Negative pressure wound therapy with instillation, a cost-effective treatment for abdominal mesh exposure

Deleyto, Esther; García-Ruano, Ángela; González‐López, José Rafael

doi:10.1007/s10029-017-1691-y

Cited by 10 publications

(21 citation statements)

References 24 publications

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“…However, being able to deliver NPWT as an outpatient can save on additional inpatient costs. This was an approach utilised in all three of our cases, as previously described in a group of patients with complex abdominal wall surgical site issues following general surgical procedures [44].…”

Section: Discussionmentioning

confidence: 99%

Surgical Site Infections Complicating the Use of Negative Pressure Wound Therapy in Renal Transplant Recipients

Lam

Lau

Laurence

et al. 2019

Case Reports in Transplantation

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Surgical site infections (SSI) of the abdominal wall in renal transplant recipients can on occasion require management with negative pressure wound therapy (NPWT). This is often successful, with a low risk of further complications. However, we describe three cases in which persistent or recurrent surgical site sepsis occurred, whilst NPWT was being deployed in adults with either wound dehiscence or initial SSI. This type of complication in the setting of NPWT has not been previously described in renal transplant recipients. Our case series demonstrates that in immunosuppressed transplant recipients, there may be ineffective microbial or bacterial bioburden clearance associated with the NPWT, which can lead to further infections. Hence recognition for infections in renal transplant patients undergoing treatment with NPWT is vital; furthermore, aggressive management of sepsis control with early debridement, antimicrobial use, and reassessment of the use of wound dressing is necessary to reduce the morbidity associated with surgical site infections and NPWT.

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Section: Discussionmentioning

confidence: 99%

Surgical Site Infections Complicating the Use of Negative Pressure Wound Therapy in Renal Transplant Recipients

Lam

Lau

Laurence

et al. 2019

Case Reports in Transplantation

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“…The influence of what has been termed “micro‐debridement” by repetitive wound washing may be independent from the type of irrigating fluid . Especially when biofilm infected hardware cannot be easily removed without severe damage to the patient, the use of antimicrobial substances has been shown to be helpful in salvaging devices or vital tissue . In our study, we used an antiseptic, which is the standard solution for wound irrigation in our daily routine and which would potentially allow a comparison with our previous treatment results without NPWT.…”

Section: Discussionmentioning

confidence: 99%

“…27,28 Especially when biofilm infected hardware cannot be easily removed without severe damage to the patient, the use of antimicrobial substances has been shown to be helpful in salvaging devices or vital tissue. 29,30 In our study, we used an antiseptic, which is the standard solution for wound irrigation in our daily routine and which would potentially allow a comparison with our previous treatment results without NPWT. In our study, we excluded wounds with exposed devices or hardware because this appears to be another entity because of the biofilm problem.…”

Section: Discussionmentioning

confidence: 99%

Negative pressure wound treatment with computer‐controlled irrigation/instillation decreases bacterial load in contaminated wounds and facilitates wound closure

Ludolph

Fried

Kneppe

et al. 2018

International Wound Journal

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Microbial wound contamination is known to be a hindrance to wound healing. Negative pressure wound therapy (NPWT) with or without irrigation is known to optimise conditions in problem wounds. The aim of this study was to investigate the influence of computer-controlled wound irrigation with NPWT on the bacterial load in contaminated wounds. A total of 267 patients were treated with NPWT with automated instillation because of problematic wounds using an antiseptic instillation solution. In 111 patients, a minimum of 4 operative procedures were necessary, and swabs were taken at least at the first and at the fourth operation in a standardised procedure. The number of different bacteria and the amount of bacteria were analysed during the course. In a subgroup of 51 patients, swabs were taken at all 4 operative procedures and analysed separately. In an overall analysis, the number of different bacteria and the amount of bacteria significantly decreased independent of wound localisation and diagnosis. NPWT with automated instillation demonstrates a positive influence in the reduction of bacterial load in problem wounds. Thus, it may help to optimise wound conditions before definite wound closure.

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“…Successful use of NPWTi‐d has been reported in treating a wide variety of complicated wounds including diabetic foot wounds, extremity and trunk wounds, pressure ulcers, venous leg ulcers, sternal wounds, breast wounds, abdominal wounds with intact synthetic mesh, necrotising fasciitis after debridement, and infected wounds requiring operative debridement …”

Section: Resultsmentioning

confidence: 99%

Negative pressure wound therapy with instillation: International consensus guidelines update

Kim

Attinger

Constantine³

et al. 2019

International Wound Journal

116

131

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The use of negative pressure wound therapy with instillation and dwell time (NPWTi-d) has gained wider adoption and interest due in part to the increasing complexity of wounds and patient conditions. Best practices for the use of NPWTid have shifted in recent years based on a growing body of evidence and expanded worldwide experience with the technology. To better guide the use of NPWTi-d with all dressing and setting configurations, as well as solutions, there is a need to publish updated international consensus guidelines, which were last produced over 6 years ago. An international, multidisciplinary expert panel of clinicians was convened on 22 to 23 February 2019, to assist in developing current recommendations for best practices of the use of NPWTi-d. Principal aims of the meeting were to update recommendations based on panel members' experience and published results regarding topics such as appropriate application settings, topical wound solution selection, and wound and patient characteristics for the use of NPWTi-d with various dressing types. The final consensus recommendations were derived based on greater than 80% agreement among the panellists. The guidelines in this publication represent further refinement of the recommended parameters originally established for the use of NPWTi-d. The authors thank Karen Beach and Ricardo Martinez for their assistance with manuscript preparation.

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Negative pressure wound therapy with instillation, a cost-effective treatment for abdominal mesh exposure

Cited by 10 publications

References 24 publications

Surgical Site Infections Complicating the Use of Negative Pressure Wound Therapy in Renal Transplant Recipients

Surgical Site Infections Complicating the Use of Negative Pressure Wound Therapy in Renal Transplant Recipients

Negative pressure wound treatment with computer‐controlled irrigation/instillation decreases bacterial load in contaminated wounds and facilitates wound closure

Negative pressure wound therapy with instillation: International consensus guidelines update

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