All Hands on Deck! A Challenging Case with a Multidisciplinary Team Using Negative-pressure Wound Therapy as the Cornerstone for Treatment

Abstract

The use of negative-pressure wound therapy (NPWT) has become the new standard of care for complex wounds. NPWT with instillation (NPWTi) has been shown to assist wound progression in a variety of wound types in an acute hospital setting with increased progression toward healing. We present the case of a 70-year-old male with Crohn's disease, who had post-operative life-threatening complications following hernia repair. His complex abdominal wound and a high-output fistula required the assistance of an entire clinical team.The multidisciplinary team's approach toward the patient was equivalent to the team's approach to the complex wound: "All Hands On Deck!" The cornerstone of our management was NPWT, specifically NPWTi. Instillation therapy was initiated. Complex foam application and innovative strategies to keep a grossly contaminated wound from becoming the final straw to a patient's demise appeared our greatest challenge.NPWTi was utilized and optimized, where every type of foam, bridge, and securement was needed to gain success. This patient's progress could be wholly attributed to the commitment and experience of a group of care providers who were led by their knowledge and experience in NPWT in the most challenging circumstances.

Application of maple leaf‐shaped flap combined with negative pressure wound therapy in the perianal circular skin defect reconstruction

“…Experimental studies and clinical evidence have proved the efficacy of NPWT in wound healing. It can reduce edema, promote tissue regeneration, and increase neovascularization, leading to accelerated wound healing 18–20 . Moreover, the device of NPWT can ensure the transanal drainage tube was in position during the healing process in our reported cases.…”

“…It can reduce edema, promote tissue regeneration, and increase neovascularization, leading to accelerated wound healing. [18][19][20] Moreover, the device of NPWT can ensure the transanal drainage tube was in position during the healing process in our reported cases. Postoperative management is equally important.…”