A solution for complex wounds: the evidence for negative pressure wound therapy with instillation

Anghel, Ersilia; Kim, Paul J.; Attinger, Christopher E.

doi:10.1111/iwj.12664

Cited by 31 publications

(21 citation statements)

References 23 publications

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“…For this purpose a dedicated intra-abdominal dressing connected to an irrigation-suction system (VAC VERAFLO Therapy, KCl, San Antonio, TX) was employed and programmed with the following parameters: 200 cc of 0.9% sodium chloride solution used as instilled fluid, instillation time of 60 seconds, solution dwell time of 10 minutes, and vacuum aspiration time of 120 minutes at 125 mm Hg. 20,22-24 All the patients were in spontaneous breathing during the open abdomen phase.…”

Section: Methodsmentioning

confidence: 99%

Advantages of Damage Control Strategy With Abdominal Negative Pressure and Instillation in Patients With Diffuse Peritonitis From Perforated Diverticular Disease

Brillantino¹,

Andreano²,

Lanza³

et al. 2019

Surg Innov

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Purpose. To evaluate the results of Damage Control Strategy (DCS) in the treatment of generalized peritonitis from perforated diverticular disease in patients with preoperative severe systemic diseases. Methods. All the patients with diffuse peritonitis (Hinchey 3 and 4) and the American Society of Anesthesiologists (ASA) score ≥3 were included and underwent DCS consisting of a 2-step procedure. The first was peritoneal lavage, perforated colon-stapled resection, and temporary abdominal closure with negative pressure wound therapy combined with instillation. The second step, 48 hours later, included the possibility of restoring intestinal continuity basing on local and general patients’ conditions. Results. Thirty patients (18 [60%] women and 12 [40%] men, median age 68.5 [range = 35-84] years) were included (18 [60%] ASA III, 11 [36.7%] ASA IV, and 1 [0.03%] ASA V). Seven patients (23.3%) showed sepsis and 1 (3.33%) septic shock. At second surgery, 24 patients (80%) received a colorectal anastomosis and 6 patients (20%) underwent a Hartmann’s procedure. Median hospital stay was 18 days (range = 12-62). Postoperative morbidity rate was 23.3% (7/30) and included 1 anastomotic leak treated with Hartmann’s procedure. Consequently, at discharge from hospital, 23 patients (76.6%) were free of stoma. Primary fascial closure was possible in all patients. Conclusions. DCS with temporary abdominal closure by negative pressure wound therapy combined with instillation in patients with diffuse peritonitis from complicated diverticulitis could represent a feasible surgical option both in hemodynamically stable and no stable patients, showing encouraging results including a low stoma rate and an acceptable morbidity rate.

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Section: Methodsmentioning

confidence: 99%

Advantages of Damage Control Strategy With Abdominal Negative Pressure and Instillation in Patients With Diffuse Peritonitis From Perforated Diverticular Disease

Brillantino¹,

Andreano²,

Lanza³

et al. 2019

Surg Innov

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“…The system is composed of a Barovac wound drainage system and saline infusion set. agement of complex wounds with infection, NPWT with instillation and dwell time (NPWTi-d) can be used as adjuvant therapy along with appropriate debridement and antibiotic therapy [3]. This therapy can control the range of fluid instillation and irrigation and has been reported to overcome some limitations of standard NPWT [4] by delivering topical wound solutions directly to the wound, according to conditions set by the physicians.…”

Section: Discussionmentioning

confidence: 99%

Closed Irrigation System for Wound Management of Complicated Ischial Pressure Ulcers

Sung

Lee

2021

J Wound Manag Res

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In patients with complicated ischial pressure ulcers, surgical repair is often delayed until the general condition of the patient improves, and in extremely ill patients, surgery might never be performed. Since deep ischial ulcers are usually associated with a profuse discharge, large sinus cavity, and are adjacent to the anus, maintaining effective dressing is challenging for surgeons. In order to manage such ischial ulcers, we devised a closed irrigation system using the Barovac (50–90 mmHg) wound drainage device and a saline infusion set. The system was applied to a 50-year-old paraplegic man who was diagnosed with impending sepsis due to a longstanding ischial ulcer with secondary infection. Using the saline infusion set, we infused 200 mL of saline into the ischial cavity every 6 hours in the ward. After a 10-minute dwell time, the fluid in the cavity, including the exudate and wound debris, was drained continuously through the wound drainage device. This system was very helpful in keeping the patient’s ischial wound clean until his general condition improved and surgical repair could be undertaken. We therefore believe that our closed irrigation system provides an effective, convenient, and inexpensive dressing method for patients with complicated ischial wounds.

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“…11,15 Para tanto, observou-se que os profissionais de enfermagem estão dentre os membros da equipe multidisciplinar mais requisitado para realizar a assistência as pessoas com feridas. Quanto aos protocolos institucionais, observou-se sua importância para a equipe, pois além do auxílio aos integrantes da comissão de pele/feridas, estes podem dar segurança aos demais profissionais que atendem o cliente, orientando as pessoas com lesões quanto à importância da continuidade do tratamento.…”

Section: Discussionunclassified

Perspectiva do enfermeiro frente à assistência no tratamento de feridas em ambiente hospitalar.

Machado

Costa

Pissaia

et al. 2017

Rev Epidemiol Control Infect

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Exceto onde especificado diferentemente, a matéria publicada neste periódico é licenciada sob forma de uma licença Creative Commons -Atribuição 4. //dx.doi.org/10.17058/reci.v7i3.8920 Páginas 01 de 06 não para fins de citação Background and Objectives: considering the importance of the nursing professional in nursing care, this study aimed to understand the perspective of nurses during nursing care in the treatment of wounds in hospital settings. Methods: this is a descriptive cross-sectional study with a qualitative approach, carried out with ten nurses who are members of the Wound Commission in a medium-sized hospital in Vale do Taquari -RS. Results: there is a consensus on the importance of the nursing staff's work, mainly when the professional is a member of a multidisciplinary team for effective treatment of wounds, being a crucial element in the process of lesion prevention or treatment, as well as in the creation of scientific protocols and training, in assistance qualification, without forgetting the importance of records, as an important communication tool. Conclusion: it is concluded that continuing education programs are required, focusing on case discussion and evaluation, as well as the importance of this committee in the treatment of patients, due to its multidisciplinary structure. Nursing, Team. Wounds and Injuries. Education, Nursing. Integrality in Health. Health Education. RESUMO ABSTRACT Justificativa e Objetivos: diante da importância do profissional enfermeiro sobre os cuidados de enfermagem, este estudo teve como objetivo compreender a perspectiva do enfermeiro frente aos cuidados de enfermagem no tratamento de feridas em ambiente hospitalar. Keywords:Métodos: trata-se de um estudo descritivo, do tipo transversal, com abordagem qualitativa, realizado com dez enfermeiros integrantes da Comissão de Feridas de um hospital de médio porte no Vale do Taquari -RS. Resultados: existe um consenso sobre a importância do trabalho do enfermeiro, principalmente inserido em equipe multidisciplinar para efetividade no tratamento das feridas, sendo este, figura chave no processo de prevenção ou tratamento de lesões, bem como na construção de protocolos científicos e treinamentos, para qualificação da assistência, sem esquecer a importância dos registros, como importante ferramenta de comunicação. Conclusão:conclui-se que há necessidade de programas de educação continuada que enfoque a discussão e avaliação de caso, bem como se observa a importância dessa comissão no tratamento dos pacientes, devido a sua estruturação multidisciplinar. Descritores INTRODUÇÃONo atual momento, a área da saúde vivencia inúmeras mudanças nos seus processos de trabalho compactuados pela constante experimentação do saber científico e abandono de práticas fragmentadas e especialização disciplinar, direcionando a assistência a práticas lineares e de cunho multidisciplinar focada no ser humano.1 Neste sentido, os novos modelos de atuação profissionais são facilitados por protocolos assistenciais multidisciplinares, que guia...

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A solution for complex wounds: the evidence for negative pressure wound therapy with instillation

Cited by 31 publications

References 23 publications

Advantages of Damage Control Strategy With Abdominal Negative Pressure and Instillation in Patients With Diffuse Peritonitis From Perforated Diverticular Disease

Advantages of Damage Control Strategy With Abdominal Negative Pressure and Instillation in Patients With Diffuse Peritonitis From Perforated Diverticular Disease

Closed Irrigation System for Wound Management of Complicated Ischial Pressure Ulcers

Perspectiva do enfermeiro frente à assistência no tratamento de feridas em ambiente hospitalar.

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