Surgical debridement to optimise wound conditions and healing

Diefenbeck, Michael; Haustedt, Nils; Schmidt, H. G. K.

doi:10.1111/iwj.12187

Cited by 17 publications

(9 citation statements)

References 6 publications

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“…Aggressive surgical debridement is a useful tool to reduce the risk of soft tissue complications after acute soft tissue infections. 10 Surgery is the treatment of choice in organized hematoma. Organized chronic hematoma has a negative effect on wound healing for leg ulcers.…”

Section: Discussionmentioning

confidence: 99%

Chronic Expanding Organized Hematoma of the Lower Leg

Wollina

Heinig

Langner

2015

The International Journal of Lower Extremity Wounds

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Chronic expanding hematoma is a rare entity on the leg. A 55-year-old women presented with 2 small nonhealing leg ulcers. On examination we observed a painless bulky tumor-like mass that developed slowly after deep soft tissue infection almost 2 years ago. Vascular computed tomography suggested an organized hematoma. Important differential diagnoses include sarcoma and lymphoma. Treatment of choice is surgery. Histology confirmed the diagnosis of an organized hematoma. Chronic expanding hematoma is a rare cause of nonhealing leg ulcers.

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Section: Discussionmentioning

confidence: 99%

Chronic Expanding Organized Hematoma of the Lower Leg

Wollina

Heinig

Langner

2015

The International Journal of Lower Extremity Wounds

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“…The wound was repeatedly ushed after removal of the branch, removal of the granulation and hardening of the bones. Considering that the cause of the infection had been removed, to reduce the patient's pain and the number of operations, we used bone cement with antibiotics to ll the cavity [8,9].…”

Section: Third Operationmentioning

confidence: 99%

Should We Think More About Chronic Osteomyelitis After Trauma? A Case Report of Osteomyelitis of the Cuboid Bone

Zhang

Wang

Song

et al. 2020

Preprint

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Osteomyelitis is a refractory infectious disease in surgery, which takes a long time to be treated and the condition is easy to be repeated, which causes a heavy burden to individuals and families. Actively looking for the cause is the key to the treatment of osteomyelitis. In our work, we encountered a patient with cuboid osteomyelitis who had forgotten the history of injury and had received surgical treatment before seeing a doctor in our hospital, which caused great difficulties to our work. In the work of diagnosis and treatment, we constantly adjust the treatment plan and treatment ideas, and finally remove the branches from the infected focus, and obtain satisfactory treatment results.

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“…In 2000, Attinger stated that, after a thorough patient assessment, the most important step to treating any wound is sufficient debridement to remove all foreign material, unhealthy, or non‐viable tissue until the wound edges and base consist of only normal and healthy tissue . In 2013, Diefenbeck concluded that adequate surgical debridement is the prerequisite for the successful treatment of skin, soft tissue and bone tissue . Goss et al reported that surgical wound debridement is necessary before treating infected wounds with NPWTi‐d .…”

Section: Clinical Approach Flow Diagrammentioning

confidence: 99%

Clinical recommendations and practical guide for negative pressure wound therapy with instillation

Gupta

Gabriel

Lantis

et al. 2015

International Wound Journal

102

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Effective wound management involves a comprehensive assessment of the patient and the wound to determine an optimal wound treatment plan. It is critical to identify and address factors that may impair wound healing, prior to selecting the most appropriate therapy for each patient. Negative pressure wound therapy (NPWT) is a well-established advanced therapy that has been successful in adjunctive management of acute and chronic wounds. In recent years, the introduction of topical wound solution delivery in combination with NPWT has provided further benefits to wound healing. A commercially available system now offers automated, volumetric control of instilled topical wound solutions with a dwell time in combination with NPWT (NPWTi-d; V.A.C. VeraFlo™ Therapy, KCI, an Acelity company, San Antonio, TX). This NPWTi-d system differs from other instillation systems in that a timed, predetermined volume of topical wound solution is intermittently delivered (versus continuously fed) and allowed to dwell in the wound bed (without NPWT), for a user-selected period of time before NPWT is resumed. This added accuracy and process simplification of solution delivery in tandem with NPWT have prompted use of NPWTi-d as first-line therapy in a wider subset of complex wounds. However, considerably more research is required to validate efficacy of NPWTi-d in various wound types. The purpose of this review is to provide a relevant overview of wound healing, describe current literature supporting the adjunctive use of NPWTi-d, propose a clinical approach for appropriate application of NPWTi-d and conclude with case studies demonstrating successful use of NPWTi-d. Based on this review, we conclude that either a large case series examining effects of NPWTi-d on different wound types or possibly a large prospective registry evaluating NPWTi-d with real-world topical wound solutions versus immediate debridement and closure would be valuable to the medical community in evaluating the efficacy of this promising therapy.

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Surgical debridement to optimise wound conditions and healing

Cited by 17 publications

References 6 publications

Chronic Expanding Organized Hematoma of the Lower Leg

Chronic Expanding Organized Hematoma of the Lower Leg

Should We Think More About Chronic Osteomyelitis After Trauma? A Case Report of Osteomyelitis of the Cuboid Bone

Clinical recommendations and practical guide for negative pressure wound therapy with instillation

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