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negative pressure wound therapy,wound dressing

Elizabeth F McElroy
Negative pressure wound therapy with instillation and dwell time (NPWTi-d) is an automated system used to deliver, dwell, and remove topical solutions from the wound bed. Recently, a reticulated open cell foam dressing with through holes (ROCF-CC) was developed, which assists with wound cleansing by removing thick exudate and infectious materials. We present our experience using NPWTi-d with ROCF-CC on complex wounds when complete surgical debridement was inappropriate because of medical instability, recurrent non-viable tissue, or palliative treatment plan...
February 19, 2019: International Wound Journal
Michael P Kuncewitch, Aaron U Blackham, Clancy J Clark, Rebecca M Dodson, Gregory B Russell, Edward A Levine, Perry Shen
Surgical site infection (SSI) and incisional hernia are common complications after major pancreatectomy. We investigated the effects of negative pressure wound therapy (NPWT) on short- and long-term wound outcomes in patients undergoing pancreatectomy. A randomized controlled trial comparing the effect of NPWT with standard surgical dressing (SSD) on wounds was performed in 265 patients undergoing open gastrointestinal resections from 2012 to 2016. We performed a subset analysis of 73 patients who underwent pancreatectomy...
January 1, 2019: American Surgeon
Cody C Frear, Bronwyn Griffin, Leila Cuttle, Steven M McPhail, Roy Kimble
BACKGROUND: Although negative pressure wound therapy (NPWT) is widely used in the management of several wound types, its efficacy as a primary therapy for acute burns has not yet been adequately investigated, with research in the paediatric population particularly lacking. There is limited evidence, however, that NPWT might benefit children with burns, amongst whom scar formation, wound progression and pain continue to present major management challenges. The purpose of this trial is to determine whether NPWT in conjunction with standard therapy accelerates healing, reduces wound progression and decreases pain more effectively than standard treatment alone...
February 13, 2019: Trials
William Tettelbach, Jonathan Arnold, Alberto Aviles, Christopher Barrett, Animesh Bhatia, Michael Desvigne, Lisa J Gould, Marcus S Speyrer, Mark Suski, Colin J Traynor, Lucian Vlad
Use of ultra-portable, mechanically powered disposable negative pressure wound therapy (dNPWT) has grown as an adjunctive modality to manage wounds in outpatient care and to expedite transition of inpatients to an outpatient setting. This technology has demonstrated similar efficacy and usability for mobile outpatients when compared with electrically powered negative pressure wound therapy devices. It was designed for patients with smaller, low to moderately exudating wounds and does not require batteries or a power source...
February 2019: Wounds: a Compendium of Clinical Research and Practice
R Svensson-Björk, M Zarrouk, G Asciutto, J Hasselmann, S Acosta
BACKGROUND: Surgical-site infection (SSI) after groin incisions for arterial surgery is common and may lead to amputation or death. Incisional negative pressure wound therapy (NPWT) dressings have been suggested to reduce SSIs. The aim of this systematic review with meta-analysis was to assess the effects of incisional NPWT on the incidence of SSI in closed groin incisions after arterial surgery. METHODS: A study protocol for this systematic review of RCTs was published in Prospero (CRD42018090298) a priori, with predefined search, inclusion and exclusion criteria...
February 6, 2019: British Journal of Surgery
Ying Yuan, Yahui Niu, Weidong Xiao, Baiwen Qi, Xiang Hu, Aixi Yu
BACKGROUND: Lymphatic leakage is one of the severe complications after lymphadenectomy. However, efficient treatment it still unclear. MATERIALS AND METHODS: We employed inguinal lymphadenectomy and saphenous lymphatic vessel excision to establish a inguinal lymphatic leakage rabbit model. Rabbits with bilateral lymphatic leakage were divided in two groups, which were subject to negative pressure wound therapy (NPWT) on right sides and dressing change on left sides, respectively...
March 2019: Journal of Surgical Research
Helen Ker, Abbas Al-Murrani, Gill Rolfe, Richard Martin
BACKGROUND: Skin cancer rates in New Zealand are estimated to be the highest in the world. Split-skin grafting is a common procedure after skin cancer excision in the lower limb. We sought to evaluate the cost-effectiveness of negative pressure wound therapy (NPWT) with same-day discharge in patients undergoing split-skin grafting of the lower limb for the treatment of skin cancer. MATERIALS AND METHODS: Using effectiveness and quality of life data from a blinded, randomized single-center trial, a decision analytic model was developed from the perspective of the New Zealand hospital health-care buyer...
March 2019: Journal of Surgical Research
Isabell Renno, Anja M Boos, Raymund E Horch, Ingo Ludolph
BACKGROUND: Negative pressure wound therapy applied over closed incisions (ciNPT) has been shown to influence wound healing. Therefore, the aim of this study was to examine the short-term effects of ciNPT on skin perfusion patterns in postbariatric wounds. METHODS: 17 patients were included. Patients from the study group received a ciNPT dressing with a continuous negative pressure of - 125 mmHg for five days. Two intra- and two postoperative measurements were performed using both a combined laser Doppler spectrophotometry and an ICG angiography system to determine oxygen saturation (sO2), hemoglobin content (rHb) and perfusion patterns...
January 14, 2019: Clinical Hemorheology and Microcirculation
Daniel Schiltz, Carina Wenzel, Eva Brix, Lukas Prantl, Christian D Taeger
No abstract text is available yet for this article.
January 10, 2019: Journal of Tissue Viability
Fabian Matthias Eckstein, Valesca Pinsel, Matthias Christian Wurm, André Wilkerling, Eva-Maria Dietrich, Sebastian Kreißel, Cornelius von WIlmowsky, Tilo Schlittenbauer
INTRODUCTION: Impaired wound healing, chronic wounds and extended soft tissue defects present a crucial problem in reconstructive surgery of the head and neck region, even more after radiation therapy. In such cases the standard is a prolonged open wound treatment. The negative pressure instillation therapy might present an alternative therapy option. MATERIAL AND METHODS: In this study the effects of negative pressure instillation therapy on the healing of chronic wounds in 15 patients diagnosed with impaired wound healing were investigated...
December 19, 2018: Journal of Cranio-maxillo-facial Surgery
Fabiana Martins Paula, Edivania Anacleto Pinheiro, Vanessa Marcon de Oliveira, Cristiane Munaretto Ferreira, Maria Tereza Ferreira Duenhas Monreal, Marisa Dias Rolan, Vanessa Terezinha Gubert de Matos
RATIONALE: Necrotizing fasciitis is a destructive tissue infection with rapid progression and high mortality. Thus, it is necessary that high-performance dressings be introduced as possibilities of treatment. PATIENT CONCERNS: Female patient, 44 years of age, admitted to hospital unit complaining of lesion in the gluteal region and drainage of purulent secretion in large quantity followed by necrosis. DIAGNOSES: The diagnosis of necrotizing fasciitis was carried out with the computerized tomography examination result and its association with the patient's clinical condition...
January 2019: Medicine (Baltimore)
Sharon A Lawrence, Caitlin A McIntyre, Alessandra Pulvirenti, Kenneth Seier, Yuting Chou, Mithat Gonen, Vinod P Balachandran, T Peter Kingham, Michael I D'Angelica, Jeffrey A Drebin, William R Jarnagin, Peter J Allen
INTRODUCTION: Pancreaticoduodenectomy is historically associated with incisional surgical site infection (iSSI) rates between 15-20%. Prospective studies have been mixed with respect to the benefit of individual interventions directed at decreasing iSSI. We hypothesized that the application of a perioperative bundle during pancreaticoduodenectomy would significantly decrease the rate of iSSI. METHODS: An initial cohort of 150 consecutive post-pancreaticoduodenectomy patients were assessed within 2-4 weeks of operation to determine baseline iSSI rates...
January 7, 2019: Journal of the American College of Surgeons
Divya R L Pawar, Sujee Jeyapalina, Kelli Hafer, Kent N Bachus
Negative Pressure Wound Therapy (NPWT) has been shown to limit downgrowth around percutaneous devices in a guinea pig model. However, the influence of NPWT on peri-prosthetic tissue characteristics leading to limited downgrowth is still unclear. In order to investigate this, 12 CD hairless rats were assigned into two groups, NPWT and Untreated (n = 6/group). Each animal was implanted with a porous coated titanium percutaneous device and was dressed with a gauze and semi-occlusive base dressing. Post-surgery, animals in the NPWT Group received a regimen of NPWT treatment (-70 to -90 mmHg)...
January 10, 2019: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
Kersten Reider, Elizabeth McElroy, Stormy Lemay
The human body is a complex, multisystem organism that can manifest disease processes in a multitude of ways. Over the decades, technological advancements have allowed us to make precise diagnoses so that clinicians can thoroughly treat the underlying cause. Frequently these disease processes require surgical intervention to eliminate the progression and provide the patient with positive outcomes. When surgical intervention is required, the patient is often left with large complex wounds. Just like medical advancements, wound care modalities have made vast technological improvements...
October 29, 2018: Curēus
Elizabeth McElroy, Stormy Lemay, Kersten Reider, Amir B Behnam
Chronic venous insufficiency (CVI) and venous leg ulcers (VLUs) have major financial implications for patients and healthcare professionals. VLUs, in particular, require significant care, can be slow to heal, and have a high rate of recurrence. These factors combine to make VLUs a major burden on the healthcare system. Recent estimates show that the cost of treatment of VLUs per patient in the United States is $10,000 to $12,000 per year, with the average lifetime cost of care greater than $40,000. Infected VLUs often require surgical debridement for the removal of bacterial burden and biofilm...
October 27, 2018: Curēus
Stormy Lemay, Elizabeth McElroy, Kersten Reider
Necrotizing soft tissue infection is a rapidly spreading bacterial infection that can quickly destroy a person's muscles, skin, and underlying tissue. In this retrospect chart review, we will look at how the utilization of negative pressure wound therapy with instillation and dwell (NPWTi-d) and novel reticulated open cell foam (ROCF-CC) assisted with the healing of a patient's wound along with decreasing the time spent in the operating room. NPWTi-d provided the benefits of wound healing such as solubilizing the infectious material and removing the devitalized tissue...
October 26, 2018: Curēus
John P Livingstone, Ian G Hasegawa, Patrick Murray
Necrotizing fasciitis is a rapidly spreading infection of the soft tissue, which carries significant morbidity and mortality. This condition is treated with broad-spectrum antibiotics, irrigation and surgical debridement of the affected area, and hemodynamic support. Negative pressure wound therapy (NPWT) has been utilized after surgical debridement to promote wound healing, especially when significant debridement has occurred. Newer forms of NPWT such as negative pressure wound therapy with instillation and dwell time (NPWTi-d) have shown even greater promise by reducing the time to clear infections and promoting greater debridement with fewer procedures...
October 23, 2018: Curēus
James A Keeney, James L Cook, Stacee W Clawson, Ajay Aggarwal, James P Stannard
BACKGROUND: The potential value of incisional negative pressure wound therapy (iNPWT) on lower extremity total joint arthroplasty (TJA) wound healing has been supported in a few retrospective studies. We performed this prospective, randomized, controlled trial to assess the impact of iNPWT on wound appearance, early complications, and late infection rates following hip and knee TJA compared with a standard surgical dressing. METHODS: Three-hundred ninety-eight patients undergoing primary or revision lower extremity TJA were randomized into iNPWT or conventional wound dressing groups...
December 15, 2018: Journal of Arthroplasty
Mitchell A Webb, Michael S Bleszynski, Leo Chen, Jack Chiu, Adam Meneghetti, Ormond N Panton
BACKGROUND: In colorectal surgery, indications for incisional negative pressure wound therapy (iVAC) remain unclear. We sought to compare rates of surgical site infection (SSI) in patients who received iVAC or standard sterile dressing (SSD). METHODS: Institutional colorectal NSQIP data between 2014 and 2018 was reviewed. SSI rates were compared between iVAC and SSD cohorts using the NSQIP surgical risk calculator (NSQIP SRC) for risk-adjusted analysis. Secondary outcomes included other wound complications, morbidity, mortality, disposition destination and overall length of stay...
December 15, 2018: American Journal of Surgery
Robin T Wu, Brandon J Sumpio, Samuel Miller, Bauer E Sumpio
Vascular groin wound and median sternotomy infections are challenging complications that may lead to serious sequela. Traditional gauze dressings have poor bacteria barrier properties, and so there has been a recent enthusiasm for the use of closed-incision negative-pressure therapy as an effective closed environment, which controls exudate and helps hold the incision edges together. Studies suggest that it may reduce surgical site infection in cardiothoracic and vascular surgery.
January 2019: Plastic and Reconstructive Surgery
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