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https://www.readbyqxmd.com/read/28088597/phase-ii-randomized-trial-of-negative-pressure-wound-therapy-to-decrease-surgical-site-infection-in-patients-undergoing-laparotomy-for-gastrointestinal-pancreatic-and-peritoneal-surface-malignancies
#1
Perry Shen, Aaron Blackham, Stacey Lewis, Clancy Clark, Russell Howerton, Harveshp Mogal, Rebecca Dodson, Gregory B Russell, Edward A Levine
BACKGROUND: Surgical site infections (SSI) remain a major source of morbidity and cost after resection of intra-abdominal malignancies. Negative pressure wound therapy (NPWT) has been reported to significantly reduce SSI when applied to the closed laparotomy incision. This paper reports results of a randomized clinical trial examining the effect of NPWT on SSI rates in surgical oncology patients with increased risk for infectious complications. STUDY DESIGN: From 2012-2016, 265 patients underwent open resection of intra-abdominal neoplasms stratified into three groups: gastrointestinal (n=57), pancreas (n=73), and peritoneal surface malignancy (n=135)...
January 11, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28058229/systematic-review-of-the-negative-pressure-wound-therapy-in-kidney-transplant-recipients
#2
Badri Man Shrestha
AIM: To review negative pressure wound therapy (NPWT) as an important addition to the conventional methods of wound management. METHODS: A systematic review, performed by searching the PubMed, EMBASE and Cochrane Library databases, showed 11 case reports comprising a total of 22 kidney transplantation (KT) patients (range, 1 to 9), who were treated with NPWT. Application of NPWT was associated with successful healing of wounds, leg ulcer, lymphocele and urine leak from ileal conduit...
December 24, 2016: World Journal of Transplantation
https://www.readbyqxmd.com/read/28050534/the-use-of-negative-pressure-wound-therapy-in-the-treatment-of-infected-wounds-case-studies
#3
Daniel de Alcântara Jones, Wilson Vasconcelos Neves Filho, Janice de Souza Guimarães, Daniel de Araújo Castro, Antonio Marcos Ferracini
OBJECTIVE: To evaluate the results and benefits obtained from the topical use of negative pressure wound therapy (NPWT) in patients with infected wounds. METHODS: This was a retrospective study of 20 patients (17 males and three females, mean age 42 years) with infected wounds treated using NPWT. The infected wounds were caused by trauma. The treatment system used was VAC.(®) (Vacuum Assisted Closure, KCI, San Antonio, United States) applied to the wound in continuous mode from 100 to 125 mmHg...
November 2016: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28043851/negative-pressure-wound-therapy-in-orthopaedic-surgery
#4
REVIEW
N Robert
Negative pressure wound therapy (NPWT) consists in applying subatmospheric pressure to a wound that is sealed off by a specially designed dressing and connected by a tube to a suction pump and drainage collection system. Skin defects are extremely common in orthopaedic and trauma surgery. NPWT is valuable across a range of indications. Proven effects include an increase in blood flow, stimulation of angiogenesis, and a decrease in wound surface area. NPWT can be used to treat post-traumatic and surgical wounds, burns, and chronic wounds such as pressure sores and ulcers...
December 30, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28032154/negative-pressure-wound-therapy-as-effective-and-comfortable-management-after-treatment-of-osmidrosis
#5
Jin Yong Shin, Si-Gyun Roh, Nae-Ho Lee, Kyung-Moo Yang
: Although osmidrosis has been widely discussed in respect to its treatment modalities, there has been no definite consideration of postoperative management after the treatment of osmidrosis. We have tested the 40-125 mmHg range of negative pressure. We present negative pressure wound therapy (NPWT) of 70 mmHg for postoperative management in osmidrosis because NPWT has a role in removing fluid, such as blood or seroma, and diminishing the dead space between the skin and subcutaneous tissue...
December 28, 2016: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28025309/safety-and-efficacy-of-prophylactic-negative-pressure-wound-therapy-following-open-saphenous-vein-harvest-in-cardiac-surgery-a-feasibility-study
#6
Arthur J Lee, Christina E Sheppard, William D T Kent, Holly Mewhort, Khokan C Sikdar, Paul W M Fedak
OBJECTIVES: Surgical site complications following great saphenous vein (GSV) harvest presents a significant risk of morbidity. Negative pressure wound therapy (NPWT) has shown promise in the treatment and prophylaxis of open wounds and surgical incisions but has not been studied following GSV harvest. We performed a feasibility study examining the use of NPWT following GSV harvest for coronary bypass surgery. METHODS: Sixty-four patients were recruited in this single-centre, single-blind, randomized controlled trial...
December 26, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28009772/acute-kidney-injury-following-exploratory-laparotomy-and-temporary-abdominal-closure
#7
Tyler J Loftus, Azra Bihorac, Tezcan Ozrazgat-Baslanti, Janeen R Jordan, Chasen A Croft, R Stephen Smith, Philip A Efron, Frederick A Moore, Alicia M Mohr, Scott C Brakenridge
BACKGROUND: Acute kidney injury (AKI) following exploratory laparotomy and temporary abdominal closure (TAC) is poorly understood but clinically significant. We hypothesized that the prevalence of AKI would be highest 96 hours following TAC, early hypoxemia would predict AKI, and that AKI would be an independent predictor of mortality. METHODS: We performed a retrospective analysis of 251 acute care surgery patients managed with TAC by negative pressure wound therapy (NPWT)...
December 22, 2016: Shock
https://www.readbyqxmd.com/read/28003941/negative-pressure-wound-therapy-with-instillation-in-a-chronic-non-healing-right-hip-trochanteric-pressure-ulcer
#8
Kevin W Broder, Brian Nguyen, Richard M Bodor
Complex pressure ulcer wound sites often present with a wide scope of barriers to healing ranging from high colonization of multi-drug-resistant pathogens to tortuous internal anatomy which make the wound recalcitrant to traditional wound care including standard negative pressure wound therapy (NPWT). Negative pressure wound therapy with instillation (NPWTi-d) provides an opportunity to manage and heal wounds with indications not met by standard NPWT such as cavitating wounds with complex undermining and tunneling...
November 14, 2016: Curēus
https://www.readbyqxmd.com/read/27988849/bacterial-reduction-and-shift-with-npwt-after-surgical-debridements-a-retrospective-cohort-study
#9
Thorsten Jentzsch, Georg Osterhoff, Pawel Zwolak, Burkhardt Seifert, Valentin Neuhaus, Hans-Peter Simmen, Gerrolt N Jukema
BACKGROUND: Surgical debridement, negative-pressure wound therapy (NPWT) and antibiotics are used for the treatment of open wounds. However, it remains unclear whether this treatment regimen is successful in the reduction and shift of the bacterial load. METHODS: After debridement in the operating room, NPWT, and antibiotic treatment, primary and secondary consecutive microbiological samples of 115 patients with 120 open wounds with bacterial or yeast growth in ≥1 swab or tissue microbiological sample(s) were compared for bacterial growth, Gram staining and oxygen use at a level one trauma center in 2011...
December 17, 2016: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/27984596/potential-future-applications-for-negative-pressure-wound-therapy-and-installation-devices
#10
Reuben A Falola, Caitlin M Ward, Madison J Kim, Tammer Elmarsafi, John S Steinberg, Karen K Evans, Christopher E Attinger, Paul J Kim
Negative-pressure wound therapy (NPWT) applies vacuum pressure to a wound bed sealed by an adhesive dressing to improve wound healing. A cleansing solution, often antibiotics or saline, may be instilled into the wound bed concurrently and removed via suction, thus enhancing the therapeutic effect. The therapeutic effect results from improved blood flow and removal of inflammatory factors. Since 1995, the FDA has approved NPWT for medical use. Since then, this technology has been applied to different types of wounds, including diabetic and decubitus ulcers and postsurgical incisional wounds...
16, 2016: Surgical Technology International
https://www.readbyqxmd.com/read/27980886/a-case-review-series-of-christiana-care-health-system-s-experience-with-negative-pressure-wound-therapy-instillation
#11
Robert Felte, Kathy E Gallagher, Glen H Tinkoff, Mark Cipolle
Acute and chronic wounds afflict a multitude of patients to varying degrees. Wound care treatment modalities span the spectrum of technological advancement and with that differ greatly in cost. Negative pressure wound therapy (NPWT) can now be combined with instillation and dwell time (NPWTi-d). This case review series of 11 patients in a community hospital setting provides support for the utilization of NPWTi-d. Additionally, current literature on the use of NPWTi-d in comparison to NPWT will be reviewed.  We highlight three specific cases...
November 7, 2016: Curēus
https://www.readbyqxmd.com/read/27977577/negative-pressure-wound-therapy-aids-recovery-following-surgical-debridement-due-to-severe-bacterial-cellulitis-with-abdominal-abscess-post-cesarean-a-case-report-care-compliant
#12
Christopher N J Young, Ka Ying Bonnie Ng, Vanessa Webb, Sarah Vidow, Rajeswari Parasuraman, Sameer Umranikar
INTRODUCTION: Bacterial cellulitis post-Cesarean section is rare. Negative pressure wound therapy (NPWT) is widely used in various medical specialities; its effectiveness in obstetrics however remains the topic of debate-used predominantly as an adjunct to secondary intention specific to high-risk patient groups. Its application in the treatment of actively infected wounds post-Cesarean is not well documented. Here, we document NPWT in the treatment of an unusually severe case of bacterial cellulitis with abdominal abscess postpartum...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27977520/reliability-and-concurrent-validity-of-the-narrow-path-walking-test-in-persons-with-multiple-sclerosis
#13
Uri Rosenblum, Itshak Melzer
BACKGROUND AND PURPOSE: About 90% of people with multiple sclerosis (PwMS) have gait instability and 50% fall. Reliable and clinically feasible methods of gait instability assessment are needed. The study investigated the reliability and validity of the Narrow Path Walking Test (NPWT) under single-task (ST) and dual-task (DT) conditions for PwMS. METHODS: Thirty PwMS performed the NPWT on 2 different occasions, a week apart. Number of Steps, Trial Time, Trial Velocity, Step Length, Number of Step Errors, Number of Cognitive Task Errors, and Number of Balance Losses were measured...
January 2017: Journal of Neurologic Physical Therapy: JNPT
https://www.readbyqxmd.com/read/27930570/successful-treatment-of-a-rare-extended-retroperitoneal-necrotizing-soft-tissue-infection-caused-by-extended-spectrum-beta-lactamase-producing-escherichia-coli-a-case-report
#14
Rui He, Xin Qi, Bing Wen, XiangYan Li, Li Guo
RATIONALE: Retroperitoneal necrotizing soft tissue infection (NSTI) is a rare but life-threatening disease. Here, we present a case of extended retroperitoneal NSTI caused by extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli (E coli). PATIENT CONCERNS: The patient complained of progressive redness, swelling, and right flank pain for 10 days, extending to the scrotum for 1 day. DIAGNOSES: He was admitted with an initial diagnosis of cellulitis...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27909643/source-control-and-graft-preservation-using-negative-pressure-wound-therapy-with-antibiotic-instillation-a-case-report
#15
Victoria Gilbert, Timothy Kelly, Robert Grossi
Negative pressure wound therapy (NPWT) is widely used to treat many types of complex wounds, and the advent of the instillation and dwell time (NPWTi-d) technique has enhanced this system with the addition of automated treatment with topical solutions. In the field of vascular surgery, NPWT is utilized to help close wounds over underlying grafts; however keeping these wounds free of infection and avoiding large reoperation when infection occurs remains a challenge. In this case report we present a patient who required acute intervention for limb ischemia, with a large wound created in the groin for anastomosis of a prosthetic graft bypass...
October 31, 2016: Curēus
https://www.readbyqxmd.com/read/27909640/treating-fasciotomy-wounds-with-negative-pressure-wound-therapy-with-instillation-and-dwell-time-npwti-d
#16
Priscilla Lee
Acute compartment syndrome (ACS) is a serious complication of lower-extremity trauma caused by accidents or post-procedure complications. ACS is characterized by increased pressure within the compartment, resulting in reduced blood flow, tissue hypoxia, and tissue necrosis. Fasciotomies to relieve pressure and debridement of necrotic tissue comprise primary treatment. My purpose is to present initial experience using negative pressure wound therapy with instillation and dwell time (NPWTi-d)* to treat fasciotomy wounds in two patients...
October 28, 2016: Curēus
https://www.readbyqxmd.com/read/27905814/medicare-and-medicaid-programs-cy-2017-home-health-prospective-payment-system-rate-update-home-health-value-based-purchasing-model-and-home-health-quality-reporting-requirements-final-rule
#17
(no author information available yet)
This final rule updates the Home Health Prospective Payment System (HH PPS) payment rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor; effective for home health episodes of care ending on or after January 1, 2017. This rule also: Implements the last year of the 4-year phase-in of the rebasing adjustments to the HH PPS payment rates; updates the HH PPS case-mix weights using the most current, complete data available at the time of rulemaking; implements the 2nd-year of a 3-year phase-in of a reduction to the national, standardized 60-day episode payment to account for estimated case-mix growth unrelated to increases in patient acuity (that is, nominal case-mix growth) between CY 2012 and CY 2014; finalizes changes to the methodology used to calculate payments made under the HH PPS for high-cost "outlier" episodes of care; implements changes in payment for furnishing Negative Pressure Wound Therapy (NPWT) using a disposable device for patients under a home health plan of care; discusses our efforts to monitor the potential impacts of the rebasing adjustments; includes an update on subsequent research and analysis as a result of the findings from the home health study; and finalizes changes to the Home Health Value-Based Purchasing (HHVBP) Model, which was implemented on January 1, 2016; and updates to the Home Health Quality Reporting Program (HH QRP)...
November 3, 2016: Federal Register
https://www.readbyqxmd.com/read/27901391/comparison-of-antibacterial-effects-among-three-foams-used-with-negative-pressure-wound-therapy-in-an-ex-vivo-equine-perfused-wound-model
#18
COMPARATIVE STUDY
Lore L Van Hecke, Maarten Haspeslagh, Katleen Hermans, Ann M Martens
OBJECTIVE To compare antibacterial effects among 3 types of foam used with negative-pressure wound therapy (NPWT) in an ex vivo equine perfused wound model. SAMPLES Abdominal musculocutaneous flaps from 6 equine cadavers. PROCEDURES Each musculocutaneous flap was continuously perfused with saline (0.9% NaCl) solution. Four 5-cm circular wounds were created in each flap and contaminated with 10(6) CFUs of both Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus (MRSA). After a 1-hour incubation period, 1 of 4 treatments (NPWT with silver-impregnated polyurethane foam [NPWT-AgPU], polyurethane foam [NPWT-PU], or polyvinyl alcohol foam [NPWT-PVA] or a nonadherent dressing containing polyhexamethylene biguanide without NPWT [control]) was randomly applied to each wound...
December 2016: American Journal of Veterinary Research
https://www.readbyqxmd.com/read/27901277/negative-pressure-wound-therapy-for-prevention-and-treatment-of-surgical-site-infections-after-vascular-surgery
#19
REVIEW
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
https://www.readbyqxmd.com/read/27898352/management-of-the-open-abdomen-using-negative-pressure-wound-therapy-with-instillation-in-severe-abdominal-sepsis-a-review-of-48-cases-in-hospital-mexico-costa-rica
#20
Pablo Sibaja, Alfredo Sanchez, Guillermo Villegas, Alvaro Apestegui, Esteban Mora
INTRODUCTION: Despite the numerous advances in recent years, severe abdominal sepsis (with associated organ failure associated with infection) remains a serious, life-threatening condition with a high mortality rate. OA is a viable alternative to the previously used scheduled repeat laparotomy or continuous peritoneal lavage. The use of Negative Pressure Wound Therapy (NPWT) has been described as a successful method of management of the open abdomen. Adding instillation of saline solution to NPWT in a programmed and controlled manner, could offer the clinician an additional tool for the management of complex septic abdomen...
November 17, 2016: International Journal of Surgery Case Reports
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