Manchester Royal Infirmary Hospital, Orthopaedics, Manchester, England.
NHS Wales Aneurin Bevan University Health Board, Caerleon, Newport, Wales.
Wounds. 2024 Mar;36(3):90-94. doi: 10.25270/wnds/23102.
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.
To report the use of custom-made NPWT dressings to manage complex infected wounds of the lower limb.
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.
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.
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.
负压伤口疗法(NPWT)已被用于治疗各种伤口。关于使用定制的 NPWT 治疗感染性伤口,证据有限。NPWT 敷料通过增加局部血流量和抗生素浓度以及从伤口中清除渗出物来促进伤口愈合。
报告使用定制的 NPWT 敷料来管理下肢复杂感染性伤口。
作者回顾性审查了印度哥印拜陀 PSG 医学院附属医院 2018 年 1 月 1 日至 2020 年 12 月 31 日期间使用清创术和低成本定制 NPWT 敷料连接到墙壁抽吸治疗的 43 例下肢复杂感染性伤口患者的记录。
共有 43 例下肢感染性伤口患者接受了定制的 NPWT 敷料治疗。5 例患者需要进行二次清创。为了获得最佳的伤口肉芽形成,平均需要更换 5 次敷料,23%(n=10)的患者需要二次缝合,62%(n=27)需要使用皮肤软组织扩张术(STS)来覆盖伤口。6 例患者实现了二期愈合。从开始治疗到伤口准备好接受覆盖(STS 或二次缝合)的平均时间为 2.5 周(范围,1-5 周),完全愈合的平均时间为 5 周(范围,3-7 周)。最常见的伤口分离株是金黄色葡萄球菌(60%)。没有发生并发症。
在复杂的下肢感染性伤口中,使用定制的 NPWT 敷料是安全的。这些敷料保持伤口干燥并促进愈合。NPWT 联合抗生素治疗可协同作用,促进伤口愈合和控制感染。