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Vacuum assisted closure

Ester Comellas, Facundo J Bellomo, Iván Rosales, Luis F Del Castillo, Ricardo Sánchez, Pau Turon, Sergio Oller
Endoluminal vacuum-assisted closure (E-VAC) is a promising therapy to treat anastomotic leakages of the oesophagus and bowel which are associated with high morbidity and mortality rates. An open-pore polyurethane foam is introduced into the leakage cavity and connected to a device that applies a suction pressure to accelerate the closure of the defect. Computational analysis of this healing process can advance our understanding of the biomechanical mechanisms at play. To this aim, we use a dual-stage finite-element analysis in which (i) the structural problem addresses the cavity reduction caused by the suction and (ii) a new constitutive formulation models tissue healing via permanent deformations coupled to a stiffness increase...
February 2018: Royal Society Open Science
Sang Won Kim, Jun Nyung Lee, Hyun Tae Kim, Eun Sang Yoo
A vesicocutaneous fistula (VCF) is a tract that is formed abnormally between the bladder and the external surface of the body. VCF results in a great deal of inconvenience, discomfort, and physical disability for the affected patient. This condition can be caused by extensive trauma with pelvic bone fracture, radical pelvic surgery, irradiation of pelvic malignancies, hip arthroplasty, a large bladder calculus, and various other pathologies. The management of VCF should be approached on a case-by-case basis because of the complexity of the disease...
March 2018: Turkish Journal of Urology
M Rottoli, M P Di Simone, C Vallicelli, L Vittori, G Liguori, L Boschi, G Poggioli
BACKGROUND: Anastomotic leak after ileal pouch-anal anastomosis (IPAA) could lead to poor functional results and failure of the pouch. The aim of the present study was to analyze the outcomes of the vacuum-assisted closure therapy as the unique treatment for anastomotic leaks following IPAA without any additional surgical operations. METHODS: Consecutive patients with anastomotic leak after IPAA treated at our institution between March 2016 and March 2017 were prospectively enrolled...
March 3, 2018: Techniques in Coloproctology
Wei Yuan, Xuan Liu, Xiaoshu Zhou, Lei Pei, Yue Zhu
STUDY DESIGN: A retrospective study. OBJECTIVE: To compare the clinical outcomes of continues irrigation suction systems (CISS) or vacuum assisted closure system (VACS) in early deep wound infection (DWI) after thoracolumbar instrumentation. SUMMARY OF BACKGROUND DATA: DWI after thoracolumbar instrumentation is challenging and debridement followed by either CISS or VACS has been proven to be effective. So far which one of the system has more advantages over the other remains unclear...
February 23, 2018: Spine
Jian-Ping Wu, Zhen-Huan Jiang, Xiao-Jun Feng, Jian-Nong Jiang, Mao-Hua Cheng
BACKGROUND The aim of this study was to investigate the effects of negative pressure therapy in the regeneration of the rabbit sciatic nerve using vacuum assisted closure (VAC). MATERIAL AND METHODS Thirty male New Zealand white rabbits underwent surgical injury of the sciatic nerve, followed by negative pressure therapy using vacuum assisted closure (VAC), in three treatment groups: Group A: 0 kPa; Group B: -20 kPa; Group C: -40 kPa. At 12 weeks following surgery, the following factors were studied: motor nerve conduction velocity (MNCV); the number of myelinated nerve fibers; the wet weight of the gastrocnemius muscle...
February 19, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
T Chan, M S Bleszynski, D S Youssef, M Segedi, S Chung, C H Scudamore, A K Buczkowski
INTRODUCTION: Damage control laparotomy with vacuum assisted closure (VAC) is used for selective cases in trauma. In liver transplantation, VAC has also been applied for management of intra-operative hemorrhage. The primary objective was to evaluate peri-operative blood loss and blood product utilization in VAC compared to primary abdominal closure (PAC) at the index transplant operation. METHODS: Retrospective review of all adults undergoing deceased donor liver transplantation (2007-2011) at a single center tertiary care institution...
January 31, 2018: American Journal of Surgery
Karl Waked, Philippe Ballaux, Dominique Goossens, Koen Cathenis
The objective is to describe the 'Two Bridges Technique' (TBT), which has proven to be successful and has been the standard technique at our centre for vacuum-assisted closure (VAC) of post-sternotomy mediastinitis. An extensive literature search was performed in four databases to identify all published articles concerning VAC for post-sternotomy mediastinitis. Several VAC methods have been used; however, no article has described our specific technique. TBT consists of a two-bridges construction using two types of foam with different pore sizes, which ensures an equally divided negative pressure over the wound bed and stabilisation of the chest...
February 12, 2018: International Wound Journal
So Young Lee, Kun Woo Kim, Jae-Ik Lee, Dong-Kyun Park, Kook-Yang Park, Chul-Hyun Park, Kuk-Hui Son
Early diagnosis followed by primary repair is the best treatment for spontaneous esophageal perforation. However, the appropriate management of esophageal leakage after surgical repair is still controversial. Recently, the successful adaptation of vacuum-assisted closure therapy, which is well established for the treatment of chronic surface wounds, has been demonstrated for esophageal perforation or leakage. Conservative treatment methods require long-term fasting with total parenteral nutrition or enteral feeding through invasive procedures, such as percutaneous endoscopic gastrostomy or a feeding jejunostomy...
February 2018: Korean Journal of Thoracic and Cardiovascular Surgery
Michael Schlumberger, Raul Mayr, Christian Koidl, Martin Eichinger, Tobias Roth
INTRODUCTION: Nonunion after open fracture of the lower leg is a frequent complication with a prevalence of up to 40%. In cases with major bone defects, revision of the osteosynthesis with bone grafting is commonly performed. Until today, there is no report on treatment of a tibial nonunion with transplantation of a heterotopic ossification. PRESENTATION OF CASE: We present a case of a 27-year-old male patient, who suffered from a paragliding accident with major injuries...
February 9, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Hulya Nalcacioglu, Y Kamil Yakupoglu, Gurkan Genc, Nursen Belet, Sema Gulnar Sensoy, Asuman Birinci, Ozan Ozkaya
Renal transplant recipients are on long-term potent immunosuppressive therapy, which makes them highly vulnerable to opportunistic fungal infections. Dematiaceous, or dark-pigmented saprophytic fungi, are being increasingly seen as opportunistic pathogens of mycoses in immunosuppressed patients. One of these is Aureobasidium pullulans, which is a black yeast-like dematiaceous fungus found ubiquitously in the environment that can cause various opportunistic human infections. Most infections occur by traumatic inoculation, such as keratitis and cutaneous lesions; disseminated mycoses are very rare and occur only in severely immunocompromised patients...
February 1, 2018: Pediatric Transplantation
S R Ali, H Mohamedbhai
No abstract text is available yet for this article.
January 24, 2018: Annals of the Royal College of Surgeons of England
H F Geerdes-Fenge, P Pongratz, J Liese, E C Reisinger
A 26-year-old HIV-negative male from Ghana was treated for cervical, intrathoracic and abdominal lymph node tuberculosis (TB) and tuberculous hepatitis. Penetration of the thoracic trachea by a mediastinal lymph node had caused bronchomucosal TB. Sputum culture grew M. africanum, sensitive to all first-line antituberculous drugs. Four weeks after the beginning of directly observed treatment with isoniazid, rifampin, pyrazinamide and ethambutol, the right cervical lymph node increased in size, liquefied and caused a spontaneous fistula...
January 12, 2018: Infection
Santiago A Endara, Fernando J Terán, Armando J Serrano, Manuela J Castillo, Gabriel A Molina
Esophageal fistulas in the cervical region are usually difficult to manage and carry a high morbidity. We report a case of an esophago-colonic fistula after colonic interposition, successfully managed with vacuum-assisted closure 'V.A.C. system', (Kinetic Concepts Inc., San Antonio, TX, USA). The patient initially presented with purulent fluid from the cervical wound 13 days after surgery. Esophagogram confirmed a leak. Since the patient had a history of anastomotic leaks, a surgical intervention was not the treatment of choice...
January 2018: Journal of Surgical Case Reports
Fabio Kamamoto, Ana Lucia Munhoz Lima, Marcelo Rosa de Rezende, Rames Mattar-Junior, Marcos de Camargo Leonhardt, Kodi Edson Kojima, Carla Chineze Dos Santos
OBJECTIVES: Negative-pressure wound therapy has been widely adopted to reduce the complexity of treating a broad range of acute and chronic wounds. However, its cost is high. The objective of this study was to evaluate the following two different methods of negative-pressure wound therapy in terms of healing time: a low-cost method of negative-pressure wound therapy (a pressure stabilizer device connected to a hospital wall-vacuum system with a gauze-sealed dressing, USP) and the standard of care (vacuum-assisted closure, VAC)...
December 2017: Clinics
Harvey Chim, Yasmina Zoghbi, Ajani George Nugent, Wrood Kassira, Morad Askari, Christopher John Salgado
BACKGROUND: Free muscle flaps are a mainstay for reconstruction of distal third leg wounds and for large lower extremity wounds with exposed bone. However a major problem is the significant postoperative flap swelling, which may take months to resolve. We studied the efficacy and safety of immediate application of a vacuum assisted closure (VAC) dressing after a free muscle flap to the lower extremity. METHODS: Over a 19 months period, all consecutive free muscle flaps for lower extremity reconstruction at a Level I trauma center were evaluated prospectively for postoperative flap thickness, complications and flap survival...
January 2018: Archives of Plastic Surgery
Efstathios Drampalos, Hasan Raza Mohammad, Chris Kosmidis, Moez Balal, Jason Wong, Anand Pillai
BACKGROUND: Chronic osteomyelitis necessities appropriate infected bone and soft tissue excision. The authors describe the Silo surgical technique for the treatment of calcaneal osteomyelitis using a new antibiotic-loaded absorbable calcium sulphate/hydroxyapatite biocomposite. METHODS: The Silo method involves debridement of the dead bone and local delivery of antibiotic in drilled tunnels using the biocomposite. It is combined with multiple sampling and culture-specific systemic antibiotic treatment guided by a multidisciplinary team...
November 23, 2017: Foot
Matthew E Pontell, Noah Saad, Brian S Winters, Joseph N Daniel, Adam Saad
The reverse sural adipofascial flap (RSAF) is used to reconstruct challenging wounds of the foot and ankle. It offers several advantages over the traditional reverse sural flap, including less venous congestion. To complete the reconstruction, split-thickness skin grafting (STSG) may be done immediately or in a delayed fashion; however, both scenarios result in suboptimal take rates and prolonged healing. An acellular dermal matrix (ADM; Integra; Ethicon Inc, Somerville, New Jersey) and negative-pressure wound therapy (NPWT) combined with RSAF followed by delayed STSG may decrease wound healing time...
January 2018: Advances in Skin & Wound Care
A Tampakis, E C Tampaki, K Kontzoglou, E Patsouris, G Kouraklis, D Lardinois
OBJECTIVE: Infections with Corynebacterium tuberculostearicum are very rare as in most of the cases its isolation is associated with tissue colonization rather than infection. CASE REPORT: An 80-year old female patient was sent to the consultation hour of thoracic surgery for evaluation of a symptomatic persistent unilateral pleural effusion of her right lung. The differential diagnosis included either the presence of a chronic pleural empyema or the presence of malignancy...
November 2017: European Review for Medical and Pharmacological Sciences
Marc Bludau, Hans F Fuchs, Till Herbold, Martin K H Maus, Hakan Alakus, Felix Popp, Jessica M Leers, Christiane J Bruns, Arnulf H Hölscher, Wolfgang Schröder, Seung-Hun Chon
BACKGROUND: Esophageal perforations and postoperative leakage of esophagogastrostomies are considered to be life-threatening conditions due to the potential development of mediastinitis and consecutive sepsis. Vacuum-assisted closure (VAC) techniques, a well-established treatment method for superficial infected wounds, are based on a negative pressure applied to the wound via a vacuum-sealed sponge. Endoluminal VAC (E-VAC) therapy as a treatment for GI leakages in the rectum was introduced in 2008...
April 2018: Surgical Endoscopy
Giorgio Novelli, Francesco Daleffe, Gisella Birra, Gabriele Canzi, Fabio Mazzoleni, Pietro Boni, Clara Maino, Carlo Giussani, Davide Sozzi, Alberto Bozzetti
The care and the management of the healing of difficult wounds at the level of the skull-facial face many problems related to patient compliance and the need to perform multiple dressings, with long periods of healing and, occasionally, a very long hospitalisation period. The introduction and evolution of negative pressure wound therapy (NPWT) in the treatment of difficult wounds has resulted in better healing, with a drastic reduction in terms of time and biological costs to the patient and cost to the health care system...
February 2018: International Wound Journal
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