Vakuumtherapie mit PHMB Gaze zur Behandlung postoperativer subkutaner Bauchdeckeninfektionen

Marquardt, Christoph; Koppes, P.; Krohs, U.; Mares, A.; Paglinawan, Rey; Höfer, Dirk; Schiedeck, Thomas

doi:10.1007/s00053-014-0478-1

Cited by 3 publications

(5 citation statements)

References 5 publications

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“…The individualized goal was determined during a baseline visit and after informed consent for study participation was obtained. Possible outcomes were (1) decrease in wound volume, (2) decrease in size of the tunneling area, (3) decrease in size of the undermining, (4) decrease in amount of slough, (5) increase in granulation tissue formation, (6) decrease in periwound swelling, and (7) wound bed progression enabling transition to another treatment modality such as topical therapy, surgical closure, or a flap or skin graft. We also evaluated the ease of device use perceived by providers caring for study participants and participant satisfaction with the device.…”

Section: Study Outcomesmentioning

confidence: 99%

“…For example, traditional NPWT devices are challenging when delivered in outpatients or home care settings, with a complex administrative burden to ensure that billing accurately reflects usage on each individual patient 4. These devices can also be relatively expensive, with scheduled collection and returning of each device costing an average of $60 per home visit 6,7. In addition, devices must be cleaned between patients' reducing availability 4.…”

Section: Introductionmentioning

confidence: 99%

“…4 These devices can also be relatively expensive, with scheduled collection and returning of each device costing an average of $60 per home visit. 6,7 In addition, devices must be cleaned between patients' reducing availability. 4 From the patient's perspective, larger devices can be cumbersome and may impair mobility.…”

Section: Introductionmentioning

confidence: 99%

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Single-Use Negative Pressure Wound Therapy Applied on Various Wound Types

Amin

Homsombath

Rumbaugh

et al. 2023

Journal of Wound, Ostomy &Amp; Continence Nursing

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PURPOSE:The purpose of this study was to determine whether a single-use negative pressure wound therapy (NPWT) system achieves individualized goals of therapy when used to treat patients with a variety of wound types. DESIGN: Multiple case series. SUBJECTS AND SETTING:The same comprised 25 participants; their mean age was 51.2 years (SD: 18.2; range: 19-79 years); 14 were male (56%) and 11 were female (44%). Seven study participants withdrew from study participation. Wound etiologies vary; 4 had diabetic foot ulcers; 1 had a full-thickness pressure injury; 7 were treated for management of an abscess or cyst; 4 had necrotizing fasciitis, 5 had nonhealing postsurgical wounds, and 4 had wounds of other etiologies. Data were collected at 2 ambulatory wound care clinics located in the Southeastern United States (Augusta and Austell, Georgia). METHODS: A single-outcome measure was selected for each participant by his or her attending physician at a baseline visit.Selected end points were (1) decrease in wound volume, (2) decrease in size of the tunneling area, (3) decrease in size of the undermining, (4) decrease in the amount of slough, (5) increase in granulation tissue formation, (6) decrease in periwound swelling, and (7) wound bed progression toward transition to another treatment modality (such as standard dressing, surgical closure, flap, or graft). Progress toward the individualized goal was monitored until the goal was achieved (study end point) or a maximum of 4 weeks following initiation of treatment. RESULTS:The most common primary treatment goal was to achieve a decrease in wound volume (22 of 25 study participants), and the goal to increase granulation tissue was chosen for the remaining 3 study participants. A majority of participants (18 of 23, 78.3%) reached their individualized treatment outcome. The remaining 5 participants (21.7%) were withdrawn during the study (for reasons not related to the therapy). The median (interquartile range [IQR]) duration of NPWT therapy was 19 days (IQR: 14-21 days). Between baseline and the final assessment, median reductions in wound area and volume were 42.7% (IQR: 25.7-71.5) and 87.5% (IQR: 30.7-94.6). CONCLUSIONS:The single-use NPWT system achieved multiple individualized treatment objectives in a variety of wound types. Individually selected goals of therapy were met by all study participants who completed the study.

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Section: Study Outcomesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Single-Use Negative Pressure Wound Therapy Applied on Various Wound Types

Amin

Homsombath

Rumbaugh

et al. 2023

Journal of Wound, Ostomy &Amp; Continence Nursing

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“…82 Furthermore, PHMB effectively controlled the polymicrobial bioburden of delayed closure surgical wounds. 73,93 Most studies have been done on infected chronic wounds of varying aetiologies. In the consensus guideline on wound antisepsis, seven trials are listed, of which three are RCTs.…”

Section: Risks: Mutagenicity Teratogenicity and Carcinogenicitymentioning

confidence: 99%

“…99 Clinical results underline results in porcine models. 84,93,[100][101][102][103][104][105] The superiority of NPWTi versus NPWT in a retrospective, historical, cohort, controlled study 106 were not be confirmed in a prospective, multicentre, non-comparative clinical trial by the same author. 107 Decolonisation of methicillin-resistant Staphylococcus aureus (MRSA)-colonised patients with PHMB were successful in 47% of cases; if altered skin was colonised, only 22% had decolonisation success.…”

Section: Risks: Mutagenicity Teratogenicity and Carcinogenicitymentioning

confidence: 99%

Re-evaluation of polihexanide use in wound antisepsis in order to clarify ambiguities of two animal studies

et al. 2019

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Objective: Due to classification of the agent polihexanide (PHMB) in category 2 ‘may cause cancer’ by the Committee for Risk Assessment of the European Chemicals Agency in 2011, the users of wound antiseptics may be highly confused. In 2017, this statement was updated, defining PHMB up to 0.1% as a preservative safe in all cosmetic products. In the interest of patient safety, a scientific clarification of the potential carcinogenicity of PHMB is necessary. Methods: A multidisciplinary team (MDT) of microbiologists, surgeons, dermatologists and biochemists conducted a benefit-risk assessment to clarify the hazard of antiseptic use of PHMB. Results: In two animal studies, from which the assessment of a carcinogenic risk was derived, PHMB was administered orally over two years in extremely high concentrations far above the NO(A)EL (no-observed-(adverse-) effect level) in rats and mice. Feeding in the NO(A)EL range resulted in no abnormal effects. In one male in the highest dose group of 4000ppm PHMB, an adenocarcinoma was found, which the author attributed to chronic inflammation of the colon with systemic atypical exposure. The increasing incidence of hemangiosarcomas highly probably resulted from increased endothelial proliferation, triggered by the exceedingly high dosage fed, because PHMB is not genotoxic and there is no evidence for epigenetic effects. Discussion: It is well known that PHMB is not absorbed when applied topically. Considering the absence of genotoxicity and epigenetic effects together with the interpretation of the animal studies, it is the consensus of the multidisciplinary experts that a carcinogenic risk from PHMB-use for wound antisepsis can be ruled out. Conclusion: On this basis and considering their effectiveness, tolerability and clinical evidence, the indications for PHMB based wound antiseptics are justified.

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