New Continuous Negative-Pressure and Irrigation Treatment for Infected Wounds and Intractable Ulcers

Abstract

The two treatments of continuous irrigation and negative pressure were observed to have an additive and synergistic effect for earlier wound healing. Furthermore, the present method can dramatically reduce the number of dressing changes required, patient pain, psychological stress, and treatment cost.

A Team Approach to the Management of Intractable Leg Ulcers

“…However, even in NPWT, control is more difficult for severer infection, and wound healing is delayed. 3) IW-COPIT, in which continuous irrigation is simultaneously performed to control infection, was first reported by Kiyokawa, et al 3) Subsequently, this method has been improved by Kiyokawa, Takahashi, and Morinaga, et al, 12,13) and is used in many institutions at present. In this study, skin ulcers were also treated by IW-CONPIT combined with artificial dermis application in our institution, and good wound bed preparation and wound closure were achieved even in patients with exposed bone or tendon.…”

“…8) In our institution, results almost comparable to theirs were obtained. Even in patients without circulatory improvement, activation of the wound surface and infection control became possible using NPWT 4,5) and IW-CONPIT, 3) and the healing rate in the non-revascularization group was 59%. As shown in Table 2, healing was also observed in 6 (55%) of the 11 limbs showing an SPP <45 mmHg.…”

“…Therefore, conventionally, stump plasty or coverage with a skin flap was indispensable. However, due to the advent of intra-wound continuous negative pressure therapy (IW-CONPIT) 3) and negative pressure wound therapy (NPWT), 4,5) the induction of granulation in such tissue with poor blood flow from the surround area became possible. Therefore, as plastic surgery in the Non-PAD group, active debridement of necrotic tissue was performed, and when neither bone nor tendon was exposed, conservative treatment for secondary healing or skin grafting was performed for wound closure.…”

The Combination Application of Space Filling and Closed Irrigation Suction in Reconstruction of Sacral Decubitus Ulcer

“…In addition, the method is different from irrigation suction reported by Kiyokawa. 13 We applied the siphon principle through placing the irrigation bag about 1.5 m above the bed surface, without application of negative pressure suction simultaneously. This ensured the irrigation fluid containing antibiotics could remain in the wound for a certain time and could not be quickly washed away.…”

Treatment of pelvic defect and infection with endoprosthesis exposure by topical negative pressure and irrigation with myocutaneous flap

“…Combined treatment comprising TNP and irrigation has been reported, producing a synergistic effect that results in faster wound healing. 7 We report a case of infection after hemipelvectomy that resulted in exposure of the endoprosthesis and bone cement. To manage the infection associated with endoprosthesis exposure, traditional treatment strategies involve removal of the exposed endoprosthesis with skin grafting after eradication of the infection.…”