Carlotta Scarpa, Martina Grigatti, Sandro Rizzato, Alberto Crema, Vincenzo Vindigni, Franco Bassetto
{"title":"Novel foam dressing with through holes and negative pressure wound therapy with instillation and dwell time: a retrospective cohort study.","authors":"Carlotta Scarpa, Martina Grigatti, Sandro Rizzato, Alberto Crema, Vincenzo Vindigni, Franco Bassetto","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>NPWTi-d of a topical wound solution has been shown to benefit healing in a variety of wound types. This therapy has traditionally been applied via a standard ROCF-V. In 2017, a new ROCF-CC was introduced at the practice of the authors of the current manuscript for adjunctive management of patients with wounds with thick exudate and/or nonviable tissue and in cases in which surgical debridement is not available or not appropriate.</p><p><strong>Objective: </strong>To compare the efficacy of NPWTi-d with ROCF-CC dressing (treatment) vs NPWTi-d with ROCF-V dressing (control).</p><p><strong>Materials and methods: </strong>An observational retrospective cohort study of hospital records of patients with VLUs treated with NPWTi-d who received ROCF-CC dressings (n = 11) vs standard ROCF-V dressings (n = 11) was conducted. NPWTi-d was chosen to promote wound healing in VLUs that were not fully responsive to advanced dressings and/or compression bandage. Solution dwell time was 10 minutes, followed by 2.5-hour NPWT cycles at -125 mm Hg. Dressings were changed every 72 hours.</p><p><strong>Results: </strong>Overall, mean ± SD duration of therapy and hospital length of stay were shorter in the treatment group vs the control group (duration of therapy, 8.63 days ± 7.05 vs 11.72 days ± 17.41, respectively; P = .05, and length of stay, 9.9 days ± 2.98 vs 12.81 days ± 4.26, respectively; P = .08), but these differences were not statistically significant. Mean wound area reduction was greater in the treatment group than in the control group (14.63 cm2 ± 13.24 and 10.72 cm2 ± 14.06, respectively; P = .51), but this was not significant.</p><p><strong>Conclusion: </strong>ROCF-CC dressings were a useful tool in assisting wound bed preparation and reducing time to skin graft closure in this series of complex VLUs.</p>","PeriodicalId":23752,"journal":{"name":"Wounds : a compendium of clinical research and practice","volume":"36 3","pages":"67-72"},"PeriodicalIF":1.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140852286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jad F Zeitouni, Reagan Collins, Patricia Arledge, Yana Puckett, Catherine F Ronaghan
{"title":"Use of dynamic tissue system adhesive skin closure device and multi-tissue platform porcine xenograft to achieve primary closure after wide local excision of a melanoma.","authors":"Jad F Zeitouni, Reagan Collins, Patricia Arledge, Yana Puckett, Catherine F Ronaghan","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Wide local excision with sentinel lymph node biopsy has been the standard of care for melanoma with a Breslow depth greater than 1 mm. Wide local excision with 1- to 2-cm margins can result in large wounds that cannot be primarily closed. Traditionally, management has included reconstruction with autologous flaps and skin grafting.</p><p><strong>Case report: </strong>The authors of this case report achieved successful closure of a large posterior calf wound after 2-cm-wide local excision of the melanoma biopsy site in a 61-year-old male. The dermal lesion was a Clark level IV superficial spreading malignant melanoma with Breslow depth of 1.1 mm. Wound closure was achieved with a DTS adhesive skin closure device coupled with MTP xenograft powder as a healing adjunct.</p><p><strong>Conclusion: </strong>The results of this patient's case indicate that DTS adhesive skin closure device should be considered as an additional option for the closure of large defects following wide local excision in the management of melanoma.</p>","PeriodicalId":23752,"journal":{"name":"Wounds : a compendium of clinical research and practice","volume":"36 3","pages":"80-83"},"PeriodicalIF":1.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140864222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cerys Griffiths, Emily Oakes, Daniel Cook, Lynne Salmon, Alex Lawton
{"title":"An investigation of the antimicrobial efficacy of a nonwoven CMC PHMB dressing and the ability of the dressing to absorb wound slough.","authors":"Cerys Griffiths, Emily Oakes, Daniel Cook, Lynne Salmon, Alex Lawton","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To conduct an in vitro investigation into the slough absorption and retention attributes of a gelling fiber dressing composed of CMC fibers and PHMB (Dressing A), and to assess its antimicrobial efficacy under compression.</p><p><strong>Materials and methods: </strong>Dressing A is indicated for use with secondary dressings or bandaging, and conditions that replicate this compression element were applied. Dressing A was compared with 5 other dressings. Antimicrobial efficacy testing was conducted over a 7-day challenge period.</p><p><strong>Results: </strong>Dressing A absorbed an average of 33 g/100 cm2 per sample of viscous solution, 28% more than the other dressings tested. A greater than or equal to 6-log reduction of all microorganisms tested was achieved within 168 hours with Dressing A.</p><p><strong>Conclusion: </strong>The CMC PHMB gelling fiber dressing is able to absorb and retain viscous solutions (simulated slough). The antimicrobial efficacy of the dressing under compression was demonstrated by total eradication of all microorganisms tested.</p>","PeriodicalId":23752,"journal":{"name":"Wounds : a compendium of clinical research and practice","volume":"36 2","pages":"47-49"},"PeriodicalIF":1.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140120802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Wound healing outcomes following treatment with synthetic hybrid-scale fiber matrix after resection of soft tissue tumors or infections.","authors":"Bennie Lindeque, Daniel Moon","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Wide excision of soft tissue tumors or infections often results in large defects that can be challenging to manage. Advanced treatment modalities-including NPWT, skin grafts, and xenografts-can all be considered for post-resection wound management, but each has its limitations. An SHSFM, engineered to resemble human extracellular matrix, has demonstrated positive wound healing outcomes in prior studies.</p><p><strong>Materials and methods: </strong>Adult patients at a single institution who underwent resection of soft tissue tumor or infected tissue followed by treatment with SHSFM from 2020-2023 were retrospectively reviewed.</p><p><strong>Results: </strong>Ten patients were included in the review after meeting the inclusion criteria. Overall, 7 of 10 wounds had documented complete closure, with 3 lost to follow-up. Average time to wound closure was 119 days. Patients either healed via secondary intention or were bridged to a split-thickness skin graft. The average VSS score was 3.3 when assessed.</p><p><strong>Conclusion: </strong>The current case series demonstrated that the SHSFM can support granulation tissue formation over exposed structures as a bridge to skin graft or can completely reepithelialize large wounds without skin grafting. The SHSFM offers a novel treatment option for post-resection surgical wounds.</p>","PeriodicalId":23752,"journal":{"name":"Wounds : a compendium of clinical research and practice","volume":"36 2","pages":"34-38"},"PeriodicalIF":1.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140120807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Clinical observations in patients with open abdomens managed with negative pressure therapy using a perforated foam dressing: a limited case series with brief literature review.","authors":"Luis G Fernández, Marc R Matthews","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Emergency laparotomy has become an increasingly more frequent and expensive general surgery procedure in terms of cost and resource utilization. Primary fascial closure at the index procedure may not be feasible in many patients, requiring use of the open abdomen (OA)technique. Patients with OA are most often managed with temporary abdomen closure (TAC). Open abdomen negative pressure therapy (OA-NPT) has been shown to be an effective TAC technique, which facilitates re-exploration, protects visceral organs, mitigates fascial retraction, prevents loss of abdominal domain, and provides effective volumetric abdominal fluid management.</p><p><strong>Objective: </strong>This study assessed the clinical use and outcomes of a next-generation perforated polyurethane foam dressing that has been developed for use with OA-NPT.</p><p><strong>Materials and methods: </strong>The authors evaluated a next-generation OA-NPT foam dressing to provide TAC in 4 patients who required OA management. Two surgeons at different facilities exercised their independent surgical discretion in selecting the patients who would receive the next generation OA-NPT foam dressing. Surgical interventions to resolve the underlying pathology were completed using the OA technique. Postoperatively, all patients had intermittent urinary bladder pressures recorded as an indirect method for approximating intra-abdominal pressure (IAP) and to monitor clinical evidence of intra-abdominal hypertension (IAH) or abdominal compartment syndrome.</p><p><strong>Results: </strong>In these patients, primary fascial closure was achieved and no appreciable increase in IAP was noted. No gastrointestinal complications related to the next generation perforated OA-NPT foam dressing were noted.</p><p><strong>Conclusions: </strong>Based on the authors' clinical assessment of the 4 patients who required OA management, the new, perforated OA-NPT foam dressing was effective in providing increased medial tension and contraction without an appreciable increase in IAP.</p>","PeriodicalId":23752,"journal":{"name":"Wounds : a compendium of clinical research and practice","volume":" ","pages":"61-66"},"PeriodicalIF":1.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25374008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Correction to: Dehydrated human amnion/chorion membrane allograft for postoperative wounds following Mohs micrographic surgery: a retrospective comparative evaluation.","authors":"Sadaf Moradi, Ana Ormaza, Navid Ezra","doi":"10.25270/wnds/23034R2","DOIUrl":"10.25270/wnds/23034R2","url":null,"abstract":"","PeriodicalId":23752,"journal":{"name":"Wounds : a compendium of clinical research and practice","volume":"36 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140120803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Topical phenytoin improves wound healing with analgesic and antibacterial properties and minimal side effects: a systematic review.","authors":"Kaiser O'Sahil Sadiq, Yogamba Mysore Shivakumar, Eshwar Kumar Burra, Kamran Shahid, Yonas Teferra Tamene, Shefali Piyush Mody, Tuheen Sankar Nath","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Although phenytoin's potential benefits in wound healing, pain relief, and infection control across various wound types have been previously reported, its use in wound care remains limited.</p><p><strong>Objective: </strong>To conduct a comprehensive review to assess the efficacy of topical phenytoin compared with standard and alternative treatments for different wound types.</p><p><strong>Materials and methods: </strong>The authors last searched Cochrane Library, PubMed, PubMed Central, and MEDLINE in June 2023. All English-language human RCTs and NRCTs from any time were included. The RoB 2 was used to assess quality of randomized trials, and the ROBINS-I was used to assess the quality of nonrandomized trials. Studies with a low risk of bias or some concerns in no more than 1 domain were included. Data collected and analyzed included wound type, interventions, sample size, outcome measures, and adverse effects.</p><p><strong>Results: </strong>The search yielded 101 studies, of which 17 RCTs and 8 NRCTs were eligible for inclusion. Of the included studies, 56% had a low risk of bias in all domains. The sample sizes varied between 20 and 130 (median, 60), with a total sample size of 1653 patients. Phenytoin improved wound healing in 17 of the 24 studies that evaluated it (71%), increased granulation tissue in 9 of the 10 studies that evaluated it (90%), provided analgesic effects in 7 of the 13 studies that evaluated it (54%), and inhibited bacterial contaminants in 6 of the 8 studies that evaluated it (75%). Adverse effects were rare (29%), minimal, and transient.</p><p><strong>Conclusion: </strong>Phenytoin enhances wound healing and offers analgesic and antibacterial properties with minimal adverse effects. Further research is needed on optimal dosage of phenytoin, as well as frequency, delivery vehicles, and effects on other postoperative wounds.</p><p><strong>Background: </strong>Although phenytoin's potential benefits in wound healing, pain relief, and infection control across various wound types have been previously reported, its use in wound care remains limited.</p><p><strong>Objective: </strong>To conduct a comprehensive review to assess the efficacy of topical phenytoin compared with standard and alternative treatments for different wound types.</p><p><strong>Materials and methods: </strong>The authors last searched Cochrane Library, PubMed, PubMed Central, and MEDLINE in June 2023. All English-language human RCTs and NRCTs from any time were included. The RoB 2 was used to assess quality of randomized trials, and the ROBINS-I was used to assess the quality of nonrandomized trials. Studies with a low risk of bias or some concerns in no more than 1 domain were included. Data collected and analyzed included wound type, interventions, sample size, outcome measures, and adverse effects.</p><p><strong>Results: </strong>The search yielded 101 studies, of which 17 RCTs and 8 NRCTs were eligible for inclusion. O","PeriodicalId":23752,"journal":{"name":"Wounds : a compendium of clinical research and practice","volume":"36 2","pages":"50-60"},"PeriodicalIF":1.4,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140120805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Diego Silva-Mendoza, Dylan Joule, Michael Lavor, Matthew J Weiner
{"title":"Use of high-frequency electrical stimulation in gastrocutaneous fistula closure: a case report.","authors":"Diego Silva-Mendoza, Dylan Joule, Michael Lavor, Matthew J Weiner","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Gastrocutaneous fistula is a rare complication following Roux-en-Y gastric bypass, a commonly performed bariatric surgery. While most ECFs respond to conservative management, some do not close despite adequate nutritional support, infection source control, and drainage management. As such, the chronicity of these difficult-to-treat wounds can be physically and economically costly to patients.</p><p><strong>Case report: </strong>A 53-year-old female with a history of Roux-en-Y gastric bypass developed a gastrocutaneous fistula secondary to a perforated gastrojejunal ulcer, requiring immediate surgical intervention. After being discharged from the hospital, 37 days of conservative management and NPWT did not reduce the size of the fistula tract. To help control the patient's chronic abdominal pain and increase the rate of wound healing, the patient underwent treatment with HFES (20 kHz) delivered using a handheld transcutaneous electrical nerve stimulator. This electrotherapy was found to reduce the majority of the patient's pain within the first treatment session. The patient's fistula also began to decrease in size within 1 week of initiating treatment.</p><p><strong>Conclusion: </strong>This case report details the successful closure of a gastrocutaneous fistula after administration of HFES 3 times a week over the course of 25 days. The mechanism of action of HFES and its role in the wound healing process are also discussed.</p>","PeriodicalId":23752,"journal":{"name":"Wounds : a compendium of clinical research and practice","volume":"36 2","pages":"39-42"},"PeriodicalIF":1.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140120806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Misdiagnosis of cutaneous epithelioid angiosarcoma as diabetic foot ulcer: a case study.","authors":"Yousef Almheirat, Lamis Elyamani, Ouissal Hormi, Nassiba Zerrouki, Nada Zizi, S Dikhaye","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>AS is a malignant tumor that originates from vascular endothelial cells and is known for a high rate of local recurrence and metastasis.</p><p><strong>Case report: </strong>A 48-year-old male presented with cutaneous epithelioid AS. Cutaneous AS of the foot is quite rare, especially in the absence of predisposing factors, and in this patient it was previously misdiagnosed as a DFU.</p><p><strong>Conclusion: </strong>Physicians should be aware of this rare presentation of cutaneous AS. The authors of the current report advise regular clinical reassessment of chronic ulcers and biopsies of nonhealing wounds, even when adequate wound treatment has been administered, with the goal of identifying ulcerated skin malignancies and preventing delay in providing appropriate treatment.</p>","PeriodicalId":23752,"journal":{"name":"Wounds : a compendium of clinical research and practice","volume":"36 2","pages":"43-46"},"PeriodicalIF":1.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140120804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lauren E Berger, Daisy L Spoer, Samuel S Huffman, Eleanor Drew, Ian T Greenwalt, Kenneth L Fan
{"title":"A case of necrotizing fasciitis of the breast following lumpectomy and oncoplastic closure.","authors":"Lauren E Berger, Daisy L Spoer, Samuel S Huffman, Eleanor Drew, Ian T Greenwalt, Kenneth L Fan","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>NF is a life-threatening soft tissue infection that most commonly occurs in the lower extremity. While presenting symptoms such as erythema, severe pain, sepsis, and wound crepitation are well documented, diagnosis of NF of the breast often is obscured by a low clinical index of suspicion due to its relative rarity as well as by the breast parenchyma that physically separates the underlying fascia and overlying skin. Several risk factors have previously been identified, such as underlying infection, diabetes, advanced age, and immunosuppression. However, the gross morbidity and high mortality associated with NF warrant continued surveillance of contributing factors across any anatomic location. Fifteen cases in the literature document the development of NF following breast surgery.</p><p><strong>Case report: </strong>The authors of this case report aim to expand on the current literature through the presentation of a unique case of NF of the breast following right breast lumpectomy and oncoplastic closure with left reduction mammaplasty in an immunocompromised patient found to have concurrent perforated sigmoid diverticulitis.</p><p><strong>Conclusion: </strong>This case exemplifies how frequent postoperative surveillance, a low threshold for intervention, and efficient coordination of care are vital to minimizing the morbidity and mortality risks associated with NF of the breast.</p>","PeriodicalId":23752,"journal":{"name":"Wounds : a compendium of clinical research and practice","volume":"36 1","pages":"1-7"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139991348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}