A new low-cost negative-pressure wound therapy versus a commercially available therapy device widely used to treat complex traumatic injuries: a prospective, randomized, non-inferiority trial

Abstract

OBJECTIVES:Negative-pressure wound therapy has been widely adopted to reduce the complexity of treating a broad range of acute and chronic wounds. However, its cost is high. The objective of this study was to evaluate the following two different methods of negative-pressure wound therapy in terms of healing time: a low-cost method of negative-pressure wound therapy (a pressure stabilizer device connected to a hospital wall-vacuum system with a gauze-sealed dressing, USP) and the standard of care (vacuum-assisted closure, VAC).METHODS:This is a randomized, controlled, non-inferiority, unblinded trial. Patients admitted with complex injuries to a trauma center in a public referral hospital who were indicated for orthopedic surgery were randomized to a USP or VAC group. The primary outcome was the time required to achieve a “ready for surgery condition”, which was defined as a wound bed with healthy granulation tissue and without necrosis or purulent secretion. Wound bed area contraction, granulation tissue growth and the direct costs of the dressings were secondary outcomes.RESULTS:Variation in area and granulation tissue growth were essentially the same between the systems, and healing time was equal between the groups (p=0.379). In both systems, serial debridement increased wound area (p=0.934), and granulation tissue was also increased (p=0.408). The mean treatment cost was US$ 15.15 in the USP group and US$ 872.59 in the VAC group.CONCLUSIONS:For treating complex traumatic injuries, USP was non-inferior to and less expensive than VAC.

Transrectal endoscopic drainage with vacuum-assisted therapy in patients with anastomotic leaks following rectal cancer resection

“…The described Endo-SPONGE system is not available in some countries. In some publications, the authors describe efficacy of homemade devices in the endoscopic treatment of anastomotic leaks after surgery [18][19][20]. We never used that kind of devices due to availability of Endo-SPONGE system.…”

“…Thus, 17/18 (94.44%) patients with a low intestinal anastomotic leak avoided radical surgical treatment. In all 13 patients with protective ileostomy, surgical reconstruction of continuity of the gastrointestinal tract with closure of ileostomy was performed average of 14 (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25) weeks form the end of endotherapy.…”

A novel treatment for esophageal lesions following atrial fibrillation ablation

“…A custom ENPT drain system (Figures 2–4) was assembled using nonsterile gauze, routine drainage probe, a routine needle, and a sterile plastic cut based on the defect size 7–13 . After customization (5 cm in length and <1 cm in diameter), the drain system was positioned at the tip of the nasogastric tube (NGT) and secured using permanent suture.…”

Adaptive expression of biofilm regulators and adhesion factors of Staphylococcus aureus during acute wound infection under the treatment of negative pressure wound therapy in vivo

“…Digital images were captured using the same parameters (15.0 kV, x5,000 magnification) and analyzed by three blinded experienced observers (one microbiologist and two pathologists). Wound sample and granulation tissue was evaluated as described by Kamamoto et al (28). Bacterial aggregates and necrosis were observed in the region of interest, which were regions with bacterial aggregates and necrosis below the wound surface.…”