Treating Fasciotomy Wounds with Negative Pressure Wound Therapy with Instillation and Dwell Time (NPWTi-d)

Lee, Priscilla

doi:10.7759/cureus.852

Cited by 7 publications

(6 citation statements)

References 6 publications

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“…It required additional surgery under general anesthesia, pain at graft donor site, infection, risk of graft non-14 adherence and cosmetic problem. Therefore, many different innovative techniques have been introduced to overcome the complications of Split-thickness skin 20 grafting like negative pressure wound therapy, Figure 05) Our study has limitation that it has small sample size and it lack control group. Furthermore, patients with co-morbidities were not included to see the outcomes.…”

Section: Discussionmentioning

confidence: 99%

Dermotraction as a Simple and Effective Technique for Fasciotomy Wound Closure.

Saeed¹,

Rana²,

Masood³

et al. 2018

Annals KEMU

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Background| Fasciotomy is the best treatment option of acute compartment syndrome, but it results into large wounds which are difficult to manage. Different techniques have been utilized to manage the fasciotomy wounds which have their respective merits and demerits. This study was conducted to evaluate yet another novel technique which requires skin stapler and Prolene #1 sutures. Methods| This descriptive cases series was done using non-probability convenient sampling technique from January 2015 and June 2017 at Department of Orthopedics Surgery, King Edward Medical University / Mayo Hospital, Lahore. We included 24 fasciotomy wounds. They were managed with Dermotraction technique. We excluded patients with vascular injury. All wounds were successfully closed within an average time of seven days. The procedure was found to be cost effective, easy to execute and with minimal complications. Results| Amongst the total 13 patients, all were males of age ranging from 14 to 45year with mean age of 28.46±9.97. Majority, 10 patients (77 %) had acute compartment syndrome of leg and each patient managed with two fasciotomy wounds (N= 20). All fasciotomy wounds were closed with serial traction technique and the average time of closure was 07 days ranging from 3 days to 17 days 8.61±2.63. Conclusion| We concluded from the study that dermotraction technique has good outcome in fasciotomy wound closer and healing and it is a cost effective.

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Section: Discussionmentioning

confidence: 99%

Dermotraction as a Simple and Effective Technique for Fasciotomy Wound Closure.

Saeed¹,

Rana²,

Masood³

et al. 2018

Annals KEMU

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“…Effective treatment, low incidence of SSI, positive cosmetic effect and cost-effectiveness have supported the widespread choice of this method therapy. Furthermore, NPWT promotes granulation tissue formation, improves microcirculation and shortens hospitalization period [15][16][17]. Indications to apply NPWT involve hard to heal wounds including diabetic foot ulcers, traumatic and post-operative wounds, wounds with necrotizing fasciitis [18].…”

Section: Discussionmentioning

confidence: 99%

“…To prevent complications leading to permanent disabilities, a prophylactic fasciotomy is applied. This method is associated with the risk of surgical site infection (SSI), injuries to the peroneal nerve and the necessity of prolonged patient hospitalization [4]. In order to avoid complications, the wound should be closed as soon as possible.…”

Section: Introductionmentioning

confidence: 99%

Using Negative Pressure Wound Therapy in the Treatment of Wounds After Fasciotomy in Acute Compartment Syndrome - Retrospective Case Series Study

Miszczuk¹,

Błońska-Staniec²,

Michalska³

et al. 2020

Preprint

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Background and Objectives: Acute compartment syndrome (ACS) is an emergency condition of the lower limb in which prophylactic fasciotomy is required to prevent complications. A negative pressure wound therapy (NPWT) used to the treatment of fasciotomy wounds provide beneficial clinical results. This study aimed to exchange the authors’ experience of using the NPWT installation system on the lower limb wounds after fasciotomy in ACS. Materials and Methods: This is a retrospective study enrolled consecutive patients with ACS, who underwent fasciotomy and was treated with the NPWT installation system at Department of Vascular Surgery, Provincial Hospital in Kielce from April 2016 to July 2017. Results: The study enrolled 15 patients with a diagnosis of ACS (87% men, mean age 65 years old). An open four-compartment fasciotomy (87%) or two-compartment fasciotomy (13%) was performed. The NPWT was applied on the first day after fasciotomy in 87% of patients. Therapy was initiated by the negative pressure of 125 mm Hg, which maintained at this level until the therapy was finalized. In 80% of patients, the vacuum-assisted wound closure (VAC) dressing changes were performed every 3 days. The first approximation of fasciotomy wounds margins occurred on the 4th day after surgery among 67% of individuals. The average time of using VAC on fasciotomy wounds was 9 days. The average time to definitive closure edges of fasciotomy wounds was 12 days. The average time of hospital stay was 17 days. Conclusions: Our experience indicates the legitimacy of using NPWT in wound treatment after fasciotomy in ACS. The NPWT enables faster primary closure of wounds, reduces edema, as well as decreases hospitalization time.

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“…Weiland used hyperbaric oxygen in conjunction with VAC in order to enhance the reduction of oedema and found that wound closure ranged from 3–18 days in three patients 19. Another modification of the technique was presented by Lee, who used negative-pressure wound therapy with automated wound solutions instillation and dwell time 20. Lee found that such a therapy promoted granulation tissue formation over the bone in a critically-ill and malnourished patient.…”

Section: Negative-pressure Therapymentioning

confidence: 99%

Optimising Wound Closure Following a Fasciotomy: A narrative review

Alkhalifah¹,

Almutairi²

2019

Sultan Qaboos Univ Med J

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Compartment syndrome is a surgical emergency that could be resolved by a fasciotomy. However, performing substantial skin incisions may lead to life-threatening complications. This narrative review aimed to present the available methods of wound closure and preferential factors for using each technique. Viable and noninfected wounds were most often treated by gradual approximation techniques, such as the simple or modified shoelace technique, the prepositioned intracutaneous suture or several commercially-available mechanical devices. In addition, applying negative pressure therapy was found to be feasible, particularly when combined with approximation techniques. Skin grafting was reserved for severely-dehiscent wounds while other non-invasive approaches were considered for other subsets of patients with inadvisable surgical interventions. Treatment decision should be made in view of the patient’s condition, ease of application, availability of resources, cost of treatment and aesthetic outcomes.Keywords: Compartment Syndrome; Fasciotomy; Wound Closure Techniques; Negative-Pressure Wound Therapy.

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Treating Fasciotomy Wounds with Negative Pressure Wound Therapy with Instillation and Dwell Time (NPWTi-d)

Cited by 7 publications

References 6 publications

Dermotraction as a Simple and Effective Technique for Fasciotomy Wound Closure.

Dermotraction as a Simple and Effective Technique for Fasciotomy Wound Closure.

Using Negative Pressure Wound Therapy in the Treatment of Wounds After Fasciotomy in Acute Compartment Syndrome - Retrospective Case Series Study

Optimising Wound Closure Following a Fasciotomy: A narrative review

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