Uses of Negative Pressure Wound Therapy in Orthopedic Trauma

Gage, Mark J.; Yoon, Richard S.; Egol, Kenneth A.; Liporace, Frank A.

doi:10.1016/j.ocl.2014.11.002

Cited by 22 publications

(17 citation statements)

References 23 publications

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“…Our review found a number of case studies, case series and non‐randomised controlled trials that described ciNPT use. These studies included high‐risk patients with one or more comorbidities who underwent various surgical procedures, including vascular bypass, sternotomy and caesarean section . In 2013, Condé‐Green et al reported that patients undergoing abdominal hernia repairs treated with ciNPT had a lower surgical site occurrence (SSO) rates (22% versus 63%, P = 0·02) and dehiscence (9% versus 38%, P = 0·014) compared with patients treated with wound dressings .…”

Section: Resultsmentioning

confidence: 99%

“…Despite the small number of ciNPT studies, in comparison to the large number on NPWT, current literature supports its benefit in high‐risk patients and incisions. A majority of the 100 publications reported decreased rates of SSIs, dehiscence and haematoma/seroma formation . A recent meta‐analysis reported a 50% reduction in the rate of SSIs in the ciNPT group compared with the control group (OR 0·564; P < 0·00001) .…”

Section: Discussionmentioning

confidence: 99%

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Closed incision negative pressure therapy: international multidisciplinary consensus recommendations

Willy

Agarwal

Andersen

et al. 2016

International Wound Journal

167

148

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Surgical site occurrences (SSOs) affect up to or over 25% of patients undergoing operative procedures, with the subset of surgical site infections (SSIs) being the most common. Commercially available closed incision negative pressure therapy (ciNPT) may offer surgeons an additional option to manage clean, closed surgical incisions. We conducted an extensive literature search for studies describing ciNPT use and assembled a diverse panel of experts to create consensus recommendations for when using ciNPT may be appropriate. A literature search of MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials using key words 'prevention', 'negative pressure wound therapy (NPWT)', 'active incisional management', 'incisional vacuum therapy', 'incisional NPWT', 'incisional wound VAC', 'closed incisional NPWT', 'wound infection', and 'SSIs' identified peer-reviewed studies published from 2000 to 2015. During a multidisciplinary consensus meeting, the 12 experts reviewed the literature, presented their own ciNPT experiences, identified risk factors for SSOs and developed comprehensive consensus recommendations. A total of 100 publications satisfied the search requirements for ciNPT use. A majority presented data supporting ciNPT use. Numerous publications reported SSI risk factors, with the most common including obesity (body mass index ≥30 kg/m 2 ); diabetes mellitus; tobacco use; or prolonged surgical time. We recommend that the surgeon assess the individual patient's risk factors and surgical risks. Surgeons should consider using ciNPT for patients at high risk for developing SSOs or who are undergoing a high-risk procedure or a procedure that would have highly morbid consequences if an SSI occurred.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Closed incision negative pressure therapy: international multidisciplinary consensus recommendations

Willy

Agarwal

Andersen

et al. 2016

International Wound Journal

167

148

View full text Add to dashboard Cite

show abstract

“…In addition, this negative pressure reduces the bacterial load and wound oedema and facilitates growth of granulation tissue while maintaining a relatively clean and isolated system . Since then, the NPWT system has been used in not only plastic surgery but also trauma surgery, orthopaedic surgery, and even obstetrics . NPWT treatment has been shown to result in shorter healing times for wounds with fewer dressing changes, improved outcomes, and reduced hospital costs .…”

Section: Introductionmentioning

confidence: 99%

“…8,9 Since then, the NPWT system has been used in not only plastic surgery but also trauma surgery, orthopaedic surgery, and even obstetrics. [10][11][12][13] NPWT treatment has been shown to result in shorter healing times for wounds with fewer dressing changes, improved outcomes, and reduced hospital costs. 14 However, despite the benefits of NPWT, its role in treating head and neck wounds with fistulas has not been studied extensively.…”

Section: Introductionmentioning

confidence: 99%

Systematic review of negative pressure wound therapy for head and neck wounds with fistulas: Outcomes and complications

Lin

Huang

Cheng

2019

International Wound Journal

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Fistula formation in head and neck wounds is considered one of the most challenging complications that a head and neck reconstructive surgeon may encounter. The current mainstay of treatment is aggressive surgical debridement followed by vascularised soft tissue coverage. Negative pressure wound therapy (NPWT) has been successfully used for the closure of complicated wounds for decades. This study analysed the outcomes and complications of NPWT in the management of head and neck wounds with fistulas. A systematic search of studies published between January 1966 and September 2019 was conducted using the PubMed, MEDLINE, EMBASE, and SCOPUS databases and using the following key words: “negative pressure wound therapy,” “head and neck,” and “fistula.” We included human studies with abstract and full text available. Analysed endpoints were rate of fistula closure, follow‐up duration, and complications if present. Nine retrospective case series (Level IV evidence) that collectively included 122 head and neck wounds with orocutaneous fistulas, pharyngocutaneous fistulas, and salivary contamination were examined. The number of patients included in each study ranged from 5 to 64. The mode of NPWT varied among the included studies, with most adopting a continuous pressure of −125 mm Hg. Mean durations of NPWT ranged from 3.7 to 23 days, and the reported fistula closure rate ranged from 78% to 100%. To achieve complete wound healing, six studies used additional procedures after stopping NPWT, including conventional wound dressings and vascularised tissue transfer. Information regarding follow up was provided in only three of the nine studies, where patients were followed for 5, 10, and 18 months. No serious adverse events were reported. NPWT for head and neck wounds with fistulas may be considered a safe treatment method that yields beneficial outcomes with a low risk of complications. The current data originated mainly from studies with low levels of evidence characterised by heterogeneity. Therefore, definitive recommendations based on these data cannot be offered. Additional high‐quality trials are warranted to corroborate the findings of this systematic review.

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“…Tagen, abhängig vom individuellen Zustand des Patienten und den lokalen Wundbedingungen, gewechselt[16]. Eröffnung der Muskellogen am lateralen und medialen Unterschenkelepifaszial rahmiger Eiter.Die antibiotische Therapie wird unterteilt in ein empirisches und ein erregerspezifisches Regime.…”

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Aktuelle Konzepte zur Behandlung von Haut- und Weichteilinfektionen in Orthopädie und Unfallchirurgie

Rüden¹,

Kühl²,

Erichsen³

et al. 2018

Z Orthop Unfall

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Skin and soft tissue infections include the skin as well as fascia, muscles, ligaments, tendons, synovial membranes, fat, blood vessels, nerves, and fibrous tissues. They range from superficial infections to deep infections with a necrotizing clinical course. These infections can promptly progress with severe systemic complications, requiring rapid management, and proper surgical and medical treatment. This manuscript provides recommendations based on current practice guidelines for diagnosis and treatment of surgically relevant skin and soft tissue infections in adults. Furthermore, it deals with a clinical guide of immediate identification of life threatening necrotizing clinical courses, detection of pathogens and the use of appropriate surgical, antimicrobial, and adjuvant treatment options.

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Uses of Negative Pressure Wound Therapy in Orthopedic Trauma

Cited by 22 publications

References 23 publications

Closed incision negative pressure therapy: international multidisciplinary consensus recommendations

Closed incision negative pressure therapy: international multidisciplinary consensus recommendations

Systematic review of negative pressure wound therapy for head and neck wounds with fistulas: Outcomes and complications

Aktuelle Konzepte zur Behandlung von Haut- und Weichteilinfektionen in Orthopädie und Unfallchirurgie

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