Singh A, Panda K, Mishra J, Dash A
Department of Orthopaedics, Siksha O Anusandhan University Institute of Medical Sciences and SUM Hospital, Bhubaneswar, India.
Malays Orthop J. 2020 Nov;14(3):129-136. doi: 10.5704/MOJ.2011.020.
The incidence of compound fractures and severe soft tissue loss has increased manifolds due to high speed traffics. Negative Pressure Wound Therapy (NPWT) is a treatment modality for managing soft tissue aspect of such injuries. It reduces the need of flap coverage. However, many patients from developing countries cannot afford a conventional NPWT. We developed an indigenous low cost NPWT for our patients and supplemented it with Topical Pressurised Oxygen Therapy (TPOT). We conducted this study to compare its treatment outcome with the use of conventional NPWT.
The study was conducted from 2018 to 2020 at a tertiary care teaching hospital. A total of 86 patients were treated with NPWT and their results were assessed for various parameters like reduction in wound size, discharge, infection, etc. We included patients with acute traumatic wounds as well as chronic infected wounds, and placed them in three treatment groups to receive either conventional NPWT, Indigenous NPWT and lastly NPWT with supplement TPOT.
We observed a significant reduction of wound size, discharge and infection control in all three groups. The efficacy of indigenous NPWT is at par with conventional NPWT. Only six patients who had several comorbidities required flap coverage while in another four patients we could not achieve desired result due to technical limitations.
Indigenous NPWT with added TPOT is a very potent and cost effective method to control infection and rapid management of severe trauma seen in orthopaedic practice. It also decreases the dependency on plastic surgeons for management of such wounds.
由于高速交通的发展，开放性骨折和严重软组织缺损的发生率成倍增加。负压伤口治疗（NPWT）是处理此类损伤软组织问题的一种治疗方式。它减少了皮瓣覆盖的需求。然而，许多来自发展中国家的患者负担不起传统的NPWT。我们为我们的患者开发了一种本土低成本的NPWT，并辅以局部加压氧疗（TPOT）。我们进行这项研究以比较其与传统NPWT的治疗效果。
该研究于2018年至2020年在一家三级护理教学医院进行。共有86例患者接受了NPWT治疗，并对他们在伤口大小缩小、分泌物、感染等各种参数方面的结果进行了评估。我们纳入了急性创伤性伤口以及慢性感染伤口的患者，并将他们分为三个治疗组，分别接受传统NPWT、本土NPWT，最后一组接受NPWT并辅以TPOT。
我们观察到所有三组的伤口大小、分泌物和感染控制都有显著减少。本土NPWT的疗效与传统NPWT相当。只有6例患有多种合并症的患者需要皮瓣覆盖，而另外4例患者由于技术限制未能达到预期效果。
添加TPOT的本土NPWT是控制感染和快速处理骨科实践中严重创伤的一种非常有效且具有成本效益的方法。它还减少了在处理此类伤口时对整形外科医生的依赖。
