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The Usefulness of Topical Negative Pressure (TNP) As a Supporting Method for the Surgical Treatment of Venous Ulcers with the use of Middle-Split Thickness Skin Graft

100%

Zieliński M., Pukacki F., Oszkinis G., Gabriel M., Waliszewski K., Majewski W.

Polish Journal of Surgery

2008

vol. 80

issue 3

124-131

The most effective method of treatment for venous ulcers resistant to conservative therapy is operation.The surgical procedure consists of resection of the entire ulceration followed by perforated middle-split thickness skin graft transplant. Postoperative treatment requires both long term elevation of the patient's leg and frequent dressing changing.The aim of the study was to assesses the effectiveness of TNP as a method supporting surgical treatment.Material and methods. From 2004 to 2006 in the Poznań Clinic of General and Vascular Surgery of Medical University, 25 patients (16 women and 9 men) were treated for venous ulcers resistant to conservative treatment. The patients' ages varied from 50 to 82 years (average: 69), and the time of ulceration presence ranged from 6 months to 6 years (average: 2 years and 5 months). Patients were divided into two groups: all patients in group I (n=14) underwent surgical treatment with the use of middle split thickness skin grafting, whereas all patients in group II (n=11) underwent surgical treatment with support of TNP - VAC® Subsequent parameters, including the time of hospitalization, time and effectiveness of skin graft healing, and patient's subjective comfort of the therapy, were analyzed.Results. The average hospitalization time was significantly shorter in group II than group I (18 vs 24 days, p<0.0005). The average healing time in group II was significantly shorter than that in group I (31 vs 42 days, p<0.00002). Additional skin grafting was necessary in four cases from group I but none from group II. Subjective therapy comfort was higher among patients from group II than group I.Conclusions. TNP is a useful method supporting the surgical treatment of venous ulcers that are resistant to conservative treatment.

Management of hard-to-heal wounds arising as a result of surgical oncology treatment- usage of the modern wound dressings

75%

Lik P., Nejc D.

Polish Journal of Surgery

2019

vol. 91(1)

10-13

The problem of hard-to-heal wounds concerns 1-1.5% of the total population and about 3% of the population above 60 years of age. The risk factors associated with impaired wound healing are diabetes, arterial and venous insufficiency, advanced atherosclerosis, obesity, and inadequate wound supply. As a result of these pathological processes may develop localized wound infection, disseminated infection, tissue necrosis, and even chronic inflammation carcinogenesis. In the group of patients with malignant tumors, there are wounds arising in the course of the underlying disease and as a result of medical treatment. Wound healing is a significant problem and is often complicated due to the patient’s general condition, comorbidities and complex treatment of cancer, which includes surgery, radiotherapy, and chemotherapy. Radiotherapy used for local-regional control of disease after surgical treatment has a negative effect on healing by causing fibrosis of tissues and blood vessels damage, while chemotherapy interferes with the process of cell proliferation.

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2 Polish Journal of Surgery

1 2019

1 2008

1 Gabriel M.

1 Lik P.

1 Majewski W.

1 Nejc D.

1 Oszkinis G.

1 Pukacki F.

1 Waliszewski K.

1 Zieliński M.

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The Usefulness of Topical Negative Pressure (TNP) As a Supporting Method for the Surgical Treatment of Venous Ulcers with the use of Middle-Split Thickness Skin Graft

Management of hard-to-heal wounds arising as a result of surgical oncology treatment- usage of the modern wound dressings