Incisional Negative Pressure Wound Therapy Following Surgical Repair of Lower Extremity Fractures

Quatman, Carmen E.; Villarreal, Michael; Cochran, Amalia

doi:10.1001/jama.2019.22531

Cited by 5 publications

(3 citation statements)

References 14 publications

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“…The mean area of the wound reduced rapidly in NPWT group patients after the treatment period compared to the SWT group patients by 32 sq cm. The results obtained in our study were relevant to the results of Quatman et al who found a 28% reduction in the mean area of wound compared to 36% in our study [ 23 ]. Efficient debridement due to NPWT leads to the removal of devitalized and necrotic tissues.…”

Section: Discussionsupporting

confidence: 88%

A Comparative Study on Efficacy of Negative Pressure Wound Therapy Versus Standard Wound Therapy for Patients With Compound Fractures in a Tertiary Care Hospital

Kumaar¹,

Shanthappa²,

Ethiraj³

2022

Cureus

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Background: Orthopedic surgeons face a difficult task in treating serious open fractures, which usually result in complications, morbidity, and even amputation. Compound fracture wounds were traditionally treated with a standard saline dressing. To avoid infection and problems during therapy, several studies found that open fractures require early skeletal stability as well as soft tissue repair. In favoring the above fact vacuum-assisted closure (VAC) is now undergoing a paradigm shift. With this background, this study aimed to compare the effects of VAC dressing versus standard wound dressing on compound fracture wounds. Methodology: This study has been conducted as a single-blind randomized control trial among 128 patients who got admitted to the Department of Orthopedics, R L Jalappa Hospital attached to Sri Devaraj Urs Medical College, Karnataka, India from August 2019 to November 2021. The study participants were randomly allotted into two groups negative pressure wound therapy (NPWT) and standard wound therapy (SWT) consisting of 64 participants in each group. VAC dressing was used on group NPWT, while normal saline wound dressing was used on group SWT. Both groups were followed up for a month after their discharge from the hospital. Frequency in dressing changes wound healing time, infection presence, and hospitalization days were all recorded and compared over one month. The data collection was done using questionnaires and the statistical analysis was done with SPSS version 21 (Chicago, IL: IBM Corp.). Results: There was a statically significant difference favoring group NPWT compared to group SWT with a hospital stay, number of dressings required, wound size reduction, wound healing time, and deep infection rate (p<0.05). Conclusions: The use of NPWT speeds up the healing of compound fracture wounds significantly. It is affordable and can be used as a substitute in resource-constrained areas to reduce infection and manage open fracture wounds quickly.

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Section: Discussionsupporting

confidence: 88%

A Comparative Study on Efficacy of Negative Pressure Wound Therapy Versus Standard Wound Therapy for Patients With Compound Fractures in a Tertiary Care Hospital

Kumaar¹,

Shanthappa²,

Ethiraj³

2022

Cureus

View full text Add to dashboard Cite

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“…NPWT accelerates wound healing via (1) mechanical properties: promoting blood flow to the wound, maintaining a moist environment, reducing edema, placing the wound under tension and (2) biochemical properties: leading to alterations in the microbial milieu [87][88][89][90]. While previous studies advocated for its use, in a recent Wound Healing in Surgery for Trauma (WHIST) RCT, which included 1548 patients, Costa et al found no statistical difference with the use of iNPWT for surgical wounds associated with lower limb fractures from major trauma [83,[90][91][92].…”

Section: Incisional Negative Pressure Wound Therapy (Inpwt)mentioning

confidence: 99%

Perioperative management of acetabular and pelvic fractures: evidence-based recommendations

Yakkanti

Mohile

Cohen-Levy

et al. 2021

Arch Orthop Trauma Surg

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Purpose The American Academy of Orthopaedic Surgeons does not currently provide clinical practice guidelines for management of PAF. Accordingly, this article aims to review and consolidate the relevant historical and recent literature in important topics pertaining to perioperative management of PAF. Methods A thorough literature review using PubMed, Cochrane and Embase databases was performed to assess preoperative, intraoperative and postoperative management of PAF fracture. Topics reviewed included: time from injury to definitive fixation, the role of inferior vena cava filters (IVCF), tranexamic acid (TXA) use, intraopoperative cell salvage, incisional negative pressure wound therapy (NPWT), intraoperative antibiotic powder use, heterotopic ossification prophylaxis, and pre-and postoperative venous thromboembolism (VTE) prophylaxis. Results A total of 126 articles pertaining to the preoperative, intraoperative and postoperative management of PAF were reviewed. Articles reviewed by topic include 13 articles pertaining to time to fixation, 23 on IVCF use, 14 on VTE prophylaxis, 20 on TXA use, 10 on cell salvage, 10 on iNPWT 14 on intraoperative antibiotic powder and 20 on HO prophylaxis. An additional eight articles were reviewed to describe background information. Five articles provided information for two or more treatment modalities and were therefore included in multiple categories when tabulating the number of articles reviewed per topic. ConclusionThe literature supports the use of radiation therapy for HO prophylaxis, early (< 5 days from injury) surgical intervention and the routine use of intraoperative TXA. The literature does not support the routine use of iNPWT or IVCF. There is inadequate information to make a recommendation regarding the use of cell salvage and wound infiltration with antibiotic powder. While the routine use of chemical VTE prophylaxis is recommended, there is insufficient evidence to recommend the optimal agent and duration of therapy.

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“…Além disso, a TPN pode oferecer proteção contra infecções por microorganismos, pois a ferida é vedada pelo dispositivo. Os efeitos biológicos da TPN no leito da ferida dependem do nível pressórico subatmosférica aplicado [31][32][33][34] .…”

Section: Tratamento De úLceras Cutâneas Em Indivíduos Diabéticosunclassified

Alterações moleculares de fibroblastos presentes no leito da ferida crônica de portadores de diabetes mellitus submetidos à terapia por pressão subatmosférica

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Incisional Negative Pressure Wound Therapy Following Surgical Repair of Lower Extremity Fractures

Cited by 5 publications

References 14 publications

A Comparative Study on Efficacy of Negative Pressure Wound Therapy Versus Standard Wound Therapy for Patients With Compound Fractures in a Tertiary Care Hospital

A Comparative Study on Efficacy of Negative Pressure Wound Therapy Versus Standard Wound Therapy for Patients With Compound Fractures in a Tertiary Care Hospital

Perioperative management of acetabular and pelvic fractures: evidence-based recommendations

Alterações moleculares de fibroblastos presentes no leito da ferida crônica de portadores de diabetes mellitus submetidos à terapia por pressão subatmosférica

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