Effectiveness of negative pressure wound therapy in complex surgical treatment of necrotizing fasciitis of the upper limb

BACKGROUND Necrotizing fasciitis(NF)of the upper extremities is a severe surgical pathology,and the incidence of this disease has been steadily increasing in recent decades.Surgical treatment is accompanied by the formation of extensive wounds,which can be treated with significant difficulties.In recent years,negative pressure wound therapy(NPWT)has proven to be highly effective.It is also promising for the treatment of NF.AIM To explore the effectiveness of NPWT in the treatment of NF of the upper extremities.METHODS The results of the treatment of 36 patients with NF of the upper extremities in two groups(NPWT group and control group;2022−2023)were retrospectively analyzed.In the NPWT group,the NPWT method(120 mmHg;constant mode)was used after surgical treatment.The number of vacuum-assisted dressings in patients ranged from 1 to 3,depending on the dynamics of the wound process.The duration of fixation of one bandage was up to 2−3 d.In the control group,conventional methods of local wound treatment were used.The following indicators were analyzed:The treatment delay,the prevalence of inflammation,the microbial landscape,the number of debridements,the duration of wound preparation for surgical closure,and the nature of skin plastic surgery.RESULTS Most patients experienced a significant treatment delay[4 d,interquartile range(IQR):2–7 d],which led to the spread of the pathological process to the forearm and shoulder.The most common pathogens were Staphylococcus aureus(14;38.9%)and Streptococcus pyogenes(22;61.1%).The average number of debridements per patient was 5(IQR:3–7),with no difference between groups.The average time to prepare wounds for surgical closure was 11±4 d in the NPWT group and 29±10 d(P=0.00001)in the control group.In the NPWT group,the wounds were more often closed with local tissues(15;83.3%),and in the control group,split-thickness skin grafts were more often used(4;50%).CONCLUSION The predominant isolation of Staphylococcus aureus and/or Streptococcus pyogenes from the lesions allowed us to classify these patients as NF type II.Multiple debridement procedures have become a feature of this disease treatment.The use of NPWT has significantly reduced the time required to prepare wounds for surgical closure.Early closure of wounds allows for more frequent use of local tissue repair,which ensures better results.NPWT is a highly effective way to prepare wounds for early surgical closure in patients with upper extremity NF.

To investigate the clinical effect of modified closed negative pressure suction technique combined with flap transplantation on the treatment of deep chronic refractory wounds

Objective:To investigate the clinical effect of modified closed negative pressure suction technique combined with flap transplantation on the treatment of deep chronic refractory wounds.Methods:During March of 2015 to April of 2018,52 cases of patients with deep chronic refractory wounds were selected as research objects.They were divided into the control group and the treatment group by use of the random number table method,with 26 cases in each group.Among them,the control group was given conventional debridement combined with flap reconstruction,and the treatment group was treated with modified closed negative pressure suction technique combined with flap transplantation to observe the clinical effect.Results:(1)According to the analysis on the effect of flap transplantation,the excellent and good rate of the treatment group was 92.3%,and in the control group,it was 76.9%(p<0.05).(2)According to the statistics,the incidence of complications in the treatment group was lower than that in the control group(p<0.05).Conclusions:Modified closed negative pressure suction technique combined with flap transplantation has a good effect on the treatment of deep chronic refractory wounds with fewer complications.

Application of apical negative pressure irrigation in the nonsurgical treatment of radicular cysts:A case report

BACKGROUND Radicular cysts are one of the most common odontogenic cystic lesions found in the jaw.Nonsurgical treatment of large radicular cysts is a topic of ongoing debate,and there is still no clear consensus on the most effective therapies.The apical negative pressure irrigation system aspirates the cystic fluid and releases the static pressure in the radicular cyst,representing a minimally invasive approach for decompression.In this case,the radicular cyst was in close proximity to the mandibular nerve canal.We used nonsurgical endodontic treatment with a homemade apical negative pressure irrigation system and the prognosis was good.CASE SUMMARY A 27-year-old male presented to our Department of General Dentistry with complaints of pain in the mandibular right molar when chewing.The patient had no history of drug allergies or systemic disease.A multidisciplinary management approach was designed and included root canal retreatment with a homemade apical negative pressure irrigation system,deep margin elevation and prosthodontic treatment.According to a 1-year follow-up period,the patient showed a favorable outcome.CONCLUSION This report reveals that nonsurgical treatment with an apical negative pressure irrigation system may provide new insights into the treatment of radicular cysts.

Comparison Study of Different Drainage Tube Diameters with Negative Pressure Suction after Valve Replacement Surgery

Objective: This study aims to compare the effects of different drainage tube diameters (22F vs. 26F) combined with negative pressure suction on patients after valve replacement surgery, including postoperative indicators and complications. Methods: A total of 104 patients undergoing valve replacement surgery were included and divided into a 22F group (45 patients) and a 26F group (59 patients). The basic characteristics, postoperative ICU stay duration, drainage duration, postoperative complications, and pain scores were compared between the two groups. All data were analyzed using SPSS statistical software, with p Results: There were no significant differences between the two groups in terms of age, sex, and underlying diseases. The ICU stay duration and drainage duration showed no significant differences (p > 0.05). The total drainage volume in the 22F group was significantly lower than that in the 26F group (225 vs. 380 ml, p = 0.035), and the pain scores on the third postoperative day were also significantly lower in the 22F group (p Conclusion: Compared to the 26F group, patients in the 22F group exhibited less postoperative drainage volume and lower pain scores, suggesting that the 22F drainage tube may have better clinical outcomes after valve replacement surgery.

Slow-pull and different conventional suction techniques in endoscopic ultrasound-guided fine-needle aspiration of pancreatic solid lesions using 22-gauge needles

AIM To evaluate the cytological diagnostic capacity and sample quality of the slow-pull technique and compare them with different suction techniques.METHODS From July 2010 to December 2015, 102 patients with pancreatic solid lesions who underwent endoscopic ultrasound-guided fine-needle aspiration(EUS-FNA) with 22-gauge needles were retrospectively evaluated. EUS-FNA diagnosis was based on a cytological examination, and final diagnosis was based on a comprehensive standard of cytological diagnosis, surgical pathology and clinical or imaging follow-up. Cytological specimens were characterized for cellularity and blood contamination. The cytological diagnostic capacity and sample quality of the slow-pull technique and suction techniques with 5-m L/10-m L/20-m L syringes were analyzed.RESULTS Of all of the EUS-FNA procedures, the slow-pull technique and suction techniques with 5-m L/10-m L/20-m L syringes were used in 31, 19, 34 and 18 procedures, respectively. There were significant differences between these four suction techniques in terms of cytological diagnostic accuracy(90.3% vs 63.2% vs 58.8% vs 55.6%, P = 0.019), sensitivity(88.2% vs 41.7% vs 40.0% vs 36.4%, P = 0.009) and blood contamination(score ≥ 2 for 29.0% vs 52.6% vs 70.6% vs 72.2%, P = 0.003). The accuracy and sensitivity of the slow-pull technique were significantly higher than those of the suction techniques using 5-m L(P = 0.03, P = 0.014), 10-m L(P = 0.005; P = 0.006) and 20-mL syringes(P = 0.01, P = 0.01). Blood contamination was significantly lower in the slow-pull technique than in the suction techniques with 10-m L(P = 0.001) and 20-mL syringes(P = 0.007).CONCLUSION The slow-pull technique may increase the cytological diagnostic accuracy and sensitivity with slight blood contamination during EUS-FNA when using 22-gauge needles for solid pancreatic masses.

Characteristic Test Study on Bearing Capacity of Suction Caisson Foundation Under Vertical Load

Suction caisson foundations are often subjected to vertical uplift loads,but there are still no wide and spread engineering specifications on design and calculation method for uplift bearing capacity of suction caisson foundation.So it is important to establish an uplift failure criterion.In order to study the uplift bearing mechanism and failure mode of suction caisson foundation,a series of model tests were carried out considering the effects of aspect ratio,soil permeability and loading mode.Test results indicate that the residual negative pressure at the top of caisson is beneficial to enhance uplift bearing capacity.The smaller the permeability coefficient is,the higher the residual negative pressure will be.And the residual negative pressure is approximately equal to the water head that causes seepage in the caisson.When the load reaches the ultimate bearing capacity,both the top and bottom negative pressures are smaller than Su and both the top and bottom reverse bearing capacity factors are smaller than 1.0 in soft clay.Combined the uplift bearing characteristics of caisson in sandy soil and soft clay,the bearing capacity composition and the calculation method are proposed.It can provide a reference for the engineering design of suction caisson foundation under vertical load.

Consensus on the application of negative pressure wound therapy of diabetic foot wounds

Because China is becoming an aging society,the incidence of diabetes and diabetic foot have been increasing.Diabetic foot has become one of the main health-related killers due to its high disability and mortality rates.Negative pressure wound therapy(NPWT)is one of the most effective techniques for the treatment of diabetic foot wounds and great progress,both in terms of research and its clinical application,has been made in the last 20 years of its development.However,due to the complex pathogenesis and management of diabetic foot,irregular application of NPWT often leads to complications,such as infection,bleeding and necrosis,that seriously affect its treatment outcomes.In 2020,under the leadership of Burns,Trauma and Tissue Repair Committee of the Cross-Straits Medicine Exchange Association,the writing group for‘Consensus on the application of negative pressure wound therapy of diabetic foot wounds’was established with the participation of scholars from the specialized areas of burns,endocrinology,vascular surgery,orthopedics and wound repair.Drawing on evidence-based practice suggested by the latest clinical research,this consensus proposes the best clinical practice guidelines for the application and prognostic evaluation of NPWT for diabetic foot.The consensus aims to support the formation of standardized treatment schemes that clinicians can refer to when treating cases of diabetic foot.

采空区埋管抽放治理上隅角瓦斯技术研究

为了有效治理上隅角瓦斯超限,针对目前采空区埋管抽放瓦斯浓度低、纯量小的特点,设计了采空区埋管抽放的技术方案,通过现场考察抽放负压与抽放纯量的关系,得出了合理的抽放负值,在此基础上,建立了采空区瓦斯运移的数值计算模型,并通过fluent软件对采空区埋管抽放效果进行了模拟。

VSD负压吸引装置在下肢静脉性溃疡治疗中的疗效观察

目的VSD负压吸引装置在治疗下肢静脉性溃疡中的作用,并探讨其机制。方法选取住院的46例下肢静脉性溃疡患者,采用随机数字表法随机分为2组,每组23例。治疗组用VSD负压吸引护创材料封闭创面,给予持续负压吸引治疗;对照组用纳米银敷料常规包扎换药处理,观察总结两组创面愈合情况及愈合时间。结果治疗组患者治疗有效率明显高于对照组(P<0.05)。治疗组患者创面愈合时间明显短于对照组(P<0.01)。结论VSD持续负压吸引治疗对下肢静脉性溃疡的愈合有明显的促进作用。

移动式、旋流—气浮选污水处理装置

本文介绍了一种新型的双罐污水处理装置的设计思路，该装置的第一密闭罐中有一锥形旋流缸，第二密闭罐是多滤芯沉降过滤罐。该装置的原理是利用污水源的压力，通过一个喷嘴高速喷射产生的负压吸气、液旋流混合浮选，并采用多滤芯方式增大过滤面积，达到高效处理污水的目的。

口腔综合治疗台安装的管路设计

目的:为了便于口腔综合治疗台安装完成后的维护,在安装前对其管路进行设计。方法:对口腔综合治疗台的安装位置、正压管路、集中供排水、负压吸引、电源线路5个方面进行设计。结果:按照该设计方法进行的管路安装,设备运行平稳、使用正常、后期维护方便。结论:良好的管路设计可使口腔综合治疗台安装顺利,使医生的诊疗工作得心应手,也方便今后的维护、检修和更新。

持续低负压吸引治疗手术后胆漏

目的 总结使用低负压吸引器治疗手术后胆漏的经验。方法 自 1994年 5月至 1999年 10月期间 ,应用持续低负压吸引治疗 2 8例手术后胆漏。结果 因胆道疾病行手术的 4130例病人 ,2 8例发生了手术后胆漏并发症 ,均采用低负压吸引技术得到了满意的治疗 ,低负压引流时间平均为 13天 (7～ 2 3天 ) ,疗程平均 2 1天 (15～ 6 2天 ) ,无弥漫胆汁性腹膜炎和继发细菌性腹膜炎 ,无膈下积液及感染 ,无死亡病例。结论 低负压吸引能充分引流胆汁性漏出液 ,具有创伤小 ,低噪音的优点 。

Impact of solution-focused brief therapy and vacuum sealing drainage on mental health of wound care patients

BACKGROUND Improving mental health is crucial for patients who require wound treatment.AIM To analyze the effects of solution-focused brief therapy(SFBT)combined with vacuum sealing drainage on the psychological health of patients undergoing wound treatment,providing a basis for selecting wound treatment protocols.METHODS A total of 102 patients undergoing wound treatment were included,with the study period from March 2020 to March 2024.Sex was not a factor,and patients were randomly assigned to two groups of 51 cases each.The control group received negative pressure wound therapy(NPWT),while the experimental group received NPWT plus SFBT.The recovery of wounds,granulation tissue scores,and psychological health levels were compared between the two groups.Statistical analysis was conducted using SPSS Windows software version 26.0 and GraphPad Prism 8.0.RESULTS Post-treatment,the levels of high-sensitivity C-reactive protein,white blood cell count,and lactate dehydrogenase in the experimental group were significantly lower than those in the control group(P<0.05).The two groups had no significant difference in granulation tissue scores(P<0.05).The psychological health level in the experimental group was significantly higher than in the control group(P<0.05).CONCLUSION The combination of SFBT and NPWT accelerates wound healing,promotes granulation tissue growth,and improves psychological well-being,making it a valuable approach for clinical application.

低压吸引对乳腺癌患者术后积液的预防价值分析

目的探究低压吸引在预防乳腺癌患者术后积液中的价值。方法选取2018年1月至2020年1月滑县人民医院收治的45例乳腺癌患者作为研究对象,根据采用不同的术后吸引方式随机分为探究组23例和常规组22例。探究组术后予以低压吸引,常规组予以常规引流法。比较两组视觉模拟评分(VAS)、恢复时长、并发症发生率等情况。结果探究组治疗3 d、10 d后VAS评分较常规组降低(P<0.05)。探究组引流管留置时间、伤口愈合时间、住院时间较常规组缩短(P<0.05)。探究组总引流量、换药次数、抗生素用量较常规组减少(P<0.05)。探究组术后1个月皮下积液、切口感染、皮瓣坏死等并发症发生率较常规组减少(P<0.05)。结论乳腺癌患者术后予以低压吸引能后明显改善其治疗预后,并能够积极预防积液等不良并发症的出现。

肠瘘采用改良双套管持续冲洗负压吸引治疗的效果探讨

目的探究在肠瘘的治疗中改良双套管持续冲洗负压吸引治疗的临床应用效果。方法整群选取2013年6月—2015年5月在该院治疗的肠瘘患者98例,按照随机分组原则将肠瘘患者分为对照组和治疗组各49例,对照组患者采取常规的单腔引流治疗,治疗组患者则采用改良双套管持续冲洗负压吸引治疗,对比两组患者的治疗相关指标。结果治疗组患者的引流液量、吻合口狭窄发生率、再手术率以及住院时长指标均显著低于对照组,差异有统计学意义(P<0.05)。结论在肠瘘的临床治疗中应用改良双套管进行持续冲洗负压吸引治疗能够显著改善患者的临床治疗效果,优化患者临床相关指标,缩短住院时长,值得在临床上推广应用。

负压吸引系统治疗糖尿病足伴感染的创面修复效果分析

目的分析负压吸引系统治疗糖尿病足伴感染的创面修复效果。方法随机选取2018年11月—2019年11月我院收治的60例糖尿病足伴感染的患者,将其按照简单随机化法均分为对照组和观察组,对照组应用常规治疗,观察组应用负压吸引系统治疗,两组治疗疗效、创面修复面积、不良反应发生率对比。结果两组糖尿病足伴感染的患者治疗前肉芽评分、经皮氧分压检测值、溃疡体积测量值对比,均P>0.05,治疗后观察组肉芽评分、溃疡体积测量值较之前下降幅度及经皮氧分压检测值较之前提高幅度均优于对照组,数据组内、组间对比,P<0.05。结论对糖尿病伴感染患者应用负压吸引系统治疗效果较好,能有效修复其创面,并且不良反应也较少。

顾氏外科“早期置管引流后期负压吸引”治疗深部肛周脓肿临床研究

目的:评价顾氏外科特色疗法"早期置管引后期负压吸引"治疗深部肛周脓肿的疗效和安全性。方法:采用队列研究的方法,自2014年1月至2015年12月分别在上海中医药大学附属龙华医院和温州市中心医院肛肠科治疗的深部肛周脓肿住院患者。观察组采用"早期置管引流后期负压吸引法",对照组采用"切开挂线法"。观察指标包括患者一般情况、实验室和影像学检查、脓肿性质、内口情况、愈合率、愈合时间、脓肿复发及瘘管形成情况等。结果:共59例深部肛周脓肿患者接受手术治疗并完成6月随访,其中观察组29例,平均年龄38.86岁,男/女为26/3,有明显内口者14例。对照组30例,平均年龄43.3岁,男/女为26/4,有明显内口者16例。观察组和对照组经治疗后:总体愈合率51.7%vs 46.7%,平均愈合时间32.8 d vs 43.1 d(P<0.05),脓肿复发率13.8%vs 23.3%,瘘管形成率48.3%vs 53.3%,复杂性肛瘘的发生率24.1%vs.36.7%。2组患者术后Wexner肛门失禁功能评分0.48 vs 1.67(P<0.05)。结论:顾氏外科特色疗法"早期置管引流后期负压吸引"是治疗深部肛周脓肿安全有效的方法,相对经典切开挂线术愈合率和复发率相当,但愈合时间短,对肛门功能保护好。

基于MSP430的数字式拔火罐的设计

火罐是传统中医疗法中最常用的治疗器具,但其古老的操作方法和相对模糊的理论基础阻碍了火罐疗法的继续发展。本文提出了一种新型的“数字火罐”设想。其理论基础是“数字中医理论”,即中医诊断和治疗的“量化”。应用微型、低功耗的单片机MSP430实现了火罐疗法的负压和治疗时间的精确控制。

乳头隆起器矫治乳头内陷的临床应用

目的探讨利用非手术负压吸引疗法矫治乳头内陷。方法对我科自2005年10月至2006年3月30例乳头内陷患者采用非手术负压吸引治疗进行回顾性分析。结果30例均得到随访,随访时间3-6个月,随访期间观察,均获得良好的近期效果,总有效率为100%。结论乳头隆起器用于治疗先天性乳头凹陷临床近期效果满意,是一种美观、安全、有效、痛苦小、并发症少的新技术,值得临床进一步研究和推广。

Management protocol for Fournier’s gangrene in sanitary regime caused by SARS-CoV-2 pandemic:A case report

BACKGROUND Fournier's gangrene(FG)is a serious,aggressive and often deadly polymicrobial infection of the soft tissues of the perineum,the rectum and the external genital organs.It is an anatomical subcategory of necrotizing fasciitis,which has a similar etiology and treatment strategy.CASE SUMMARY A 60-year-old man was admitted to the hospital during severe acute respiratory syndrome coronavirus 2 pandemic with complaints of fever up to 38.9°C,abdominal pain,and edema of the scrotum,the penis,the perineum,and the right gluteal region for 2 d.Computed tomography of the abdomen and the pelvis revealed extensive inflammatory infiltrations of the subcutaneous tissue of the hypogastrium,and the penis;along with liquefaction and presence of gas in the subcutaneous tissues of the scrotum,the perineum,and the right gluteal region.The patient was diagnosed with FG,and was urgently qualified to undergo surgery in the Department of Urology.After performing the necessary examinations,a resection of the necrotic tissues with bilateral orchiectomy and excision of the penile and scrotal skin was performed.After surgery,he was transferred to the intensive care unit for further management.CONCLUSION Early management prevents the resection of the other organs by inhibiting the contiguous spread of infection.