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Negative pressure wound therapy

Martin Simek, Adam Chudoba, Roman Hajek, Patrick Tobbia, Martin Molitor, Petr Nemec
Deep sternal wound infection is a challenging aspect of modern cardiac surgery. The considerable mortality rate, devastating morbidity and, negative impact on long-term survival has driven cardiac and plastic surgeons to seek a more advantageous treatment solution. This review summarizes progress in the field of deep sternal wound infection treatment after cardiac surgery. Emphasis is placed on outcomes analysis of contemporary treatment strategy based on negative pressure wound therapy followed by sternotomy wound reconstruction, and its comparison with conventional treatment modalities used afore...
September 14, 2018: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
Mircea Muresan, Simona Muresan, Klara Brinzaniuc, Daniela Sala, Radu Neagoe
INTRODUCTION: Open abdomen is a concept that was developed especially in relation to abdominal compartment syndrome (ACS). OBJECTIVE: This study presents the evolution and complications related to the management of the open abdomen after decompressive laparotomy, using a standardized method based on negative pressure wound therapy (NPWT). MATERIALS AND METHODS: This observational prospective study conducted over a 9-month period included 19 patients who underwent decompressive laparotomies for ACS...
August 13, 2018: Wounds: a Compendium of Clinical Research and Practice
Leah Griffin, Laura M Leyva Casillas
OBJECTIVE: This retrospective study of 510 patients receiving negative pressure wound therapy (NPWT) in a home care setting examines the relationship between remote therapy monitoring (RTM) and patient adherence, as well as determines the impact of patient adherence on wound progression. MATERIALS AND METHODS: Adherence to treatment was continuously monitored via RTM, and patients with therapy usage < 16 hours in 1 day received an adherence call. Repeated failures to reach a noncompliant patient led to an escalation call to the caregiver to discuss treatment...
August 2018: Wounds: a Compendium of Clinical Research and Practice
Zhi Wang, Ming Bai, Ang Zeng, Zhifei Liu, Ru Zhao, Xiaojun Wang
INTRODUCTION: Resulting mostly from major injury or infection, severe acute wounds are often accompanied by septic shock or multiple organ failure and associated with high disability and mortality rates. In managing Chinese patients with wound-derived acute severe illnesses, salvage treatment in the emergency department has traditionally prioritized life support and protection of vital organs before wound repair. OBJECTIVE: This retrospective review evaluated the outcomes of patients with wound-derived acute severe illness who were treated with a new salvage protocol that combined proactive wound care with simultaneous life-support measures...
August 2018: Wounds: a Compendium of Clinical Research and Practice
M Nolff, R Albert, P Wohlsein, W Baumgärtner, S Reese, A Meyer-Lindenberg
The aim of the study was to evaluate the molecular and histological effects of negative pressure wound therapy (NPWT) on vascularisation in clinical cases of open wound treatment in dogs. Open wounds (n=10) were randomly assigned to one of two groups: NPWT treatment (n=5) or foam treatment (polyurethane-foam dressing, n=5). Wounds were matched based on age and underlying cause and analysed with respect to neovascularisation (CD31) and matrix proteinase changes (MMP-9). Histological slides were blinded and analysis was performed using automated histomorphometric software...
September 2018: Schweizer Archiv Für Tierheilkunde
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
Masatoku Arai, Shiei Kim, Hiroyuki Yokota
Open abdomen is sometimes necessary to save lives after ruptured abdominal aortic aneurysm repair. We report a case in which a staged strategy for early abdominal wall closure was applied to prevent the severe complications due to the extended period of open abdomen. An 81-year-old man with ruptured abdominal aortic aneurysm was transported to our hospital. After the first operation, which required open abdomen, prolonged visceral edema and retroperitoneal hematoma made primary fascial closure difficult. Mesh mediated fascial traction was undergone to reduce the gap in fascial dehiscence under negative pressure wound therapy...
July 2018: Chirurgia
Katsuki Danno, Chu Matsuda, Susumu Miyazaki, Takamichi Komori, Megumi Nakanishi, Masaaki Motoori, Masaki Kashiwazaki, Kazumasa Fujitani
BACKGROUND AND PURPOSE: For patients at high risk, such as those with lower-gastrointestinal perforations, it is important to establish a preventive method that reduces the incidence of surgical site infections (SSIs) significantly. We applied negative-pressure wound therapy (NPWT) as part of a delayed primary closure approach to prevent SSIs. This study evaluated the value of this technique. METHODS: We included prospectively 28 patients undergoing abdominal surgery for peritonitis caused by a lower-gastrointestinal perforation between May 2014 and November 2015...
September 5, 2018: Surgical Infections
Junho Shin, Gahee Park, Junhee Lee, Hasuk Bae
Polydeoxyribonucleotide (PDRN) is safe and effective in wound healing, cellular growth, synthesis of extracellular matrix protein, and inflammation reduction via activation of adenosine A2 receptors. We report a 28-year-old male patient treated with PDRN injections for chronic non-healing wound refractory to negative pressure wound therapy, skin graft, or growth factors. Three injections of PDRN were administered at the wound site into the anterior and medial sides of the left stump on the 1st, 4th, and 9th days of hospitalization...
August 2018: Annals of Rehabilitation Medicine
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
Menachem Motiei, Tamar Sadan, Neta Zilony, Guy Topaz, Rachela Popovtzer, Moris Topaz
AIM: Regulated negative pressure-assisted wound therapy is a fundamental, nonpharmaceutical technology for acute and chronically infected wounds, yet bacterial clearance and biofilm buildup remain a challenge for healing. Regulated irrigation combined with negative pressure (RI-NPT) is emerging as an alternative therapeutic strategy for reducing bacterial load. Here, we analyzed RI-NPT hydrokinetics and efficacy of bacterial load reduction in wounds. MATERIALS & METHODS: Escherichia coli were loaded with gold nanoparticles, quantified by flame atomic absorption spectroscopy...
August 28, 2018: Nanomedicine
Paolo Magistri, Tiziana Olivieri, Valentina Serra, Giuseppe Tarantino, Giacomo Assirati, Annarita Pecchi, Roberto Ballarin, Fabrizio Di Benedetto
Immune compromised as well as critically ill patients are at higher risk of surgical wound infection and dehiscence. Wound infections critically influence the outcomes after liver transplantation. In particular, it was shown that they significantly reduce the overall survival rate when compared to patients with uneventful wound healing, and their occurrence is associated with death or graft loss within 1-year post-transplantation. From January 2001 through December 2017, 763 patients underwent liver transplantation in our Institution, the Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, "Policlinico" University Hospital, University of Modena and Reggio Emilia, Modena, Italy...
August 24, 2018: Updates in Surgery
Dimas André Milcheski, Wellington Menezes Mota, Rodolfo Costa Lobato, Araldo Ayres Monteiro Júnior, Rolf Gemperli
OBJECTIVE: to report the experience of the Division of Plastic Surgery of the Hospital das Clínicas of the Medical School of the University of São Paulo in the treatment of cutaneous lesions due to accidental extravasation of drugs. METHODS: we included patients with lesions due to extravasation of drugs over a period of 18 months. We retrospectively evaluated the following parameters: age, diagnoses during hospitalization and comorbidities, serum levels of albumin and hemoglobin, place of hospitalization, drug involved, anatomic segment affected, therapeutic management and death during hospitalization...
August 16, 2018: Revista do Colégio Brasileiro de Cirurgiões
Yu Liu, Ningning Tang, Ke Cao, Shaohua Wang, Sijie Tang, Honghui Su, Jianda Zhou
Negative-pressure wound therapy (NPWT) is one of the most advanced therapeutic methods in the treatment of various hard-to-heal acute and refractory chronic wounds. Recent emerging evidence points to a role of the microRNA-mediated regulation of angiogenesis in ischemic tissues, and a series of microRNAs associated with angiogenesis have been successively identified. In this study, we found that miR-195 expression was significantly upregulated and the microvessel density (MVD) was increased in granulation tissue collected 7 days after NPWT compared with those in the pre-NPWT tissue...
August 24, 2018: International Journal of Lower Extremity Wounds
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
Angela M Kao, Michael R Arnold, Vedra A Augenstein, B Todd Heniford
BACKGROUND: Mesh infection remains the most feared complication after abdominal wall reconstruction, requiring prolonged hospitalizations and often, mesh removal. Understanding of current prevention and treatment strategies is necessary in the management of a common surgical problem. METHODS: A comprehensive review of the current surgical literature was performed to determine risk factors of mesh infection after abdominal wall reconstruction and best practices in their prevention and surgical management...
September 2018: Plastic and Reconstructive Surgery
Ahsan Mir, Nicholas Guys, Khashayar Arianpour, Peter F Svider, Hani Rayess, Giancarlo Zuliani, S Naweed Raza, Hosheng Lin
OBJECTIVE: To perform an evidence-based review with recommendations that evaluates the indications and utility of negative pressure wound therapy (NPWT) in the head and neck. METHODS: The authors searched the PubMed, Medline, Embase, Web of Science, and Cochrane Library databases for relevant literature. The primary outcome was successful intended use of NPWT, be it for granulation tissue formation, infection control, or complete wound closure. Patient demographics, etiology, and other clinical characteristics were explored...
August 22, 2018: Laryngoscope
Dongmei Ge
OBJECTIVE: To assess whether negative-pressure wound therapy (NPWT) reduced complications such as wound infection, dehiscence, seroma/hematoma, skin necrosis/blistering, and bleeding compared with non-NPWT treatments. METHODS: This meta-analysis involved randomized clinical trials of NPWT compared with non-NPWT on surgical wound healing. The main outcome was surgical site infections; secondary outcomes were dehiscence, seroma/hematoma, skin necrosis/blistering, bleeding, and reoperation...
September 2018: Advances in Skin & Wound Care
Fadi Al Daoud, Angelyn Thayer, Gul Sachwani Daswani, Tareq Maraqa, Vinu Perinjelil, Leo Mercer
INTRODUCTION: Seroma is a common and challenging post-operative complication that surgeons are often faced with after performing procedures in which tissue dead spaces have been created. The management strategies consist of non-operative management, percutaneous drainage, or surgical drainage. Our case report discusses the use of Doxycycline sclerotherapy in the successful resolution of a chronic abdominal wall seroma. PRESENTATION OF CASE: We present the case of a 50 year old patient with extensive history of multiple abdominal surgeries, including appendectomy, multiple hernia repairs with recurrent mesh replacement as a result of infection followed by post-operative formation of seroma after each repair...
August 13, 2018: International Journal of Surgery Case Reports
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
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