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. 2010 Jan 8:10:e9.

Wound chemotherapy by the use of negative pressure wound therapy and infusion

Nicholas A Giovinco  1 , Trung D Bui, Timothy Fisher, Joseph L Mills, David G Armstrong
Affiliations

Wound chemotherapy by the use of negative pressure wound therapy and infusion

Nicholas A Giovinco et al. Eplasty. .

Abstract

Introduction: Although the use of negative pressure wound therapy (NPWT) is broadly efficacious, it may foster some potentially adverse complications. This is particularly true in patients with diabetes who have a wound colonized with aerobic organisms. Traditional antiseptics have been proven useful to combat such bacteria but require removal of some NPWT devices to be effective.

Methods: In this article, we describe a method of "wound chemotherapy" by combining NPWT and a continuous infusion of Dakins' 0.5% solution either as a standardized technique in one device (ITI Sved) or as a modification of standard technique in another (KCI VAC) NPWT device. The twin goals of both techniques are to effectively reduce bacterial burden and to promote progressive wound healing.

Results: We present several representative case examples of our provisional experience with continuous streaming therapy through 2 foam-based negative pressure devices.

Discussion: Wound chemotherapy was successfully applied to patients with diabetes, without adverse reactions, complications, or recolonization during the course of treatment. We believe this to be a promising method to derive the benefits of NPWT without the frequent adverse sequela of wound colonization.

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Figures

Figure 1
Figure 1
Four images to exemplify the devices, dressings, and modifications used in this study. (a) ITI Sved foam dressing with an infusion and drainage port; (b) a modified KCI VAC dressing with an intravenous (IV) pump infusion catheter; (c) KCI VAC with Sved infusion catheter; and (d) a modified KCI VAC foam dressing with an IV pump infusion catheter.
Figure 2
Figure 2
Examples of cases 1 to 4 before wound chemotherapy treatment: (a) case 1; (b) case 2; (c) case 3; and (d) case 4.
Figure 3
Figure 3
Examples of cases 1 to 4 after wound chemotherapy treatment for the number of followed days: (a) case 1; (b) case 2; (c) case 3; and (d) case 4.
Figure 4
Figure 4
A 3-step method for the modification of a standard VAC foam dressing with a standard disposable suture removal kit. (a) Step 1: The initial slit in the dressing using scissors and countersinking of underlying foam using tweezers to accommodate the interface of the intravenous (IV) tubing. (b) Step 2: Insertion of the IV tubing interface into the foam through the covering dressing. (c) Step 3: The application of dressing seal around the IV tubing.
See this image and copyright information in PMC

References

    1. Armstrong DG, Attinger CE, Boulton AJ, et al. Guidelines regarding negative wound therapy (NPWT) in the diabetic foot. Ostomy Wound Manage. 2004;50(4B suppl):3S–27S. - PubMed
    1. Wu SC, Armstrong DG. Clinical outcome of diabetic foot ulcers treated with negative pressure wound therapy and the transition from acute care to home care. Int Wound J. 2008;5(suppl 2):10–16. - PMC - PubMed
    1. Armstrong DG, Lavery LA. Negative pressure wound therapy after partial diabetic foot amputation: a multicentre, randomised controlled trial. Lancet. 2005;366(9498):1704–10. - PubMed
    1. Vikatmaa P, Juutilainen V, Kuukasjarvi P, Malmivaara A. Negative pressure wound therapy: a systematic review on effectiveness and safety. Eur J Vasc Endovasc Surg. 2008;36(4):438–48. - PubMed
    1. Payne JL, Ambrosio AM. Evaluation of an antimicrobial silver foam dressing for use with V.A.C. therapy: morphological, mechanical, and antimicrobial properties. J Biomed Mater Res B Appl Biomater. 2009;89(1):217–22. - PubMed

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