Use of negative pressure therapy in the management of complex wounds initial experience of 4 years
Keywords:Negative pressure therapy, Complex wounds, Surgical wound infection, VAC®
Background: Wound management with negative pressure therapy has been used in the treatment of complex wounds in both inpatient and outpatient settings, and is increasingly used in primary care and outpatient management, as it helps to reduce patient days of hospital stay. We describe the initial 4-year experience in the use of negative pressure therapy in the management of complex wounds.
Methods: A retrospective, cross-sectional and descriptive study of our experience of the use of negative pressure therapy for the management of complex wounds in 5 years.
Results: A total of 89 patients with complex wounds managed with TPN were analysed, of which 53 were men (62.9%) and 33 were women (37.1%). Suprafacial therapy was used in 64 cases (73%). The ABTHERA® system was used in 25 cases (27%). Among the etiology of complex wounds, vulvar abscess was recorded in 1 case (1.1%), firearm wound in 1 case (1.1%), Fournier's gangrene in 1 case (1.1%), septic arthritis in 1 case (1.1%), burn wounds in 1 case (1.1%), septic arthritis in 1 case (1.1%), and burn wounds in 1 case (1.1%). 1%), burn wounds in 5 cases (5.6%), pressure ulcer wound in 6 cases (6.7%), necrotizing fasciitis in 19 cases (21.3%), abdominal sepsis in 26 cases (29.2%), surgical wound infection in 29 cases (32.5%).
Conclusions: The use of negative pressure therapy and protocolized management has provided patients in our institution with a viable therapeutic option.
Capobianco CM, Zgonis T. An overview of negative pressure wound therapy for the lower extremity. Clin Podiatr Med Surg. 2009;26:619.
Whitworth I. History and development of negative pressure therapy. In: Banwell PE, Teot L, editors. 1st International Topical Negative Pressure Focus Group Meeting. Faringdon, UK: TPX Communications. 2004;22-6.
Argenta LC, Morykwas MJ. Vacuum-assisted closure: a new method for wound control and treatment: clinical experience. Ann Plast Surg. 1997;38(6):563-77.
Venturi ML, Attinger CE, Mesbahi AN, et al. Mechanisms and clinical applications of the vacuum-assisted closure (VAC) Device: a review. Am J Clin Dermatol. 2005;6:185.
Bucalo B, Eaglstein WH, Falanga V. Inhibition of cell proliferation by chronic wound fluid. Wound Repair Regen. 1993; 1:181.
Banwell PE. Topical negative pressure therapy in wound care. J Wound Care. 1999;8:79.
Wysocki AB, Staiano-Coico L, Grinnell F. Wound fluid from chronic leg ulcers contains elevated levels of metalloproteinases MMP-2 and MMP-9. J Invest Dermatol. 1993;101:64.
Sapico FL, Ginunas VJ, Thornhill-Joynes M. Quantitative microbiology of pressure sores in different stages of healing. Diagn Microbiol Infect Dis. 1986;5:31.
Hunt TK. The physiology of wound healing. Ann Emerg Med. 1988;17:1265.
Falanga V. Growth factors and chronic wounds: the need to understand the microenvironment. J Dermatol. 1992;19:667.
Genecov DG, Schneider AM, Morykwas MJ. A controlled subatmospheric pressure dressing increases the rate of skin graft donor site reepithelialization. Ann Plast Surg. 1998;40:219.
Bovill E, Banwell PE, Teot L. Topical negative pressure wound therapy: a review of its role and guidelines for its use in the management of acute wounds. Int Wound J. 2008;5:511.
Maitret-Velázquez RM y cols. Terapia de presión negativa. Rev Mex Angiol. 2018;46(1):9-18.
Zannis J. Comparison of Fasciotomy Wound Closures Using Traditional Dressing Changes and the Vacuum-Assisted Closure Device. Ann Plast Surg. 2009;62:407.
Morykwas MJ, Argenta LC, Shelton-Brown EI. Vacuum-assisted closure: A new method for wound control and treatment. Animal studies and basic foundation. Ann Plast Surg. 1997;38:553.
Buendía Pérez J, Vila Sobral A, Ruiz G. Tratamiento de heridas complejas con terapia de presión negativa. Experiencia en los últimos 6 años en la Clínica Universitaria de Navarra, Pamplona (España). Cir plást iberolatinoam. 2011;37:65-71.
Llanos S, Danilla S, Barraza C. Effectiveness of negative pressure closure in the integration of split thickness skin grafts. Ann Surg. 2006;244:700.
Robledo-Ogazón F, Díaz JMY, Sánchez-Fernández P. Uso del sistema de cierre asistido al vacío VAC® en el tratamiento de las heridas quirúrgicas infectadas. Experiencia clínica. Cir Ciruj. 2006;74:107-13.
Smith LA, Barker DE, Chase CW, Somberg LB, Brock WB, Burns RP. Vacuum pack technique of temporary abdominal closure: a fouryear experience. Am Surg. 1997;63(12):1102-07.
Barker DE, Kaufman HJ, Smith LA, Ciraulo DL, Richart CL, Burns RP. Vacuum pack technique of temporary abdominal closure: a 7- year experience with 112 patients. J Trauma Injury Infect Crit Care. 2000;48(2):201-6.
Brox-Jimenez A, Dıaz-Gomez D, Parra-Membrives P. Sistema de cierre asistido por vacío en heridas complejas. Estudio retrospectivo. Cir Esp. 2010;87(5):312-7.
Olejnik J, Sedlak I, Brychta I, Tibensky I. Vacuum supported laparostomy-an effective treatment of intraabdominal infec-tion. Bratisl Lek Listy. 2007;108:320-3.
Boele van Hensbroek P, Wind J, Dijkgraaf M, Busch O, Goslings J. Temporary closure of the open abdomen: a systematic review on delayed primary fascial closure in patients with an open abdomen. World J Surg. 2009;33:199-207.
Alan de Costa A. Making a virtue of necessity: managing the open abdomen. ANZ J Surg. 2006;76:356-63.
Arigon JP, Chapuis O, Sarrazin E, Pons F, Bouix A, Jancovici R. Managing the open abdomen with vacuum-assisted closure therapy: retrospective evaluation of 22 patients. J Chir (Paris). 2008;145:252-61.