The use of negative pressure therapy and hyaluronic acid for the management of post‐traumatic lower limb injury

Cigna, Emanuele; Maruccia, Michele; Sorvillo, Valentina; Parisi, Paola; Palumbo, Francesca; Onesti, Maria Giuseppina

doi:10.1111/j.1742-481x.2012.01011.x

Cited by 10 publications

(4 citation statements)

References 35 publications

(29 reference statements)

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“…First, the patient's skin and soft tissue are still developing and may not have the capacity to withstand the trauma of flap surgery. Second, the size of the defect in this case was extensive and involved a significant amount of tissue loss, making it difficult to harvest enough tissue for a flap [18]. Additionally, flap surgery carries a risk of complications such as flap necrosis, hematoma, and infection, which can be especially detrimental in young patients.…”

Section: Discussionmentioning

confidence: 96%

Meek Micro-Skin Grafting and Acellular Dermal Matrix in Pediatric Patients: A Novel Approach to Massive Extravasation Injury

Maruccia

Tedeschi

Corrao

et al. 2023

JCM

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(1) Background: Extravasation injuries in pediatric patients can lead to significant harm if they are not promptly diagnosed and treated. However, evidence-based standardization on extravasation management remains limited, particularly for extensive wound necrosis. This case report presents the management of an 8-week-old premature patient with an extensive extravasation injury involving the right forearm and dorsum of the hand. (2) Methods: The patient was evaluated by a multidisciplinary team in our Neonatal Intensive Care Unit. Surgical intervention involved the debridement of necrotic tissues, followed by temporary coverage with an acellular dermal matrix. Definitive coverage was achieved through Meek micrografting after three weeks. Physical therapy was provided with pre- and post-rehabilitation range of motion assessed using goniometric measurements. Scar quality was evaluated using the Vancouver Scar Scale. (3) Results: The engraftment rate of the Meek micrografts was 93%, with 16 out of 226 micrografts lost. The patient achieved a Vancouver Scar Scale score of 6, indicating a moderate degree of scarring. Significant improvements in elbow, wrist, and finger joint range of motion were observed at a 1-year follow-up. (4) Conclusions: Close observation and heightened awareness of extravasation risks by trained personnel are crucial. Meek micrografting combined with dermal substitute coverage represents an innovative approach to managing extravasation wounds in pediatric patients.

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Section: Discussionmentioning

confidence: 96%

Meek Micro-Skin Grafting and Acellular Dermal Matrix in Pediatric Patients: A Novel Approach to Massive Extravasation Injury

Maruccia

Tedeschi

Corrao

et al. 2023

JCM

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“…2,3 In some situations, NPWT in combination with dermal substitutes and skin grafts could restore limb function, thus avoiding amputations. 4 High-energy traumas with open fractures are being increasingly treated with external fixation devices to achieve good stabilization, along with minimizing the risk of implant infections. However, the use of NPWT in association with external fixation may jeopardize the efficacy of the negative pressure treatment of the wound, increase treatment costs, or even discourage the physician from using this valuable treatment option.…”

Section: Discussionmentioning

confidence: 99%

A Novel Inexpensive Technique to Seal Negative Pressure Wound Therapy on External Fixation Devices

Caputo

Marchetti²,

Governa³

et al. 2019

Journal of Orthopaedic Trauma

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Negative pressure wound therapy, a tool widely applied to treat lower limb traumas, is useful in reconstructive procedures. However, obtaining an air-tight vacuum seal when using a negative pressure dressing around an external fixation device can be complicated and time-consuming. The plastic drape seldom adheres to screws, pins, or wires and, as such, the vacuum-seal is jeopardized.In surgical departments, colostomy paste is widely used, readily available, and applied where pins and wires make contact with the plastic drape. It is a fast, practical, and inexpensive method of preventing air leakage.In conclusion, to obtain an air-tight seal between the skin and an external fixation device, colostomy paste may be used to ensure an optimal tight-seal, even for complex and extended wounds, for 3 to 5 days without complications or the requirement for additional dressing changes. Furthermore, it is inexpensive, readily available, simple to use, and quick to apply.

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“…Our previous study showed that VSD could bi‐directionally regulate HA metabolism, restoring its content to the level that was conducive for healing. Cigna found that when a posterior tibial injury wound was treated with HA and continuous negative pressure (−125 mmHg), the patient could walk independently 6 months later, and when supplemented with the appropriate physical therapy, the patient could have an early return to daily activities. Morykwas confirmed that granulation tissues grew fastest under the −125 mmHg pressure.…”

Section: Discussionmentioning

confidence: 99%

Application of vacuum sealing drainage to the treatment of seawater‐immersed blast‐injury wounds

Shi

Sun

Cao

et al. 2015

International Wound Journal

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The aims of this study were to observe the effects of vacuum sealing drainage (VSD) with three different negative pressures on the wound healing rate, macrophage count and the expression of hyaluronic acid (HA) as well as its receptor CD44 in seawater-immersed blast-injury wounds (SIBIW) and to determine the optimal negative pressure value. In a minipig SIBIW model, different suction pressures and routine dressing were applied. Histological and immunohistochemical comparisons as well as molecular biology methods were performed to compare the wound healing conditions, macrophage count and the levels of HA and CD44. The wound healing rate of the VSD group was significantly higher than that of the control group, with the -120 mmHg group exhibiting the best effects. The macrophage count of the VSD group was higher than that of the control group. The HA level fluctuation was higher in the VSD group, with the -120 mmHg and the -180 mmHg groups showing the most significant fluctuation (P < 0·05). CD44 was expressed in the full-thickness wound-limbic tissues and was higher in the treatment group than that in the control group, with the -120 mmHg group having the most obvious expression. VSD significantly improved the healing ability and increased the macrophage count and the HA content. It also promoted CD44 expression. -120 mmHg is the optimal negative pressure value.

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The use of negative pressure therapy and hyaluronic acid for the management of post‐traumatic lower limb injury

Cited by 10 publications

References 35 publications

Meek Micro-Skin Grafting and Acellular Dermal Matrix in Pediatric Patients: A Novel Approach to Massive Extravasation Injury

Meek Micro-Skin Grafting and Acellular Dermal Matrix in Pediatric Patients: A Novel Approach to Massive Extravasation Injury

A Novel Inexpensive Technique to Seal Negative Pressure Wound Therapy on External Fixation Devices

Application of vacuum sealing drainage to the treatment of seawater‐immersed blast‐injury wounds

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