scholarly journals Limb salvage procedure in immunocompromised patients with therapy‐resistant leg ulcers—The value of ultra‐radical debridement and instillation negative‐pressure wound therapy

2020 ◽  
Vol 17 (5) ◽  
pp. 1496-1507
Author(s):  
Alexander Geierlehner ◽  
Raymund E. Horch ◽  
Wibke Müller‐Seubert ◽  
Andreas Arkudas ◽  
Ingo Ludolph
Keyword(s):  
Limb Salvage ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Salvage Procedure ◽  
Leg Ulcers ◽  
Immunocompromised Patients ◽  
Wound Therapy ◽  
Limb Salvage Procedure ◽  
Radical Debridement

scholarly journals Long-term follow-up of negative pressure wound therapy with instillation: a limb salvage procedure?

2014 ◽  
Vol 13 (5) ◽  
pp. 768-773 ◽  
Author(s):  
Daniele Bollero ◽  
Kiran Degano ◽  
Ezio N Gangemi ◽  
Domenico Aloj ◽  
Valeria Malvasio ◽  
...  
Keyword(s):  
Limb Salvage ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Salvage Procedure ◽  
Wound Therapy ◽  
Limb Salvage Procedure ◽  
Long Term Follow Up

scholarly journals LEA 10. Use of Home Negative Pressure Wound Therapy in Peripheral Artery Disease and Diabetic Limb Salvage

2018 ◽  
Vol 68 (5) ◽  
pp. e117
Author(s):  
Kai Lim ◽  
Qiantai Hong ◽  
Glenn Wei Leong Tan ◽  
Sadhana Chandrasekar ◽  
Zhiwen Joseph Lo
Keyword(s):  
Limb Salvage ◽  
Peripheral Artery Disease ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Peripheral Artery ◽  
Wound Therapy ◽  
Artery Disease

scholarly journals Use of home negative pressure wound therapy in peripheral artery disease and diabetic limb salvage

2020 ◽  
Vol 17 (3) ◽  
pp. 531-539
Author(s):  
Kai Lim ◽  
Xuxin Lim ◽  
Qiantai Hong ◽  
Enming Yong ◽  
Sadhana Chandrasekar ◽  
...  
Keyword(s):  
Limb Salvage ◽  
Peripheral Artery Disease ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Peripheral Artery ◽  
Wound Therapy ◽  
Artery Disease

scholarly journals A Hybrid Technique to Treat Inguinal Wound Infection after Arterial Surgery with Lateral Femoral Bypass and Intra-Incisional Negative Pressure Wound Therapy

2021 ◽  
Author(s):  
Yi-Fan Wu ◽  
Dong Zhang ◽  
Ai-Xi Yu ◽  
Baiwen Qi ◽  
Chao Jian
Keyword(s):  
Wound Infection ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Hybrid Technique ◽  
Wound Therapy ◽  
Imaging Evaluation ◽  
Clinical Challenge ◽  
Vascular Bypass ◽  
Radical Debridement ◽  
Staged Treatment

Abstract Background: Patients with the inguinal wound infection after arterial surgery remains clinical challenge. Sustaining lymphatic leakage have been shown as a common and potentially serious complication. However, it remains clinical challenge for surgery to deal with this tough problem. Methods: This study describes a hybrid technique of using radical debridement, lateral femoral bypass (LFB) and intra-incisional negative pressure wound therapy (iNPWT) for single-staged treatment of complex inguinal wound infection after arterial surgery (IWI-AS).Results: Between January 2017 and June 2021, 5 IWI-AS cases treated with this new method were identified. Of the patients, 3 were males and 2 were females. The average age was 49.4 years (range, 33 to 77 years). 4 cases suffered emergent operations due to the sudden bleedings. after vascular bypass reconstructions and an average of 2.2 (range:1-3) iNWPT, all cases achieved wound healing at an average duration of 4.6 weeks (range: 3-6weeks). Moreover, all cases showed no bacterial growth and grafts patency as indicated by doppler ultrasound or CT angiography postoperatively. One case did not receive bypass imaging evaluation at postoperative 12 months. Weakness of quadriceps femoris was observed in one case. Conclusion: single-staged therapy of LFB and iNPWT hybridization is a technically handy and effective method for treatment of inguinal wound infection after arterial surgery.

Novel home use of mechanical negative pressure wound therapy in diabetic foot ulcers

2021 ◽  
Vol 30 (12) ◽  
pp. 1006-1010
Author(s):  
Xuxin Lim ◽  
Li Zhang ◽  
Qiantai Hong ◽  
Enming Yong ◽  
Shufen Neo ◽  
...  
Keyword(s):  
Wound Healing ◽  
Limb Salvage ◽  
Negative Pressure ◽  
Diabetic Foot ◽  
Wound Closure ◽  
Negative Pressure Wound Therapy ◽  
Length Of Hospital Stay ◽  
Wound Therapy ◽  
Primary Wound Closure ◽  
Mean Cost

Objective: Mechanical negative pressure wound therapy is an ultraportable, light weight and disposable single-use device that has been shown to promote wound healing. This study evaluated home use of a mechanically powered negative pressure wound therapy (NPWT) in diabetic foot wounds. Methods: Patients underwent revascularisation and/or debridement or amputation before starting mechanical NPWT. Wound outcomes and images of the wounds were recorded at each follow-up visit by the wound nurse. Patients were followed up until wound closure or end of therapy. Results: A total of 12 patients (each with one wound) were included in the study. Of the 12 wounds, 33.3% (n=4) of wounds achieved primary wound closure while the remaining 66.6% (n=8) of wounds demonstrated a mean wound size reduction of 37.5±0.13%. Of the closed wounds, mean time to healing was 4.75±2.50 weeks. There was 100% limb salvage with no further debridement or amputations, and no 30-day unplanned readmissions. Mean length of hospital stay before starting home NPWT was 9.75±6.31 days. Mean number of NPWT changes was 8.33±2.67 sessions, while mean duration of therapy was 4.0±1.54 weeks. Mean cost of home NWPT therapy was US$1904±731 per patient. Conclusion: The home use of mechanically powered NPWT in diabetic foot wounds demonstrated excellent wound healing rates and 100% limb salvage, with no complications.

552 Limb Salvage: Amputations Prevented with Dehydrated Human Amnion/Chorion Membrane Allografts (dHACM) Used in Combination with Decellularized Human Collagen Matrix (dHCM)

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S124-S125
Author(s):  
Marc R Matthews ◽  
Emily Helmick ◽  
Christopher Mellon ◽  
Danielle Thornburg ◽  
Areta Kowal-Vern ◽  
...  
Keyword(s):  
Limb Salvage ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Surgical Flaps ◽  
Tissue Growth ◽  
Wound Therapy ◽  
Promising Alternative ◽  
Human Amnion ◽  
Limb Injuries ◽  
Human Collagen

Abstract Introduction Burn and traumatic limb injuries with exposed bone/tendon typically require surgical flaps or amputations for healing. Some burn patients are not candidates for these invasive techniques. Placental amniotic membrane has been used as a wound dressing for more than 100 years and may offer an alternative to flaps and/or amputations. Processed dehydrated human amnion/chorion membrane (dHACM), from human placental tissue, contains type 1 human collagen as well as non-viable cells and 285 identified regulatory proteins including growth factors, chemokines, cytokines, metalloproteinases, and other tissue growth and inflammatory mediators. dHACM has been successfully used as a dressing for wound ulcers, burns, donor sites, & surgical debridement. This study reports the use of dHCAM as a limb salvage tool in four patients with severe injuries. Methods This is a retrospective case series of patients suffering severe lower extremity injury with bone/tendon exposure that had applied dHACM/dHCM over or packed (depending on wound depth), then covered with 3% bismuth tribromophenate petrolatum dressing & glycerol/ hydroxyethylcellulose lubricant. Negative pressure wound therapy (NPWT) was initiated; wound re-evaluation occurred in seven days. dHACM/dHCM was reapplied if required (bone still exposed). Results There were 3 males and 1 female with three burns and one NSTI. The mean±sd (median) age was 58±23 (61) years; % total burn surface area 3±3 (2); length of hospital stay 48±30 (40) days; number of tangential excisions & debridements 6.5±1 (6.5); days from admission to product application 49±47 (34) and discharge 24±19 (19) days; negative pressure wound therapy (NPWT) 53±6 (56) days. All four patients continued treatment upon discharge with clinic visits and home NPWT. All recovered with good results and no complications. Treatment may be continued with NPWT therapy at home or in a skilled nursing facility. Patients healed after two to three dHACM/dHCM applications and did not require leg or foot amputations. Conclusions In select limb salvage cases, dHACM/HCM may be a promising alternative to extremity amputations, tissue transfer flaps or other techniques for secondary intention healing of wounds with bone/tendon exposure.

scholarly journals Management of large chronic venous leg ulcers with negative pressure wound therapy

2017 ◽  
Vol 4 (2) ◽  
pp. 17
Author(s):  
Dominik Andrzej Walczak ◽  
Michał Wojtyniak ◽  
Rajmund Jaguścik ◽  
Joanna Jadwiga Porzeżyńska ◽  
Wojciech Fałek ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Adult Population ◽  
Complete Healing ◽  
Leg Ulcers ◽  
Skin Grafts ◽  
Wound Therapy ◽  
Venous Leg Ulcers ◽  
Venous Ulcers ◽  
The Mean

Introduction: Venous leg ulcers (VLU) occur in 1\% of the adult population and are associated with chronic disability, diminished quality of life and high health-care costs. Treatment is often slow, difficult and recurrence is high because of inappropriate conditions of the wound bed. Patients and Methods: This study involves 14 patients with chronic venous ulcers larger than 100 cm\textsuperscript{2} treated with negative pressure wound therapy (NPWT). Patients underwent a radical debridement of all devitalized tissues and partial stripping of an insufficient great saphenous vein in the first operation. After adequate haemostasis, NPWT kit was applied. Once the wounds were determined to be clean and adequate granulation tissue formation was achieved, split-thickness skin grafts were applied. Dressing impregnated with neutral triglycerides and silver ions was used as a first layer and the black polyurethane NPWT foam was applied over it. The pain assessment was performed for 7 patients using 10 cm visual analog scale (VAS). Results: The mean number of NPWT dressing changes prior to grafting was 5.8. The mean number of NPWT foam changes was 2.8 after skin grafting. We accomplished complete healing of 92\% of applied skin grafts surface. One patient had recurrence of venous ulcers in the follow-up period. Moreover, one patient required regrafting. Conclusions: The application of NPWT provides quick wound-bed preparation and high graft take in venous ulcer treatment.

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