Effect of a new incision management system (PREVENA®) on wound healing after endophlebectomy of the common femoral vein: a case series

Abstract

BackgroundNew endovascular techniques facilitate treatment of complex deep vein obstructions in cases of post-thrombotic syndrome. In a relevant number of these patients, endophlebectomy including the implantation of an arteriovenous fistula between the common femoral artery and the femoral vein is indispensable in order to establish a good inflow. These procedures display a high risk of wound complications. Despite conservative efforts to prevent these postoperative complications, wound healing problems occur in more than 20 % of cases. The present case report is the first description of wound dressing using a PREVENA® incision management system in cases of endophlebectomy.Case presentationA single center’s experience with the incision management system PREVENA®, which was used after endophlebectomy and venous stenting in complex hybrid procedures in three white men aged 46 years, 53 years, and 61 years is the subject of this case report. Although the surgical procedures were performed under therapeutical anticoagulation and took a couple of hours, no wound complications occurred.ConclusionsThese encouraging results underline a potential benefit of the incision management system PREVENA® in cases of complex venous recanalization including endophlebectomy of the femoral vein as well as the implantation of an arteriovenous fistula.

The Use of Closed Incision Negative Pressure Therapy Immediately After Total Ankle Arthroplasty Surgeries

“…It is fundamental that the reduction of incision pressure and efforts to reduce edema be addressed as swelling may delay wound healing by causing a decrease of blood flow to the surgical area [6]. Using sutures and staples introduces focal areas of reduced perfusion leading to ischemia and fibrosis to the surgical site [18]. Any additional therapy that would decrease swelling and tension and act as a physical barrier or prevent antimicrobial colonization would contribute to incisional healing.…”

“…After the PREVENA application, the incision tension is decreased by about 45-70%, which approaches preoperative physiologic tension [7]. The reduction of the sheer stress along the suture line is key to maintaining the integrity of the closed incision [18]. This may be a result of the action of PREVENA to reduce excessive fluid in between the tissue layers.…”

Tiefes Venensystem: Hybridverfahren zur Therapie der iliofemoralen chronischen venösen Obstruktionen

“…Puggioni et al [20] Die größte Serie, die Offenheitsraten und Lebensqualität erfasst hat, zeigt bei 40 Patienten im Follow-up nach 1 Jahr eine sekundäre Offenheit von 83 % [5]. Allerdings werden durch die Inzision in der Leiste häufig Wundheilungsstörungen beobachtet [21]. Gombert et al beobachteten im Kollektiv von 97 Patienten bei 33 % Wundheilungsstörungen [18].…”