Vacuum‐assisted closure (<scp>VAC</scp>)‐Instill<sup>®</sup> with continuous irrigation for the treatment of <i>Mycoplasma hominis</i> mediastinitis

Karaca, Şaziye; Kalangos, Afksendiyos

doi:10.1111/iwj.12234

Cited by 15 publications

(11 citation statements)

References 7 publications

(5 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The negative pressure accelerates the healing process by removing exudates, reducing bacterial load, increasing the growth of granulation tissue, favouring the contraction of the lesion margins and promoting angiogenesis (4)(5)(6). VAC therapy is applied in many fields: traumatic and dehiscent surgical wounds, acute and chronic wounds, partial-thickness burns (grade I and II), sternal osteomyelitis (7)(8)(9) and mediastinitis (10)(11)(12)(13)(14)(15)(16).…”

Section: Introductionmentioning

confidence: 99%

The effectiveness of negative pressure therapy on infected wounds: preliminary results

Torto

Ruggiero²,

Parisi

et al. 2017

International Wound Journal

View full text Add to dashboard Cite

Vacuum-assisted closure (VAC) therapy is a sophisticated system that maintains a closed, humid, sterile and isolated environment. Wound infection is considered a relative contraindication. The objective of this study is to extend the indications for VAC therapy to include infected wounds by demonstrating its ability to increase the antibiotic concentration in the damaged and infected tissues. Patients who presented with ulcers infected with daptomycin-sensitive bacteria were eligible to be enrolled in this prospective study. They were given antibiotic therapy with daptomycin with a specific protocol. A biopsy of the lesion was carried out to detect tissue concentration of the drug at time 0. Afterwards, the patients were subjected to VAC therapy. At the end of VAC therapy, a second lesion biopsy was performed and analysed to detect tissue concentration of the drug at time 1. A control group was enrolled in which patients followed the same protocol, but they were treated with traditional dressings. Fisher's exact test was used to compare the two groups. The results highlighted a significant increase in the concentration of antibiotics in the study group tissue; the improvement was sensibly lower in the control group. Statistical differences were not found between the two groups. The preliminary analysis of the data showed an important increase of antibiotic concentration in the tissue after VAC therapy. Despite the encouraging data, it is necessary to broaden the sample of patients and perform the same study with other antibiotics.

show abstract

Section: Introductionmentioning

confidence: 99%

The effectiveness of negative pressure therapy on infected wounds: preliminary results

Torto

Ruggiero²,

Parisi

et al. 2017

International Wound Journal

View full text Add to dashboard Cite

show abstract

“…Clinical characteristics of M. hominis infections subsequent to thoracic surgery are summarized in review articles . According to these reviews, the types of infection varied, ranging from sternal wound infection, pericarditis, and empyema, to mediastinitis . Patients who underwent lung, heart, and heart–lung transplantation (similar to our case) have also been described .…”

Section: Discussionmentioning

confidence: 76%

Mycoplasma hominis periaortic abscess following heart–lung transplantation

Hagiya

Yoshida

Yamamoto

et al. 2017

Transplant Infectious Dis

View full text Add to dashboard Cite

We report the first case of Mycoplasma hominis periaortic abscess after heart-lung transplantation. The absence of sternal wound infection delayed the diagnosis, but the patient successfully recovered with debridement surgeries and long-term antibiotic therapy. Owing to the difficulty in detection and the intrinsic resistance to beta-lactams, M. hominis infections are prone to being misdiagnosed and undertreated. M. hominis should be suspected in cases where conventional microbiological identification and treatment approaches fail.

show abstract

“…In addition to NPWT’s benefits of removal of excess fluid, promotion of perfusion, and increased granulation tissue, instillation therapy is thought to lower wound fluid viscosity, facilitating the washout of necrotic tissue, fibrin, and clots. While simple NPWT confers some degree of mechanical stress to stimulate underlying cell proliferation, NPWTi-d applies it more gently and allows new cells to be laid down on healthy tissue [3, 6]. Cycling between negative pressure and instillation stimulates frequent debridement which has been shown to remove inhibitory factors such as metalloproteases and break up the glycocalyx that causes biofilms to form, which are much more resistant to antisepsis [3].…”

Section: Discussionmentioning

confidence: 99%

“…In a study of 142 patients with poorly healing wounds, 74 treated with traditional NPWT and 68 with NPWTi-d, statistically significant decreases were noted in number of returns to OR, length of hospital stays and time to definitive closure, with significant increases in percentage of wounds closed as well as bacterial culture improvement [5]. Although the majority of data regarding NPWTi-d is gained from orthopedic and extremity wounds, promising outcomes have been noted in case reports presenting the use of NPWTi-d in wounds associated with pleural empyema and mediastinitis, both types similar to wounds over vascular grafts in their delicate underlying structures and similar high risk patient populations [6-7]. Furthermore, NPWTi-d has been shown to reduce the time to wound closure, shorten the overall hospital stay, and thereby decrease overall costs [8].…”

Section: Discussionmentioning

confidence: 99%

Source Control and Graft Preservation Using Negative Pressure Wound Therapy with Antibiotic Instillation: A Case Report

Gilbert¹,

Kelly²,

Grossi³

2016

Cureus

View full text Add to dashboard Cite

Negative pressure wound therapy (NPWT) is widely used to treat many types of complex wounds, and the advent of the instillation and dwell time (NPWTi-d) technique has enhanced this system with the addition of automated treatment with topical solutions. In the field of vascular surgery, NPWT is utilized to help close wounds over underlying grafts; however keeping these wounds free of infection and avoiding large reoperation when infection occurs remains a challenge. In this case report we present a patient who required acute intervention for limb ischemia, with a large wound created in the groin for anastomosis of a prosthetic graft bypass. Postoperatively, the wound became infected, and the challenge became balancing infection control and graft preservation with the patient’s multiple comorbidities including postoperative non-ST segment elevation myocardial infarction (NSTEMI). To avoid a large reoperation, we chose NPWTi-d with automated instillation of an antibiotic solution. There was no reinfection or return to the operating room (OR), the patient was discharged after four weeks and the wound closed on its own shortly thereafter. This case demonstrates that for high-risk surgical patients with known wound infections in the proximity of a bypass graft, NPWTi-d with antibiotic instillation may be an effective augmentation to current treatment strategies and may be considered as a stand-alone technique for wound closure in select cases.

show abstract

Vacuum‐assisted closure (VAC)‐Instill^® with continuous irrigation for the treatment of Mycoplasma hominis mediastinitis

Cited by 15 publications

References 7 publications

The effectiveness of negative pressure therapy on infected wounds: preliminary results

The effectiveness of negative pressure therapy on infected wounds: preliminary results

Mycoplasma hominis periaortic abscess following heart–lung transplantation

Source Control and Graft Preservation Using Negative Pressure Wound Therapy with Antibiotic Instillation: A Case Report

Contact Info

Product

Resources

About

Vacuum‐assisted closure (VAC)‐Instill® with continuous irrigation for the treatment of Mycoplasma hominis mediastinitis

Cited by 15 publications

References 7 publications

The effectiveness of negative pressure therapy on infected wounds: preliminary results

The effectiveness of negative pressure therapy on infected wounds: preliminary results

Mycoplasma hominis periaortic abscess following heart–lung transplantation

Source Control and Graft Preservation Using Negative Pressure Wound Therapy with Antibiotic Instillation: A Case Report

Contact Info

Product

Resources

About

Vacuum‐assisted closure (VAC)‐Instill^® with continuous irrigation for the treatment of Mycoplasma hominis mediastinitis