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negative pressure wound therapy,wound dressing

Zhenmi Liu, Jo C Dumville, Robert J Hinchliffe, Nicky Cullum, Fran Game, Nikki Stubbs, Michael Sweeting, Frank Peinemann
BACKGROUND: Foot wounds in people with diabetes mellitus (DM) are a common and serious global health issue. People with DM are prone to developing foot ulcers and, if these do not heal, they may also undergo foot amputation surgery resulting in postoperative wounds. Negative pressure wound therapy (NPWT) is a technology that is currently used widely in wound care. NPWT involves the application of a wound dressing attached to a vacuum suction machine. A carefully controlled negative pressure (or vacuum) sucks wound and tissue fluid away from the treated area into a canister...
October 17, 2018: Cochrane Database of Systematic Reviews
S Al-Zahid, D Izadi, C J Day, A Wilson, C Stone, J Smith
We describe a rare case of cervical necrotising fasciitis caused by mastoiditis and Bezold's abscess. This case was complicated by a tracheostomy delaying wound healing. A novel strategy to repair the tracheotomy defect using Permacol™, an acellular porcine dermal substitute, and a local muscle flap not previously reported in the literature is described to allow the use of negative pressure wound therapy dressing. This technique may be employed in similar applications for non-healing tracheotomy wounds.
October 16, 2018: Annals of the Royal College of Surgeons of England
Andrew J Curley, Elizabeth B Terhune, Anthony T Velott, Evan H Argintar
Negative pressure wound therapy is becoming more commonly used to prevent wound complications in joint arthroplasty, although few studies have assessed its outcomes compared with those of a traditional dry sterile dressing. This retrospective study assessed complications that required return to the operating room in a cohort of patients who received a dry sterile dressing (n=159) vs negative pressure wound therapy (n=32). There were significantly more overall complications (P=.0293) in the dry sterile dressing group (23...
October 15, 2018: Orthopedics
Travis L Perry, Lindsay M Kranker, Erin E Mobley, Eileen E Curry, R Michael Johnson
INTRODUCTION: Fournier's gangrene (FG) remains a forbidding necrotizing soft tissue infection (NSTI) that necessitates early recognition, prompt surgical excision, and goal-directed antibiotic therapy. Traditionally, surgical management has included wide radical excision for sepsis control, but this management often leaves large, morbid wounds that require complex wound coverage, prolonged hospitalizations, and/or delayed healing. OBJECTIVE: The purpose of this case series is to report the outcomes of FG using a surrogate approach of concurrent debridement of spared skin and soft tissue, negative pressure wound therapy (NPWT), and serial delayed primary closure (DPC)...
October 2018: Wounds: a Compendium of Clinical Research and Practice
Leo M Nherera, Paul Trueman, Michael Schmoeckel, Francis A Fatoye
BACKGROUND: There is a growing interest in using negative pressure wound therapy in closed surgical incision to prevent wound complications which continue to persist following surgery despite advances in infection measures. OBJECTIVES: To estimate the cost-effectiveness of single use negative pressure wound therapy (sNPWT) compared to standard of care in patients following coronary artery bypass grafting surgery (CABG) procedure to reduce surgical site complications (SSC) defined as dehiscence and sternotomy infections...
October 3, 2018: Journal of Cardiothoracic Surgery
Ismihan Selen Onan, Okan Yildiz, Behzat Tüzün, Barış Timur, Sertaç Haydin
Vacuum-assisted closure (VAC) has been widely used to treat mediastinitis after congenital cardiac surgery, which is associated with a high risk of morbidity and mortality. The aim in this study is to review our 14 cases of mediastinitis treated with VAC therapy after congenital cardiac surgery. We retrospectively reviewed the medical records of 14 congenital heart patients with mediastinitis from January 2012 to March 2017. Patients with fever, wound discharge, sternal dehiscence, a positive wound culture or abscess diagnosed with computed tomography are accepted as mediastinitis...
October 3, 2018: Artificial Organs
Edward Ray, Stuart L Mitchell, Peter G Cordeiro
Management of radial forearm donor sites following free flap reconstruction of head and neck tumor defects typically requires split-thickness skin grafting. Tendon exposure and delayed healing are occasional problems associated with skin grafting over the distal forearm musculature. Others have reported the use of negative pressure wound therapy (NPWT) devices to bolster split-thickness grafts and improve graft take. Although this approach works well, these devices are not always approved by third-party payers for outpatient use, requiring patients to remain in the hospital or have these devices removed before discharge...
June 2018: Plastic and Reconstructive Surgery. Global Open
Pietro M Ferrando, Ada Ala, Riccardo Bussone, Laura Bergamasco, Federica Actis Perinetti, Fabrizio Malan
Background: Negative pressure wound therapy was developed for treating wounds associated with unfavorable healing factors. The principles of the negative pressure wound therapy applied on clean and closed surgical incision originate the closed incision negative pressure therapy (ciNPT). We evaluated the use of ciNPT in the setting of oncological breast surgery. Methods: From January 1, 2015, to June 31, 2015, we prospectively selected 37 patients undergoing oncological breast surgery with a minimum of 4 risk factors...
June 2018: Plastic and Reconstructive Surgery. Global Open
Shaheel Mohammad Sahebally, Kevin McKevitt, Ian Stephens, Fidelma Fitzpatrick, Joseph Deasy, John Patrick Burke, Deborah McNamara
Importance: Surgical site infections (SSIs) are common after laparotomy wounds and are associated with a significant economic burden. The use of negative pressure wound therapy (NPWT) has recently been broadened to closed surgical incisions. Objective: To evaluate the association of prophylactic NPWT with SSI rates in closed laparotomy incisions performed for general and colorectal surgery in elective and emergency settings. Data Sources: The PubMed, Embase, Cochrane Central Register of Controlled Trials, and Google Scholar databases were searched without language restrictions for relevant articles from inception until December 2017...
September 26, 2018: JAMA Surgery
Andrew Bayci, Begum Akay
BACKGROUND: Negative pressure wound therapy (NPWT) has been described for closure of complex neonatal abdominal wounds, but advanced techniques for stoma or fistula control, skin protection, and the use of high pressure therapy not as well established. CASES: We identified neonatal patients at our institution who received NPWT for a complex abdominal wound, defined as a wound associated with a stoma or fistula with partial or complete dehiscence of the abdominal fascia or skin...
September 2018: Journal of Wound, Ostomy, and Continence Nursing
Andrew J Rosenbaum, Samik Banerjee, Kristen M Rezak, Richard L Uhl
Wound management is a notable healthcare and financial burden, accounting for >$10 billion in annual healthcare spending in the United States. A multidisciplinary approach involving orthopaedic and plastic surgeons, wound care nursing, and medical and support staff is often necessary to improve outcomes. Orthopaedic surgeons must be familiar with the fundamental principles and evidenced-based concepts for the management of acute and chronic wounds. Knowledge of surgical dressings, negative pressure wound therapy, tissue expanders, dermal apposition, biologics, and extracellular matrices can aide practitioners in optimizing wound care...
August 31, 2018: Journal of the American Academy of Orthopaedic Surgeons
Devinder Singh
BACKGROUND: Complex ventral hernia repairs (VHRs) are often complicated by surgical-site occurrences such as infection, seroma, hematoma, dehiscence, necrosis, as well as hernia recurrence and mesh contamination. A review of current literature was conducted to determine whether the application of negative pressure therapy to closed incisions post abdominal wall reconstruction (AWR)/VHR reduces the risk of postoperative wound complications and hernia recurrence. METHODS: The PubMed/MEDLINE databases were searched for studies published through January 2018...
September 2018: Plastic and Reconstructive Surgery
Jeontaik Kwon, Cara Staley, Megan McCullough, Selena Goss, Mariano Arosemena, Babak Abai, Dawn Salvatore, David Reiter, Paul DiMuzio
OBJECTIVE: Vascular groin incision complications contribute significantly to patients' morbidity and rising health care costs. Negative pressure therapy over the closed incision decreases the infection rate in cardiac and orthopedic procedures. This study prospectively evaluated negative pressure therapy as a means to decrease wound complications and associated health care costs. METHODS: This was a randomized, prospective, single-institution study of 119 femoral incisions closed primarily after elective vascular surgery including both inflow (eg, aortofemoral) and outflow (eg, femoral-popliteal bypass) procedures...
August 17, 2018: Journal of Vascular Surgery
A Sogorski, M Lehnhardt, O Goertz, K Harati, N Kapalschinski, T Hirsch, A Daigeler, J Kolbenschlag
BACKGROUND: Negative Pressure Wound Therapy (NPWT) is widely used across different kinds of surgical disciplines. A controversial debate was raised by diverging results from studies that were conducted to examine the impact of NPWT on local perfusion. Thus, there is a lack of evidence for one important underlying factors that influences the physiology of wound healing under an applied NPWT-dressing. OBJECTIVE: To investigate the immediate local perfusion changes due to an applied intermittent NPWT protocol...
August 13, 2018: Journal of Tissue Viability
Andrew Applewhite, Saeed A Chowdhry, Michael Desvigne, Allen Gabriel, Rosemary Hill, Mary Anne Obst, Dawn Shepherd, Marcus Speyrer, Terry Treadwell, Lindsey Waddell
The increase in wound prevalence means more patients with wounds are being transferred through care settings than ever before. Although the goals of therapy may be the same in both settings, wound care therapies and dressings differ in availability and appropriateness for each setting. Negative pressure wound therapy (NPWT) modalities and oxidized regenerated cellulose (ORC)/collagen (C)/silver-ORC dressings are available in both inpatient and outpatient care settings, but (to-date) lack comprehensive information regarding best practices in transitioning use of these therapies between various care settings...
August 2018: Wounds: a Compendium of Clinical Research and Practice
Sandro Giannini, Antonio Mazzotti, Deianira Luciani, Giada Lullini, Giuseppe Tedesco, Isabella Andreoli, Matteo Cadossi, Cesare Faldini
OBJECTIVE: To compare the effectiveness in wound healing of negative pressure wound therapy (NPWT) versus a standard dressing in patients who underwent hip or knee revision surgery. METHOD: Participating patients scheduled for hip and knee prosthetic revision were randomised into two groups: one receiving standard povidone-iodine gauze and patch wound dressing (control group) and the other NPWT over the sutured wound area (NPWT group). Patients were evaluated by means of ASEPSIS score, occurrence of blisters, visual analogue scale (VAS) and dressing changes seven days after surgery...
August 2, 2018: Journal of Wound Care
Caputo Glenda Giorgia, Marchetti Alberto, Governa Maurizio, Dalla Pozza Edoardo
Negative pressure wound therapy, a tool widely applied to treat lower limb traumas, is useful in reconstructive procedures. However, obtaining an air-tight vacuum seal when using a negative pressure dressing around an external fixation device can be complicated and time-consuming. The plastic drape seldom adheres to screws, pins, or wires and, as such, the vacuum-seal is jeopardized.In surgical departments, colostomy paste is widely used, readily available, and applied where pins and wires make contact with the plastic drape...
July 30, 2018: Journal of Orthopaedic Trauma
N Hyldig, C A Vinter, M Kruse, O Mogensen, C Bille, J A Sorensen, R F Lamont, C Wu, L N Heidemann, M H Ibsen, J B Laursen, P G Ovesen, C Rorbye, M Tanvig, J S Joergensen
OBJECTIVE: To evaluate the reduction of surgical site infections by prophylactic incisional negative pressure wound therapy compared with standard postoperative dressings in obese women giving birth by caesarean section. DESIGN: Multicentre randomised controlled trial. SETTING: Five hospitals in Denmark. POPULATION: Obese women (prepregnancy body mass index (BMI) ≥30 kg/m2 ) undergoing elective or emergency caesarean section...
August 1, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
Kristina A Wihbey, Ellen M Joyce, Zachary T Spalding, Hayley J Jones, Todd A MacKenzie, Rebecca H Evans, June L Fung, Marlene B Goldman, Elisabeth Erekson
OBJECTIVE: To compare the occurrence of superficial surgical site infections in obese women using prophylactic negative pressure therapy with standard dressings after cesarean delivery. METHODS: We conducted a randomized controlled, nonblinded, two-center study of prophylactic negative pressure therapy compared with standard surgical dressings placed at the time of primary closure at cesarean delivery in obese women with body mass indexes (BMI) of 35 or higher (ie, class II and III obesity)...
August 2018: Obstetrics and Gynecology
Jung Woo Chang, Woong Heo, Matthew Seung Suk Choi, Jang Hyun Lee
BACKGROUND: Diabetic foot management is a challenge for reconstructive surgeons because it combines dramatically decreased circulation and chronic infection. The goal of managing this condition is to maximize viable tissue; however, unsatisfactory results, such as extremity amputation, are unavoidable in some cases. For appropriate management, thorough understanding of diabetic foot and the phased approach to its management is needed. The purpose of this study is to introduce an optimal algorithm for diabetic foot management by analyzing cases >12 years...
July 2018: Medicine (Baltimore)
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