Driver Rita K
Advanced Wound Healing Center, Jackson Purchase Medical Center.
Cureus. 2016 Nov 30;8(11):e903. doi: 10.7759/cureus.903.
Mankind has always suffered wounds throughout time due to trauma, disease, and lifestyles. Many wounds are non-healing and have continued to be challenging. However, utilizing advanced wound care treatments, such as negative pressure wound treatment with instillation and dwell time (NPWTi-d), has proven beneficial. NPWTi-d is indicated in a variety of wounds, such as trauma, surgical, acute, pressure injuries, diabetic foot ulcers, and venous leg ulcers. Bacteria and bioburden interrupts wound healing by increasing the metabolic needs, ingesting, and robbing the necessary nutrients and oxygen. Instillation therapy is the technique of intermittently washing out a wound with a liquid solution. The mechanism of action is instilling fluid into the wound bed, soaking for a determined time, loosening and cleaning of exudate, contaminants, and/or infection, removing fluid via negative pressure, thus promoting tissue growth.
The patient was diagnosed with a large lymphedema mass on the right upper thigh. Surgical removal of the lymphedema mass was indicated due to interference with quality of life. After a failed flap and surgical debridement, NPWTi-d with normal saline was implemented.
The patient had excellent results, with obvious forming of red, beefy granulation, epithelization tissue development, and a cleaner, healthier wound bed. Settings for the NPWTi-d was 18 minutes dwell time, every 2.5 hours with a constant pressure of 125 mm/hg pressure.
The NPWTi-d demonstrated to be an instrumental treatment in supporting and stimulating healing. Early application of the treatment with normal saline as the instillation fluid prepared the previously failed wound for quicker healing.
长期以来，人类一直因创伤、疾病和生活方式而受伤。许多伤口无法愈合，一直具有挑战性。然而，采用先进的伤口护理治疗方法，如带灌洗和驻留时间的负压伤口治疗（NPWTi-d），已被证明是有益的。NPWTi-d适用于多种伤口，如创伤、手术、急性、压力性损伤、糖尿病足溃疡和下肢静脉溃疡。细菌和生物负荷通过增加代谢需求、摄取和抢夺必要的营养物质和氧气来干扰伤口愈合。灌洗疗法是用液体溶液间歇性冲洗伤口的技术。其作用机制是将液体注入伤口床，浸泡一段确定的时间，松开并清除渗出物、污染物和/或感染物，通过负压排出液体，从而促进组织生长。
该患者被诊断为右上大腿有一个巨大的淋巴水肿肿块。由于影响生活质量，建议手术切除淋巴水肿肿块。在皮瓣手术和手术清创失败后，采用生理盐水进行NPWTi-d治疗。
患者取得了良好的效果，明显形成了红色、饱满的肉芽组织，上皮化组织发育良好，伤口床更清洁、更健康。NPWTi-d的设置为驻留时间18分钟，每2.5小时一次，恒定压力为125毫米汞柱。
NPWTi-d被证明是支持和刺激愈合的一种有效治疗方法。早期使用生理盐水作为灌洗液进行治疗，为先前愈合失败的伤口更快愈合做好了准备。
