Wounds : a compendium of clinical research and practice最新文献

{"title":"The use of custom-made negative pressure wound therapy to manage acute wound infections: a retrospective outcomes study.","authors":"Chandan Noel Vincent, Aakash Sethuraman Venkatesan, Dinakar Rai, Arvind Kumar Salem Muthuswamy","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>NPWT has been used to treat various wounds. Scant evidence exists on the use of custom-made NPWT for infected wounds. NPWT dressings promote wound healing by increasing local blood flow and antibiotic concentration, and by removing exudates from the wound.</p><p><strong>Objective: </strong>To report the use of custom-made NPWT dressings to manage complex infected wounds of the lower limb.</p><p><strong>Materials and methods: </strong>The authors retrospectively reviewed the records of 43 patients with complex infected wounds of the lower limb treated with debridement and low-cost, custom-made NPWT dressing connected to wall suction from January 1, 2018 to December 31, 2020, at PSG Medical College Hospital, Coimbatore, India.</p><p><strong>Results: </strong>A total of 43 patients with infected wounds of the lower limb were treated with the custom-made NPWT dressings. Second-look debridement was required in 5 patients. An average of 5 dressing changes were required for optimal wound granulation, with 23% of patients (n = 10) requiring secondary suturing and 62% (n = 27) requiring STSG for definitive coverage of the wound. Healing by secondary intention was achieved in 6 patients. The average duration from the start of therapy until the wound was ready for coverage (STSG or secondary suturing) was 2.5 weeks (range, 1-5 weeks), with an average time to complete wound healing of 5 weeks (range, 3-7 weeks). The most common wound isolate was Staphylococcus aureus (60%). No complications occurred.</p><p><strong>Conclusions: </strong>Custom-made NPWT dressings are safe to use in complex infected lower limb wounds. These dressings keep the wound dry and promote healing. Wound debridement followed by NPWT combined with antibiotic therapy can act synergistically to promote wound healing and control infection.</p>","PeriodicalId":23752,"journal":{"name":"Wounds : a compendium of clinical research and practice","volume":"36 3","pages":"90-94"},"PeriodicalIF":1.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140871405","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":"Cutaneous Crohn disease presenting as \"knife-edged\" ulcers: a case report.","authors":"Melissa A Nickles, Saman S Karimi, Heidi Kurn, Marylee Braniecki, Anne Polick, Itishree Trivedi, Nadera Sweiss, Igor A Altman","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>CCD presents as non-caseating granulomas within the skin at a site distant from the GI tract. CCD is a debilitating extraintestinal sequela of CD that can sometimes precede its GI manifestations. In the absence of GI symptoms, the histopathologic and clinical features of CCD can present as a variety of inflammatory skin conditions that can range from ruptured follicle-associated granulomas to cutaneous ulcerations. While a variety of therapeutic options for patients with CCD and concurrent luminal CD have been described in the literature, there is no standard treatment algorithm for the management of refractory CCD with limited or covert GI involvement.</p><p><strong>Case report: </strong>The authors discuss the case of a 33-year-old female who presented to the wound care clinic with multiple \"knife-edged\" cutaneous ulcerations involving the intertriginous spaces, found to be consistent with CCD. Her original cutaneous symptoms and diagnosis manifested with minimal GI involvement and responded to IVIG treatment.</p><p><strong>Conclusions: </strong>This case supports the inclusion of CCD in the differential diagnosis in patients with knife-edged granulomatous skin lesions in intertriginous locations. This clinical condition may present in the setting of no or limited GI symptoms. The management of CCD and a proposed treatment algorithm are also presented.</p>","PeriodicalId":23752,"journal":{"name":"Wounds : a compendium of clinical research and practice","volume":"36 3","pages":"84-89"},"PeriodicalIF":1.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872188","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":"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}

{"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}

{"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":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To conduct a comprehensive review to assess the efficacy of topical phenytoin compared with standard and alternative treatments for different wound types.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To conduct a comprehensive review to assess the efficacy of topical phenytoin compared with standard and alternative treatments for different wound types.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;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}

{"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}