Negative-Pressure Wound Therapy for a Replanted Finger with Complicated Wound

Abstract

Negative-pressure wound therapy (NPWT) is widely used for open wounds in various anatomical sites. Extensive research has been carried out on the application of NPWT; exposed blood vessels in the periwound area are a known contraindication to NPWT. In this study, we report a case where a replanted finger with not only exposed vessels but also uncontrolled infection was treated with NPWT. A 60-year-old man visited our emergency department with incomplete amputation of his left index and middle fingers. After replantation of his two fingers, necrosis of the middle finger with severe methicillin-resistant <i>Staphylococcus aureus</i> infection complicated managing the wound. After 3 weeks of maintaining conventional wound dressings, we performed NPWT for successful granulation tissue formation and infection control. After the treatment, the wound was completely covered by a split-thickness skin graft. We thus suggest that NPWT can be an effective reconstructive method, including for intractable wounds with exposed pedicle and severe infection after replantation.

Negative Pressure Wound Therapy for Gas Gangrene of the Fingertip with Prolonged Infection

“… 11 Reportedly, when used in cases of severe infection, it can play a role in relieving the infection and saving the affected limb. 12 Furthermore, satisfactory progress was achieved by using a new device that can perform NPWT while repeatedly cleansing the infected wound. 13 In our case, an infection that affected the patient’s general condition developed, and prolonged wound healing and increased exudate were confirmed; however, NPWT use resulted in conservative wound healing.…”