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Negative Pressure Wound Therapy for Necrotizing Fasciitis and Compartment Syndrome of the Upper Extremity — a case report

100%

Enyedi A., Mudriczki G., Bazsó T., Győry F., Susán Z., Damjanovich L., Szentkereszty Z.

Negative Pressure Wound Therapy Journal

2019

vol. 6

issue 1

5-8

Background: Necrotizing fasciitis (NF) is a lifethreateninginfection of the subcutaneous tissues that spreadsalong the underlying fascia. Despite the early and aggressivesurgical fasciotomy and necrectomy, its mortality rate is stillhigh. In NF the negative pressure wound therapy (NPWT)shows good effects on wound healing and on the primary closureof the concomitant extended tissue defects.Case report: A 32-year-old male patient was admitted witha four-day history of fever (39.1C), pain, swelling, erythemaof the right elbow and the upper arm. On admission, extensiveerythema and swelling were seen on the right forearm, arm,and the pectoral region with superficial skin bullae. Based onthe clinical symptoms and laboratory tests immediate surgerywas indicated. Extended fasciotomy and necrosectomy wereperformed on the full extremity and pectoral region. Negativepressure wound therapy was started immediately afterwardwith -120 mmHg concomitantly with antibiotic therapy.Results: After five cycles of NPWT the patient recoveredwithout needing any plastic surgical intervention. The functionaland aesthetic results were excellent.Conclusion: In the case of extended NF of the upper extremitythe aggressive surgery and NPWT are relatively safe andeffective.

Prevention and therapy of acute and chronic wounds using NPWT devices during the COVID-19 pandemic, recommendation from The NPWT Working Group

68%

Banasiewicz T., Becker R., Bobkiewicz A., Fraccalvieri M., Francuzik W., Hutan M., Laukoetter M., Malka M., Mańkowski B., Szentkereszty Z., Toth C., Veverkov L., Karlakki S., Murphy J., Maciej Z.

Negative Pressure Wound Therapy Journal

2020

vol. 7

issue 2

4-9

Recent SARS-CoV-2 pandemic leading to a rapidly increasing number of hospitalizations enforced reevaluation of wound management strategies. The optimal treatment strategy for patients with chronic wounds and those recovering from emergency and urgent oncological surgery should aim to minimize the number of hospital admissions, as well as the number of surgical procedures and decrease the length of stay to disburden the hospital staff and to minimize viral infection risk. One of the potential solutions that could help to achieve these goals may be the extensive and early use of NPWT devices in the prevention of wound healing complications. Single-use NPWT devices are helpful in outpatient wound treatment and SSI prevention (ciNPWT) allowing to minimize in-person visits to the health care center while still providing the best possible wound-care. Stationary NPWT should be used in deep SSI and perioperative wound healing disorders as soon as possible. Patient’s education and telemedical support with visual wound healing monitoring and video conversations have the potential to minimize the number of unnecessary in-person visits in patients with wounds and therefore substantially increase the level of care.

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2 Negative Pressure Wound Therapy Journal

1 2020

1 2019

2 Szentkereszty Z.

1 Banasiewicz T.

1 Bazsó T.

1 Becker R.

1 Bobkiewicz A.

1 Damjanovich L.

1 Enyedi A.

1 Fraccalvieri M.

1 Francuzik W.

1 Győry F.

1 Hutan M.

1 Karlakki S.

1 Laukoetter M.

1 Maciej Z.

1 Malka M.

1 Mańkowski B.

1 Mudriczki G.

1 Murphy J.

1 Susán Z.

1 Toth C.

1 Veverkov L.

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Negative Pressure Wound Therapy for Necrotizing Fasciitis and Compartment Syndrome of the Upper Extremity — a case report

Prevention and therapy of acute and chronic wounds using NPWT devices during the COVID-19 pandemic, recommendation from The NPWT Working Group