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VAC therapy

S Acosta, M Björck, A Wanhainen
BACKGROUND: Indications for negative-pressure wound therapy (NPWT) in vascular surgical patients are expanding. The aim of this review was to outline the evidence for NPWT on open and closed wounds. METHODS: A PubMed, EMBASE and Cochrane Library search from 2007 to June 2016 was performed combining the medical subject headings terms 'wound infection', 'abdominal aortic aneurysm (AAA)', 'fasciotomy', 'vascular surgery' and 'NPWT' or 'VAC'. RESULTS: NPWT of open infected groin wounds was associated with shorter duration of wound healing by 47 days, and was more cost-effective than alginate dressings in one RCT...
November 30, 2016: British Journal of Surgery
Angela Garcia-Ruano, Esther Deleyto, Sebastian Garcia-Fernandez
BACKGROUND: Defects of the abdominal wall pose a problem for general surgeons that negatively affects patient prognosis. In cases of abdominal wall wound dehiscence and exposed abdominal mesh, conservative treatment has not been proven effective to date. We aimed to study patient outcomes in cases of abdominal wall wound dehiscence with mesh exposure treated with vacuum-assisted closure system with intermittent instillation (VAC-instillation) as a temporary cover to achieve wound closure...
December 2016: Journal of Surgical Research
E Jennifer Edelman, Stephen A Maisto, Nathan B Hansen, Christopher J Cutter, James Dziura, Lynn E Fiellin, Patrick G O'Connor, Roger Bedimo, Cynthia Gibert, Vincent C Marconi, David Rimland, Maria C Rodriguez-Barradas, Michael S Simberkoff, Amy C Justice, Kendall J Bryant, David A Fiellin
Unhealthy alcohol use is common among HIV-positive patients, yet effective evidence-based treatments are rarely provided in clinical settings providing HIV care. Further, given patient variability in response to initial treatments, stepped care approaches may be beneficial. We describe the rationale, aims and study design for the current StartingTreatment forEthanol inPrimary care Trials (STEP Trials); three parallel randomized controlled effectiveness trials being conducted in five Infectious Disease Clinics...
November 20, 2016: Contemporary Clinical Trials
V-I Neagoe, S Zytoun, H-J Neuhaus
Lactococcus garvieae is known as a Gram-positive, catalase-negative, and facultatively anaerobic fish pathogen. The association between Lactococcus spp. and human infectious diseases is described as being mainly associated with lumbar osteomyelitis, hepatic abscess, and infective endocarditis. In the literature of orthopedic post-prosthetic infections, L. garvieae was associated with a case of hip prosthetic infection in a fishmonger woman. We present the case of a 79-year-old male patient with multiple comorbidities, who is admitted to our center with a 5-day history of pain, swelling, and motility disorder of the right knee by the presence of a bicondylar knee replacement surgery, which was performed due to gonarthrosis 17 years ago...
2016: Case Reports in Orthopedics
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
Meredith Greene, Amy C Justice, Kenneth E Covinsky
: As the number of older adults living with HIV continues to increase, understanding how to incorporate geriatric assessments within HIV care will be critical. Assessment of geriatric syndromes and physical function can be useful tools for HIV clinicians and researchers to help identify the most vulnerable older adults and to better understand the aging process in PLWH. This review focuses on the assessment of falls, frailty and physical function, first in the general population of older adults and includes a specific focus on use of these assessments in older adults living with HIV...
October 7, 2016: Virulence
Marcelo A F Ribeiro Junior, Emily Alves Barros, Sabrina Marques de Carvalho, Vinicius Pereira Nascimento, José Cruvinel Neto, Alexandre Zanchenko Fonseca
AIM: To compare the 3 main techniques of temporary closure of the abdominal cavity, vacuum assisted closure (vacuum-assisted closure therapy - VAC), Bogota bag and Barker technique, in damage control surgery. METHODS: After systematic review of the literature, 33 articles were selected to compare the efficiency of the three procedures. Criteria such as cost, infections, capacity of reconstruction of the abdominal wall, diseases associated with the technique, among others were analyzed...
August 27, 2016: World Journal of Gastrointestinal Surgery
Oğuzhan Aydoğdu, Umut Tuncel, Murat Gümüş, Alper Kurt, Nuray Oztürk, Ibrahim Alper Aksakal, Uğur Recep Çelik, Nizamettin Güzel, Unal Erkorkmaz
OBJECTIVE: The aim of the study was to present the authors' clinical observations on zinc-coated foam with negative pressure wound therapy (NPWT). MATERIALS AND METHODS: Ninety-four consecutive patients treated with zinc-coated foam with VAC therapy were retrospectively reviewed. Nonhealing wounds of at least 6 months duration with high to moderate exudate that required open wound management to secondary intervention were included in this study. The evaluation criteria consisted of the measurement of wound surface area, length of overall treatment time, and a clinical observation of granulation tissue formation in the wound bed...
August 15, 2016: Wounds: a Compendium of Clinical Research and Practice
A Daskalaki, S Xenaki, M Venianaki, A Topalidou, E Athanasakis, E Chrysos, G Chalkiadakis
INTRODUCATION: Negative pressure wound therapy (NPWT) represents an alternative method to optimize conditions for wound healing. Delayed wound closure is a significant health problem, which is directly associated with pain and suffering from patient's aspect, as well with social and financial burden. PRESENTATION OF CASE: We report a case of vacuum-assisted wound therapy with hypertonic solution distillation and continuous negative pressure application, in an infected wound after laparotomy for incisional hernia reconstruction with mesh placement...
September 2016: Annals of Medicine and Surgery
Christian Beltzer, Alexander Eisenächer, Steffen Badendieck, Dietrich Doll, Markus Küper, Stefan Lenz, Björn Dirk Krapohl
INTRODUCTION: The optimal treatment concept for temporary abdominal closure (TAC) in critically ill visceral surgery patients with open abdomen (OA) continues to be unclear. The VACM (vacuum-assisted closure and mesh-mediated fascial traction) therapy seems to permit higher delayed primary fascial closure rates (FCR) than other TAC procedures. MATERIAL AND METHODS: Patients of our clinic (n=58) who were treated by application of a VAC/VACM treatment manual in the period from 2005 to 2008 were retrospectively analysed...
2016: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
Jorge L Salinas, Christopher Rentsch, Vincent C Marconi, Janet Tate, Matthew Budoff, Adeel A Butt, Matthew S Freiberg, Cynthia L Gibert, Matthew Bidwell Goetz, David Leaf, Maria C Rodriguez-Barradas, Amy C Justice, David Rimland
BACKGROUND:  After adjustment for cardiovascular risk factors and despite higher mortality, those with human immunodeficiency virus (HIV+) have a greater risk of acute myocardial infarction (AMI) than uninfected individuals. METHODS:  We included HIV+ individuals who started combination antiretroviral therapy (cART) in the Veterans Aging Cohort Study (VACS) from 1996 to 2012. We fit multivariable proportional hazards models for baseline, time-updated and cumulative measures of HIV-1 RNA, CD4 counts, and the VACS Index...
December 1, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Jon R Davids, Kevin Diaz, Thu-Ba Leba, Samuel Adams, David E Westberry, Anita M Bagley
BACKGROUND: Children who have had surgery involving the placement of an implant frequently undergo a subsequent surgery for hardware removal. The cosmesis of surgical scars following initial and subsequent surgeries is unpredictable. Scar incision (subsequent surgical incision through the initial scar) or excision (around the initial scar) is selected on the basis of the quality of the initial scar. The outcomes following these techniques have not been determined. METHODS: This prospective, consecutive case series was designed to compare outcomes following surgical scar incision versus excision at the time of implant removal in children with cerebral palsy...
August 17, 2016: Journal of Bone and Joint Surgery. American Volume
Edwin Halliday, Anant Patel, Andrew Hindmarsh, Vijay Sujendran
Endoscopic vacuum-assisted closure (VAC) is increasingly being used as a means of managing perforations or anastomotic leaks of the upper gastrointestinal (GI) tract. Published outcomes are favourable, with few mentions of complications or morbidity. We present a case in which the management of a gastric perforation with endoscopic vacuum therapy was complicated by cervical oesophageal perforation. The case highlights the risks of such endoscopic therapeutic procedures and is the first report in the literature to describe significant visceral injury during placement of a VAC device for upper GI perforation...
July 28, 2016: Journal of Surgical Case Reports
Satoshi Miyamura, Shigeyoshi Tsuji, Takao Iwai, Masayuki Hamada
BACKGROUND: Vacuum-assisted wound closure (VAC) is useful for difficult wound beds, although sites where bleeding or infection is expected are usually regarded as problematic for this therapy. This report outlines the treatment of chronic tibial osteomyelitis (Cierny- Mader type III) due to mixed infection with Nocardia spp and Bacteroi- des fragilis by postoperative VAC therapy direct to the medullary cavity, followed by wound coverage with a gastrocnemius myocutaneous skin flap. CASE REPORT: A 64-year-old man developed chronic left tibial os- teomyelitis after a work injury...
June 2016: Wounds: a Compendium of Clinical Research and Practice
Leonardo Duranti, Luca Tavecchio, Giovanni Leuzzi, Ugo Pastorino
We herein report a case of a 56-year old man who underwent an intrapericardial right pneumonectomy plus partial left atrial resection for a lung sarcomatoid carcinoma. One month after surgery, the patient developed a broncho-pleural fistula in the right main bronchus. After the failure of several consecutive conservative and surgical treatments (bronchoscopic submucosa injection of fibrin glue, thoracostomy, Amplatzer device placement, omentoplasty, VAC therapy), the patient developed a pleural empyema. So, we decided to fill the pleural space with granulated sugar (changing thoracostomy dressing daily) with subsequent clinical improvement, allowing a definitive surgical closure through a thoracoplasty...
July 1, 2016: European Journal of Cardio-thoracic Surgery
Satoshi Shinozaki, Hiroaki Nomoto, Yoshie Kondo, Hirotsugu Sakamoto, Yoshikazu Hayashi, Hironori Yamamoto, Alan Kawarai Lefor, Hiroyuki Osawa
Alternative eradication therapies for Helicobacter pylori infection are needed because of an increasing failure rate over the past decade. The aim of this study was to determine if vonoprazan, a new potassium-competitive acid blocker, showed superiority to existing proton pump inhibitors for primary eradication of H. pylori in routine clinical practice. Data for 573 patients who underwent primary H. pylori eradication therapy were retrospectively reviewed. Regimens included clarithromycin 200 mg, amoxicillin 750 mg, and an acid-suppressing drug [lansoprazole 30 mg (LAC), rabeprazole 10 mg (RAC), esomeprazole 20 mg (EAC), or vonoprazan 20 mg (VAC)] twice daily for 1 week...
May 2016: Kaohsiung Journal of Medical Sciences
Kuen-Daw Tsai, Jonathan Cherng, Yi-Heng Liu, Ta-Wei Chen, Ho-Yiu Wong, Shu-Mei Yang, Kuo-Shen Chou, Jaw-Ming Cherng
BACKGROUND: Cinnamomum verum is used to manufacture the spice cinnamon. In addition, the plant has been used as a Chinese herbal medication. METHODS: We investigated the antiproliferative effect of 2-methoxycinnamaldehyde (2-MCA), a constituent of the cortex of the plant, and the molecular biomarkers associated with tumorigenesis in human colorectal adenocarcinoma COLO 205 cells. Specifically, cell viability was evaluated by colorimetric assay; apoptosis was determined by flow cytometry and morphological analysis with bright field, acridine orange, and neutral red stainings, as well as comet assay; topoisomerase I activity was determined by assay based upon DNA relaxation and topoisomerase II by DNA relaxation plus decatentation of kinetoplast DNA; lysosomal vacuolation and volume of acidic compartments (VACs) were determined by neutral red staining...
2016: Food & Nutrition Research
Akihiro Yoshimoto, Takafumi Inoue, Masayuki Fujisaki, Sei Morizumi, Yoshihiro Suematsu
OBJECTIVE: Surgical site infection (SSI) after cardiovascular procedures is a severe complication, potentially leading to high morbidity and mortality. In addition, during the treatment of SSI, rehabilitation is delayed, which can severely impair postoperative recovery. The aim of this study was to assess the effect of vacuum-assisted closure (VAC) therapy on rehabilitation during the treatment of SSI after cardiovascular surgery. METHODS: From January 2008 to March 2015, 10 patients underwent VAC therapy for SSI after cardiovascular operations...
August 2016: General Thoracic and Cardiovascular Surgery
Roberto Cirocchi, Arianna Birindelli, Walter L Biffl, Ventsislav Mutafchiyski, Georgi Popivanov, Osvaldo Chiara, Gregorio Tugnoli, Salomone Di Saverio
BACKGROUND: The open abdomen technique may be used in critically ill patients to manage abdominal injury, reduce the septic complications, and prevent the abdominal compartment syndrome. Many different techniques have been proposed and multiple studies have been conducted, but the best method of temporary abdominal closure has not been determined yet. Recently, new randomized and nonrandomized controlled trials have been published on this topic. We aimed to perform an up-to-date systematic review on the management of open abdomen, including the most recent published randomized and nonrandomized controlled trials, to compare negative pressure wound therapy (NPWT) with no NPWT and define if one technique has better outcomes than the other with regard to primary fascial closure, postoperative 30-day mortality and morbidity, enteroatmospheric fistulae, abdominal abscess, bleeding, and length of stay...
September 2016: Journal of Trauma and Acute Care Surgery
Takeo Togo, Tohru Hasumi, Fumihiko Hoshi, Yasushi Hoshikawa, Yoshinori Okada, Yasuki Saito
A 73-year-old man underwent right middle-lower bilobectomy for lung adenocarcinoma. He suffered from pneumonia followed by empyema due to bronchopleural fistula. On day 19 after the operation, an open window thoracostomy was created. Then the pleural space was treated conservatively with saline irrigation and petrolatum gauze packing. Progressive formation of healthy granulation tissue was observed around the bronchopleural fistula and the adjacent pulmonary artery, resulting in a complete closure of the bronchopleural fistula...
May 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
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