The Application of Negative Pressure Wound Therapy with Installation in Diabetic Foot Associated with Phlegmon
Languages of publication
The negative pressure wound therapy in the treatment of diabetic foot ulcers was used successfully for many years. In the case of complications associated with infection by this type of wound treatment to give very good results. From many years of sustained research on a device that could combine the advantages of the negative pressure wound therapy and drainage flow. Finally, in the last year, the first V.A.C. Ulta (KCI, USA) devices were included to the Polish hospital departments. In this paper we present a case of a patient of successfully using a negative pressure wound therapy with installation via a set of V.A.C. Ulta in the ischemic diabetic foot syndrome complicated by phlegmon and tissue necrosis. The patient was treated in stages. In first stage was performed angioplasty of critically stenosis of the superficial femoral artery segment. Secondly, the resection of the necrotic bone revised fingers and forefoot was conducted, and in the third step the negative pressure wound therapy with installation was used. Finally, the wound was closed by the intermediate thickness skin graft. The total duration of treatment was 21 days. The patient in good general condition with a completely healed wound was discharged. Currently, after the supply with orthopedic equipment, patient regained full mobility.
1 - 3 - 2015
3 - 7 - 2015
7 - 9 - 2014
- 1. Blume PA, Walters J, Payne W et al.: Comparison of negative pressure wound therapy using vacuum -assisted closure with advanced moist wound therapy in the treatment of diabetic foot ulcers: a multicenter randomized controlled trial. Diabetes Care 2008; 31: 631‑36.
- 2. Wachal K, Łyszyk B, Staniszewski R et al.: The assessment of applying the VAC therapy to patients with ischemic diabetic foot (DF) after necrotic changes around the deep tissues area. Zakażenia 2009; 9: 79‑80, 82‑84
- 3. Brin YS , Mumcuoglu KY , Massarwe S et al.: Chronic foot ulcer management using maggot debridement and topical negative pressure therapy. J Wound Care 2007; 16: 111‑13.
- 4. Edmonds M. The treatment of diabetic foot infections: focus on ertapenem. Vasc Health Risk Manag 2009; 5: 949‑63.
- 5. Back DA, Scheuermann-Poley C, Willy C: Recommendations on negative pressure wound therapy with instillation and antimicrobial solutions - when, where and how to use: what does the evidence show? Int Wound J 2013; 10 Suppl 1: 32‑42.
- 6. Atiyeh BS, Dibo SA, Hayek SN : Wound cleansing, topical antiseptics and wound healing. Int Wound J 2009; 6: 420‑30.
- 7. Scimeca CL , Bharara M, Fisher TK et al.: Novel use of insulin in continuous-instillation negative pressure wound therapy as „wound chemotherapy”. J Diabetes Sci Technol 2010; 4: 820‑24.
- 8. Gabriel A: Integrated negative pressure wound therapy system with volumetric automated fluid instillation in wounds at risk for compromised healing. Int Wound J 2012; 9 Suppl 1: 25‑31.
- 9. Leung B, LaBarbara L, Caroll C et al.: The Effects of Normal Saline Instillation in Conjunction With Negative Pressure Wound Therapy On Healing in a Porcine Model. Wound 2010; 22: 179 87.
- 10. Lessing MC , James RB, Ingram SC : Comparison of the Effects of Different Negative Pressure Wound Therapy Modes-Continuous, Noncontinuous, and With Instillation-on Porcine Excisional Wounds. Eplasty 2013; 13: e51.
- 11. Lessing C, Slack P, Hong K et al.: Negative Pressure Wound Therapy With Controlled Saline Instillation (NPWTi): Dressing Properties and Granulation Response In Vivo. Wound 2011; 23: 309-19.
- 12. Sureshbabu A, Okajima H, Yamanaka D et al.: IGFBP-5 induces epithelial and fibroblast responses consistent with the fibrotic response. Biochem Soc Trans 2009; 37: 882‑85.
- 13. Zhang XJ, Wu X, Wolf SE et al.: Local insulinzinc injection accelerates skin donor site wound healing. J Surg Res 2007; 142: 90‑96.
- 14. Greenway SE , Filler LE , Greenway FL. Topical insulin in wound healing: a randomised, doubleblind, placebo-controlled trial. J Wound Care 1999; 8: 526‑28.
Publication order reference