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定制负压伤口治疗:用于复杂烧伤重建的聚氨酯泡沫创新设计。

Customized Negative Pressure Wound Therapy: Innovative Design in Polyurethane Foam for Complex Burn Reconstruction.

作者信息

Amaris-Acuña Juan Sebastián, Mendoza-Toro Bibiana, Camacho-Obando David, Gómez-Ortega Viviana

机构信息

From Universidad de Los Andes, Bogotá, Colombia.

Burn Unit and Plastic and Reconstructive Surgery Department, Fundación Santa Fé de Bogotá, Bogotá, Colombia.

出版信息

Plast Reconstr Surg Glob Open. 2024 Aug 6;12(8):e6028. doi: 10.1097/GOX.0000000000006028. eCollection 2024 Aug.

Abstract

The use of negative pressure wound therapy (NPWT) throughout the entire treatment of a burn patient boosts wound healing and recovery. Hand burns require specialized management that enhances wound healing and facilitates early physical rehabilitation. Thus, this article showcases a novel idea of NPWT foam customization that boosts recovery and rehabilitation in patients with hand burns. We present two patients with hand burns treated with NPWT using a customized foam design that allowed for early rehabilitation while providing and optimized recovery. In the two cases presented, the patients required two surgical stages; in the first surgery, debridement of the burns was performed and customized NPWT with instillation was applied, and in the second surgical stage, the bed was reconstructed with partial-thickness skin grafts, which were bolstered with customized conventional NPWT. The management, reconstruction, and rehabilitation were accomplished in under 2 weeks, achieving a remarkable 100% success rate in graft integration during the acute phase on the first attempt. This highlights the effectiveness of incorporating NPWT across all burn treatment phases, expediting recovery and ensuring optimal functional outcomes for patients. Surgeons can customize different NPWT foam shapes that facilitate its use on difficult-to-treat areas, allowing for a faster recovery and better rehabilitation outcomes.

摘要

在烧伤患者的整个治疗过程中使用负压伤口治疗(NPWT)可促进伤口愈合和康复。手部烧伤需要专门的管理,以促进伤口愈合并便于早期身体康复。因此,本文展示了一种NPWT泡沫定制的新想法,可促进手部烧伤患者的康复和恢复。我们介绍了两名手部烧伤患者,他们使用定制的泡沫设计接受了NPWT治疗,这种设计在提供优化恢复的同时允许早期康复。在这两个病例中,患者需要两个手术阶段;在第一次手术中,对烧伤进行清创并应用带滴注的定制NPWT,在第二个手术阶段,用部分厚度的皮肤移植重建创面,并用定制的传统NPWT进行支撑。管理、重建和康复在2周内完成,在急性期首次尝试时移植融合成功率达到了显著的100%。这突出了在所有烧伤治疗阶段纳入NPWT的有效性,加快了恢复速度并确保了患者的最佳功能结果。外科医生可以定制不同形状的NPWT泡沫,便于在难以治疗的部位使用,从而实现更快的恢复和更好的康复效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e9eb/11302936/211f6c2067d9/gox-12-e6028-g001.jpg

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