.C.(®) Negative Pressure Wound Therapy System were used. In a porcine cadaveric study mimicking the abdominal cavity the intrinsic pressure (IP) at one and three minutes (T0, T3) and the amount of evacuated fluid were measured. RESULTS: The Redon and Jackson drainage displayed a rapid decline to IP values of almost zero comparing T0 and T3...
October 8, 2016: American Journal of Surgery
Giuseppe Santarpino, Lazlo Gazdag, Joachim Sirch, Ferdinand Vogt, Miroslaw Ledwon, Theodor Fischlein, Steffen Pfeiffer
Bilateral internal thoracic artery (BITA) grafting may be associated with a higher risk of postoperative deep sternal wound infection than monolateral internal thoracic artery grafting due to a limited blood supply to the thoracic chest wall. Because preliminary studies suggest negative pressure wound therapy (NPWT) may reduce the risk of infection, a retrospective chart review of 129 patients who underwent BITA between February 2003 and October 2014 was conducted. Of those, 21 patients received NPWT for 5 days immediately following surgery and the incisions of 108 patients were covered with a conventional gauze dressing...
December 2015: Ostomy/wound Management
Jie Zhao, Guolin Wang
BACKGROUND This study aimed to investigate the relationship between the inferior vena cava respirophasic variation (IVC collapsibility index [IVCCI]) and the general heart end-diastolic volume index (GEDVI). By determining the above relationship, we could evaluate the utility of IVCCI as an indicator. MATERIAL AND METHODS Forty-two septic patients were finally enrolled in this study. The inferior vena cava's diameter was measured with the largest at the end of expiration (IVC3) and with the smallest at the end of inspiration (IVCi) on the ultrasound (IVCCI=[(IVCD e - IVCD i)/IVCD e] ×100%)...
October 20, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Dogu Aydin, Ida Felbo Paulsen, Vibeke Egerup Bentzen, Sami Asadzadeh, Lisbet Rosenkrantz Hölmich
We demonstrate that it is possible to use a nonabsorbable mesh for abdominal wall reconstruction after total wound rupture and successfully split-skin graft directly on the mesh. Sufficient granulation tissue formation prior to skin grafting was obtained with long-term use of negative pressure wound therapy (NPWT).
October 2016: Clinical Case Reports
Dongmei Lu, Nanfang Li, Xiaoguang Yao, Ling Zhou
Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a complex chronic inflammatory respiratory disease with multiple pathogenic factors and high morbidity and mortality. Serum levels of nuclear factor-κB (NF-κB), hypoxia-inducible factor-1 alpha (HIF-1α), and surfactant protein D (SPD) were investigated in OSAHS patients, to determine their clinical significance and correlation with the pathogenesis. Patients were classified into a mild and moderate OSAHS group (n = 25) and severe OSAHS group (n = 33). Twenty healthy patients served as a control group...
October 18, 2016: Bosnian Journal of Basic Medical Sciences
Oleg Mamontov, Mikhail Bogachev, Andrey Kozlenoc
OBJECTIVE: To assess the autonomic regulation in patients with various circadian blood pressure profile (CBPP) anomalies that persisted despite of combined antihypertensive therapy. DESIGN AND METHOD: We studied 114 hypertensives aged 56,8 ± 17,9 years receiving combined antihypertensive therapy divided into two groups, with adequate (n = 61) and inadequate (n = 53) CBPP. Groups were comparable in terms of age and number of drugs intake per day (2.8 ± 1...
September 2016: Journal of Hypertension
Jolanta Malyszko, Dominika Musialowska, Edyta Zbroch, Ewa Koc-Zorawska, Jacek Malyszko
OBJECTIVE: Endocan, human endothelial cell-specific molecule, which is expressed by the vascular endothelium may play role in endothelium-dependent inflammatory process leading to the development of hypertension.The aim of the study was to estimate endocan concentration in 121 patients with primary hypertension and proper renal function as also in healthy individuals from the control group and to estimate endocan levels in subgroups with proper blood pressure control and without. DESIGN AND METHOD: The endocan concentration was estimated in 121 hypertensive patients (median age 56 min-19, max-85)...
September 2016: Journal of Hypertension
Yosuke Takahashi, Yasuyuki Sasaki, Yasuyuki Bito, Manabu Motoki, Takashi Murakami, Toshihiko Shibata
We herein report two cases of perigraft effusion mimicking graft infection after debranching thoracic endovascular repair for an anastomotic pseudoaneurysm of the distal ascending aorta. Both patients presented with a bulging tumor on the sternum. Enhanced computed tomography showed no endoleak, but extension of periprosthetic graft fluid to a subcutaneous sternal wound was present. We suspected a deep sternal wound infection; however, cultures of débrided tissues were negative. After drainage of the subcutaneous fluid or negative pressure wound therapy, both patients were doing well without recurrence of effusion...
October 14, 2016: Journal of Vascular Surgery
Samer Toume, Amit Gefen, Daphne Weihs
We observed that radially stretching cell monolayers at a low level (3%) increases the rate at which they migrate to close a gap formed by in vitro injury. Wound healing has been shown to accelerate in vivo when deformations are topically applied, for example, by negative pressure wound therapy. However, the direct effect of deformations on cell migration during gap closure is still unknown. Thus, we have evaluated the effect of radially applied, sustained (static) tensile strain on the kinematics of en mass cell migration...
October 17, 2016: International Wound Journal
Frank-Martin Haecker, Sergio Sesia
BACKGROUND: For specific therapy to correct pectus excavatum (PE), conservative treatment with the vacuum bell (VB) was introduced more than 10 years ago in addition to surgical repair. Preliminary results using the VB were encouraging. We report on our 13-year experience with the VB treatment including the intraoperative use during the Nuss procedure and present some technical innovations. METHODS: A VB with a patient-activated hand pump is used to create a vacuum at the anterior chest wall...
September 2016: Annals of Cardiothoracic Surgery
Chul Hyun Park, Oog Jin Shon, Gi Beom Kim
BACKGROUND: Traditionally, Gustilo Anderson grade IIIb open tibial fractures have been treated by initial wide wound debridement, stabilization of fracture with external fixation, and delayed wound closure. The purpose of this study is to evaluate the clinical and radiological results of staged treatment using negative pressure wound therapy (NPWT) for Gustilo Anderson grade IIIb open tibial fractures. MATERIALS AND METHODS: 15 patients with Gustilo Anderson grade IIIb open tibial fractures, treated using staged protocol by a single surgeon between January 2007 and December 2011 were reviewed in this retrospective study...
September 2016: Indian Journal of Orthopaedics
Jong Hoo Lee, Yee Hyung Kim
Although blood cultures (BCs) are an important component of diagnostic practice for antibiotic management in patients with pneumonia, several studies have questioned whether they should be performed. The objective of this study was to evaluate the predictive factors of bacteremia and the role of BCs in patients with community-onset pneumonia (community-acquired pneumonia and healthcare-associated pneumonia).This study was retrospectively conducted in patients with community-onset pneumonia who were hospitalized at Jeju National University Hospital between January 2012 and December 2014...
October 2016: Medicine (Baltimore)
Francesco De Francesco, Antonio Graziano, Letizia Trovato, Gabriele Ceccarelli, Maurizio Romano, Marco Marcarelli, Gabriella Maria Casella De Angelis, Umberto Cillo, Michele Riccio, Giuseppe Andrea Ferraro
BACKGROUND: The etiology of non-healing ulcers depends on both systemic and local factors. The introduction of advanced dressing, negative wound therapy and compression therapy have undoubtedly improved clinical outcomes. The principal aim of study was to demonstrate the efficacy of dermal micrografts in the treatment of ulcers with different etiologies. The second aim was to investigate in vitro the action of micrografts in the regenerative process. METHODS: The dermal micro-grafts were obtained from mechanical disaggregation of small pieces of skin tissue through a medical device called Rigeneracons...
October 13, 2016: Stem Cell Reviews
A A Semenkin, L A Zhivilova, G I Nechaeva, O I Chindareva, E N Loginova, T V Pritykina
AIM: To evaluate the antihypertensive efficiency and metabolic effects of controlled monotherapy with hydrochlorothiazide (HCT) and indapamide retard (IR) in hypertensive patients. SUBJECTS AND METHODS: The study included 50 patients with Stage II essential hypertension, grades 1-3 blood pressure (BP) elevation, who received 3-month monotherapy with IR (n=25) or HCT (n=25). Changes were determined in BP, blood lipid, glucose, and potassium levels. The efficiency of antihypertensive therapy was evaluated in the entire group and subgroups of patients identified in accordance with the used diuretic and the presence (n=27) or absence (n=23) of therapy at previous stages...
2016: Terapevticheskiĭ Arkhiv
Radu Campean, Matthias Hasun, Claudia Stöllberger, Johannes Bucher, Josef Finsterer, Christoph Schnack, Franz Weidinger
BACKGROUND: Reversible left ventricular dysfunction, also termed Takotsubo cardiomyopathy, is rarely reported in Addison's disease after initiation of hormone replacement therapy. The pathogenesis of this cardiomyopathy is unknown. CASE PRESENTATION: A 41-year-old white woman with a history of autoimmune Hashimoto thyroiditis diagnosed 3 years earlier and acute adrenal insufficiency diagnosed 3 weeks earlier presented with new onset of heart failure New York Heart Association class IV, which had started shortly after initiation of hormone replacement therapy with hydrocortisone 20 mg/day and fludrocortisone 0...
October 12, 2016: Journal of Medical Case Reports
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