Early use of negative pressure therapy in combination with silver dressings in a difficult breast abscess

Abstract

Combining silver-based dressings with negative pressure therapy after radical excision of chronically infected breast disease is a novel application of two technologies. One patient with complex, chronic, infected breast disease underwent radical excision of the affected area and was treated early with a combination of silver-based dressings and topical negative pressure therapy. The wound was then assessed sequentially using clinical measurements of wound area and depth, pain severity scores and level of exudation. It is possible to combine accepted techniques with modern dressing technologies that result in a positive outcome. In this case, the combination of a silver-based dressing with negative pressure therapy following radical excision proved safe and was well tolerated by the patient. Full epithelisation of the wound was achieved and there was no recurrence of the infection for the duration of the treatment.

Negative pressure and nanocrystalline silver dressings for nonhealing ulcer: A randomized pilot study

“…NPWT used for wound healing is a noninvasive technology that promotes healing. It is based on the application of mechanic stress on the tissues, which leads to an increase of angiogenesis and healthy granulation tissue in a wet environment, which in turn favors the elimination of non‐viable tissue and exudate . Also, the inpatient/hospitalized associated costs are reduced by the use of the therapy via outpatient treatment.…”

“…Also, the inpatient/hospitalized associated costs are reduced by the use of the therapy via outpatient treatment. However, NPWT may be associated with complications, mostly hemorrhage or infection . Some studies have associated the use of NPWT with an increase in the bacterial load …”

“…Nanocrystalline silver dressings are widely used and have been shown to be effective in the treatment of contaminated wounds, but the potential systemic effects of these dressings are unclear. Conversely, the increase in antibiotic‐resistant genotypes in wound biofilms has led to the development of new therapeutic strategies over the past years, such as the combined use of NPWT and silver dressings . However, there is limited literature support to the use of combining NPWT.…”

“…Conversely, the increase in antibiotic-resistant genotypes in wound biofilms 5 has led to the development of new therapeutic strategies over the past years, such as the combined use of NPWT and silver dressings. 6,7 However, there is limited literature support to the use of combining NPWT. In a contaminated open fracture model of the proximal left legs of anesthetized goats, the addition of silver dressings had a more pronounced effect on bacterial load particularly on Staphylococcus aureus (25 6 8%) compared with the standard NPWT group (115 6 19%).…”

Silver-based dressings for the reduction of surgical site infection: Review of current experience and recommendation for future studies

“…Silver dressings have also been described to promote healing of diabetic foot ulcers, and to prevent re-infection of skin ulcers after debridement [68,69]. Two case studies were found illustrating the successful wound healing achieved when NPWT is combined to silver dressings; one post-debridement for necrotizing fasciitis, and the other after radical excision of a difficult breast abscess [70,71]. The exact mechanisms by which silver promotes healing are not fully understood, and research shows mixed results.…”