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.

Negative Pressure Wound Therapy—An Effective, Minimally Invasive Therapeutic Modality in Burn Wound Management

Despite the advancement in burn therapy in the last decades the treatment of burn wounds still remains a challenging task. Infection is still a common complication;while sepsis remains the leading cause of death in severe burns. The research guided integration of new and effective techniques in burn wound management is mandatory. Negative pressure wound therapy (NPWT) is an effective and widely used technique in the management of problematic wounds. Previously existing indications include soft tissue traumas and chronic wounds such as diabetic, arterial, venous and pressure ulcers. The characteristics and challenges of these wounds have a lot in common with burns. Since the early 2000’s there are experiences with the use of NPWT for the healing of second degree burn wounds. Our clinical experience shows that it is a minimally invasive and effective way of improving burn wound management. In this article we give a review of the literature showing the mechanisms, unmapped future opportunities, financial issues, and possible adverse effects of NPWT in burn therapy.

Evaluation of the effectiveness of preventive nursing measures for pressure injuries in patients in the neurology intensive care unit

BACKGROUND Patients in neurology intensive care units(ICU)are prone to pressure injuries(PU)due to factors such as severe illness,long-term bed rest,and physiological dysfunction.PU not only causes pain and complications to patients,but also increases medical burden,prolongs hospitalization time,and affects the recovery process.AIM To evaluate and optimize the effectiveness of pressure injury prevention nursing measures in neurology ICU patients.METHODS A retrospective study was conducted,and 60 patients who were admitted to the ICU of the Department of Neurology were selected and divided into an observation group and a control group according to the order of admission,with 30 people in each group.The observation group implemented pressure injury prevention and nursing measures,while the control group adopted routine care.RESULTS Comparison between observation and control groups following pressure injury prevention nursing intervention revealed significantly lower incidence rates in the observation group compared to the control group at 48 h(8.3%vs 26.7%),7 d(16.7%vs 43.3%),and 14 d(20.0%vs 50.0%).This suggests a substantial reduction in pressure injury incidence in the observation group,with the gap widening over time.Additionally,patients in the observation group exhibited quicker recovery,with a shorter average time to get out of bed(48 h vs 72 h)and a shorter average length of stay(12 d vs 15 d)compared to the control group.Furthermore,post-intervention,patients in the observation group reported significantly improved quality of life scores,including higher scores in body satisfaction,feeling and function,and comfort(both psychological and physiological),indicating enhanced overall well-being and comfort following the implementation of pressure injury prevention nursing measures.CONCLUSION Implementing pressure injury preventive care measures for neurology ICU patients will have better results.

Negative pressure device-assisted autologous fat grafting: A case report

This report describes a novel technique for improving depressed scars using negative pressure suction-assisted autologous fat grafting.A 35-year-old woman presented with a 20-year history of bilateral central buttock con-cavities,causing aesthetic concerns.To maximize fat graft survival and enhance tissue volume,we implemented intermittent negative pressure suction on the recipient area for one month preoperatively.The patient expressed satisfaction with the cosmetic outcome,and a three-month follow-up confirmed a significantly improved fat graft survival rate.This minimally invasive,cost-effective,and easily reproducible technique offers a promising clinical strategy for treating depressed scars.

Value of negative pressure sealing drainage on wound healing of Gustilo IIIB and IIIC open fractures

BACKGROUND Gustilo III fractures have a high incidence and are difficult to treat.Patients often experience difficulty in wound healing.Negative pressure drainage technology can help shorten wound healing time and has positive value in improving patient prognosis.AIM To explore the clinical value of the negative pressure sealing drainage technique in wound healing of Gustilo IIIB and IIIC open fractures.METHODS Eighty patients with Gustilo IIIB and IIIC open fractures with skin and soft tissue injuries who were treated in the Second People’s Hospital of Dalian from March 2019 to December 2021 were selected as the research subjects.They were divided into a study group(n=40,healed with negative pressure closed drainage)and a control group(n=40,healed with conventional dressing changes)according to the variation in the healing they received.The efficacy of the clinical interventions,the variations in the regression indicators(time to wound healing,time to fracture healing,time to hospitalization),and the conversion and healing of bacterial wounds were compared 1-3 mo after the intervention.RESULTS The total effective rate of patients among the study group was 95.00%(38/40),which was notably higher than 75.00%(30/40)among the control group(P<0.05).The wound healing time,fracture healing time,and hospital stay of the patients in the study group was shorter than the control group(P<0.05).After the intervention,the negative bacterial culture at the wound site rate and wound healing rate of the patients among the study group increased compared to the control group(P<0.05).CONCLUSION Negative pressure sealing and drainage technology has a good therapeutic effect on patients with Gustilo IIIB and IIIC open fracture wounds with skin and soft tissue injury.It can notably enhance the wound healing rate and the negative rate of bacteria on the wound surface and help to speed up the recovery process of patients.

Micro-power negative pressure wound technique reduces risk of incision infection following loop ileostomy closure

BACKGROUND Prophylactic loop ileostomy is an effective way to reduce the clinical severity of anastomotic leakage following radical resection of rectal cancer.Incisional surgical site infection(SSI)is a common complication after ileostomy closure.AIM To evaluate the efficacy and safety of the micro-power negative pressure wound technique(MPNPWT)in preventing incisional SSI.METHODS This was a prospective,randomized controlled clinical trial conducted at a single center.A total of 101 consecutive patients who underwent ileostomy closure after rectal cancer surgery with a prophylactic ileostomy were enrolled from January 2019 to December 2021.Patients were randomly allocated into an MPNPWT group and a control group.The MPNPWT group underwent intermittent suturing of the surgical incision with 2-0 Prolene and was covered with a micro-power negative pressure dressing.The surgical outcomes were compared between the MPNPWT(n=50)and control(n=51)groups.Risk factors for incisional SSI were identified using logistic regression.RESULTS There were no differences in baseline characteristics between the MPNPWT(n=50)and control groups(n=51).The incisional SSI rate was significantly higher in the control group than in the MPNPWT group(15.7%vs 2.0%,P=0.031).However,MPNPWT did not affect other surgical outcomes,including intra-abdominal complications,operative time,and blood loss.Postoperative hospital stay length and hospitalization costs did not differ significantly between the two groups(P=0.069 and 0.843,respectively).None of the patients experienced adverse effects of MPNPWT,including skin allergy,dermatitis,and pain.MPNPWT also helped heal the infected incision.Our study indicated that MPNPWT was an independent protective factor[odds ratio(OR)=0.005,P=0.025)]and diabetes was a risk factor(OR=26.575,P=0.029)for incisional SSI.CONCLUSION MPNPWT is an effective and safe way to prevent incisional SSI after loop ileostomy closure.

Biosorption effects of copper ions on Candida utilis under negative pressure cavitation

Under the optimal condition of copper ions adsorption on yeast,we found some different effects among static adsorption, shaking adsorption and negative pressure cavitation adsorption, and the methods of yeast with different pretreatments also affect adsorption of copper ions. At the same time, the change of intercellular pH before and after adsorption of copper with BCECF was studied. The copper distribution was located by using PhenGreen （dipotassium salt and diacetate）, and the surface of yeast was observed by an atomic force microscope. The results showed that negative pressure cavitation can improve bioadsorption capacity of copper ions on yeast. However, the yeasts＇ pretreatment has a higher effect on bioadsorption. It indicates that heavy metal bioadsorption on yeast has much relation with its cellular molecule basis. With the adsorping, the intercellular pH of yeast increased gradually and changed from acidity to alkalescence. These results may suggest that negative pressure cavitation can compel heavy metals to transfer from the cell surface into inside cell and make the surface of yeast coarse.

Effect of continuous negative pressure water supply on the growth, development and physiological mechanism of Capsicum annuum L.

Effects of continuous negative pressure water supply on water consumption, growth and development, as well as physiological mechanism and quality of Capsicum annuum L. were investigated in this paper. Meanwhile, the optimal negative pressure water supply conditions for growth of C. annuum L. were screened out to achieve the goals of water conservation, high yield and high quality, thus providing theoretical foundation for its field production. The pot experiment within the greenhouse was utilized; the continuous negative pressure water supply was adopted; the four treatments, artificial watering（CK）, –5 k Pa（T1）, –10 k Pa（T2）, and –15 k Pa（T3） were set; and the daily water consumption, yield, as well as the biomass, nitrate reductase, root activity, vitamin C, capsaicin, and nutrient uptakes of nitrogen（N）, phosphorus（P） and potassium（K） during various stages of its growth were determined. Compared with CK, when the water supply pressure was controlled at –5 to –15 k Pa in the experiment, the total water consumption of C. annuum L. reduced by 53.42 to 67.75%, the total water consumption intensity reduced by 54.29 to 67.14%, and the water use efficiency increased by 12.66 to 124.67%. The N accumulation in a single strain of C. annuum L. from the color turning stage to the red ripe stage increased by 15.99 to 100.55%, respectively, compared with that of CK; the P accumulation increased by 20.47 to 154.00% relative to that of CK, and the K accumulation increased by 64.92 to 144.9% compared with that of CK. Compared with CK, C. annuum L. yield was remarkably improved by 13.79% at T1, and contents of vitamin C, capsaicin as well as carotenoids at all growth stages were enhanced by 13.42–147.01%, 11.54–71.01%, and 41.1–568.06%, respectively. Nitrate reductase activity, root activity and chlorophyll（a＋b） were markedly increased by 335.78–500%, 79.6–140.68% and 114.95–676.19%, respectively, from immature stage to full ripe stage. Adopting the continuous negative pressure water supply for C. annuum L. has a significant water-saving effect, and the water supply pressure being stable at –5 k Pa contributes to its growth and development, improves yield, enhances root activity, promotes nutrient uptake, and improves its quality, thus achieving the effects of water conservation, high yield, high quality and high efficiency.

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.

The Negative Thermal Expansion Property of NdMnO_(3) Based on Pores Effect and Phase Transition

A novel negative thermal expansion(NTE) material NdMnO_(3) was synthesized by solid-state method at 1 523 K. The crystal structure, phase transition, pores effect and negative expansion properties of NdMnO_(3) were investigated by variable temperature X-ray diffraction(XRD), scanning electron microscope(SEM) and variable temperature Raman spectra. The compound exhibits NTE properties in the orderly O' phase crystal structure. When the temperature is from 293 to 759 K, the ceramic NdMnO_(3) shows negative thermal expansion of-4.7×10^(-6)/K. As temperature increases, the ceramic NdMnO_(3) presents NTE property range from 759 to 1 007 K. The average linear expansion coefficient is-18.88×10^(-6)/K. The physical mechanism of NTE is discussed and clarified through experiments.

Analysis of impact pressure,rock-breaking effect,and ground vibration induced by the disposable CO_(2)fracturing tube

The technology of expansion fracturing with liquid CO_(2)(EFLCO_(2))has attracted increasing attention due to reduced vibration and damage.The disposable fracturing tube has been developed and is gradually replacing the Cardox tube.However,there is a lack of impact pressure testing of disposable tubes under real working conditions,selection of gas explosion design parameters,and systematic analysis of blasting vibration.This limitation has constrained the widespread application of disposable fracturing tubes in engineering.A joint monitoring of the pressure-time curves in the disposable tubes and boreholes was conducted.The rock-breaking effect of varying hole spacing parameters in the EFLCO_(2)design was analyzed,and a systematic study was carried out on the vibration peak value,frequency,and energy characteristics.The results show that(1)the pressure distribution characteristics,stress peak value,and duration in the disposable tubes are different from those of Cardox tubes,which show multi-peak distribution,low-pressure peak value,and short duration.The correlation between the pressure in the disposable tube,filling pressure,and liquid CO_(2)weight is established,and a theoretical calculation method for the borehole wall pressure is proposed;(2)The hole spacing in rocks of different hardness is suggested;and(3)At the same scale distance,the peak particle velocity(PPV)caused by EFLCO_(2)(PPVCO_(2))is significantly smaller than that caused by blasting(PPVexplosive).The ratio of PPVexplosive to PPVCO_(2)is a power function related to scale distance,and a distance-related zonality exist in this relationship.The frequency composition of the vibration signal caused by EFLCO_(2)is relatively simple with a narrow frequency band.Its PPV and energy are mainly concentrated in the low-frequency band.This research contributes to the optimization of disposable fracturing tubes,gas explosion design,and vibration hazard control.

The effective pressure law for permeability of clay-rich sandstones

To study the relative sensitivity of permeability to pore pressure Pp and confining pressure Pc for clay-rich rocks, permeability measurements were performed on samples of four clay-rich sandstones. A new method （hereafter denoted the ＂slide method＂） was developed and used for analyzing the permeability data obtained. The effective pressure coefficients for permeability nk were calculated. The values of nk were found to be greater than 1.0 and insensitive to changes in pressure. These results confirmed observations previously made on clay-rich rocks. Also, the coefficients nk obtained had different characteristics for different samples because of differences in the types of clay they contained. The effective pressure law （σeff=Pc-nkPp） determined using the slide method gave better results about k（oefr） than classic Terzaghi＇s law （σeff=Pc-nkPp）.

Mechanical analysis of effective pressure relief protection range of upper protective seam mining

This paper analyzes the control mechanism of coal and gas outbursts and proposes the concept of an effective pressure relief protection range, based on the stress relief of the underlying coal-rock mass and the development of a plastic zone. Also this study developed a stress change and fracture development model of the underlying coal-rock mass. In addition, the stress and depth of fracture of any point in the floor were deduced with the application of Maple Calculation Software. The specific engineering parameters of the Pingdingshan No. 12 colliery were applied to determine the relationship between the depth of fracture in the floor and the mining height. The pressure-relief principle of the underlying coal-rock mass was analyzed while varying the mining height of the upper protective seam. The findings indicate that as the depth of fracture in the floor increases, the underlying coal-rock mass experiences a limited amount of pressure relief, and the pressure relief protection range becomes narrower.Additionally, the stress distribution evolves from a ‘‘U" shape into a ‘‘V" shape. A 2.0 m mining height of protective seam situates the outburst-prone seam, Ji_(15), within the effective pressure relief protection range. The fracture development and stress-relief ratio rises to 88%, ensuring the pressure-relief effect as well as economic benefits. The measurement data show that: after mining the upper protective seam, the gas pressure of Ji_(15) dropped from 1.78 to 0.35 MPa, demonstrating agreement between the engineering application and the theoretical calculation.

Management of negative pressure wound therapy in the treatment of diabetic foot ulcers

Diabetic foot(DF) is a common complication of diabetes and the first cause of hospital admission in diabetic patients. In recent years several guidelines have been proposed to reinforce the the management of DF with a notable increase in diabetes knowledge and an overall reduction of amputations. Significant improvements have been reached in the treatment of diabetic foot ulcers(DFUs) and nowadays clinicians have several advanced medications to apply for the best local therapy. Among these, negative pressure wound therapy(NPWT) is a useful adjunct in the management of chronic and complex wounds to promote healing and wound bed preparation for surgical procedures such as skin grafts and flap surgery. NPWT has shown remarkable results although its mechanisms of action are not completely understood. In this paper, we offer a complete overview of this medication and its implication in the clinical setting. We have examined literature related to NPWT concerning human, animal and in vitro studies, and we have summarized why, when and how we can use NPWT to treat DFUs. Further we have associated our clinical experience to scientific evidence in the field of diabetic foot to identify a defined strategy that could guide clinician in the use of NPWT approaching to DFUs.

On the dissipation of negative excess porewater pressure induced by excavation in soft soil

Unloading induces negative excess porewater pressure in soil mass around a foundation pit during excavation. In this work, the dissipation rule of negative excess porewater pressure after excavation was studied. Analytical formulas for calculating the negative excess porewater pressures and the effective stresses were derived based on one-dimensional consolidation theory and Terzaghi’s effective stress principle. The influence of the dissipation of negative excess porewater pressure on earth pressure inside and outside a foundation pit and the stability of the retaining structure were analyzed through a numerical example. It was indicated that the dissipation of negative excess porewater pressure is harmful to the stability of the retaining structure and that rapid construction can make full use of the negative porewater pressure.

Asymmetric Fuzzy Control of a Positive and Negative Pneumatic Pressure Servo System

The pneumatic pressure control systems have been used in some fields. However, the researches on pneumatic pressure control mainly focus on constant pressure regulation. Poor dynamic characteristics and strong nonlinearity of such systems limit its application in the field of pressure tracking control. In order to meet the demand of generating dynamic pressure signal in the application of the hardware-in-the-loop simulation of aerospace engineering, a positive and negative pneumatic pressure servo system is provided to implement dynamic adjustment of sealed chamber pressure. A mathematical model is established with simulation and experiment being implemented afterwards to discuss the characteristics of the system, which shows serious asymmetry in the process of charging and discharging. Based on the analysis of the system dynamics, a fuzzy proportional integral derivative （PID） controller with asymmetric fuzzy compensator is proposed. Different from conventional adjusting mecha- nisms employing the error and change in error of the controlled variable as input parameters, the current cham- ber pressure and charging or discharging state are chosen as inputs of the compensator, which improves adaptability. To verify the effectiveness and performance of the pro- posed controller, the comparison experiments tracking sinusoidal and square wave commands are conducted. Experimental results show that the proposed controller can obtain better dynamic performance and relatively consis- tent control performance across the scope of work （2-140 kPa）. The research proposes a fuzzy control method to overcome asymmetry and enhance adaptability for the positive and negative pneumatic pressure servo system.

Water and salt movement in different soil textures under various negative irrigating pressures

supported by the National High-Tech R＆D Program of China （2013AA102901）

Airtight negative pressure dust-control technology and application of transpersite in the coal conveyer belt system

Presented a new coal dust control program that was airtight negative pressure dust-control technology at the transpersite,combining with analysis with the movement of air currents and numerical simulation of gas-solid flow at the transpersite,and proved the mechanism of precipitation and proliferation for coal dust-controlt in theory.The technol- ogy has made good economic results at the Heidaigou Clean Plant,not only dust concen- tration control within 10 mg/m^3 to the work site,but also substantial energy savings and cost savings.

Time-series analysis of the characteristic pressure fluctuations in a conical fluidized bed with negative pressure

The negative pressure conical fluidized bed is widely used in the pharmaceutical industry.In this study,experiments based on the negative pressure conical fluidized bed are carried out by changing the material mass and particle size.The pressure fluctuation signals are analyzed by the time and the frequency domain methods.A method for absolutely characterizing the degree of the energy concentration at the main frequency is proposed,where the calculation is to divide the original power spectrum by the average signal power.A phenomenon where the gas velocity curve temporarily stops growing is observed when the material mass is light,and the particle size is small.The standard deviation and kurtosis both rapidly change at the minimum fluidization velocity and thus can be used to determine the flow regime,and the variation rule of the kurtosis is independent of both the material mass and particle size.In the initial fluidization stage,the dominant pressure signal comes from the material movement;with the increase in the gas velocity,the power of a 2.5 Hz signal continues to increase.A method of dividing the main frequency by the average cycle frequency can conveniently determine the fluidized state,and a novel concept called stable fluidized zone proposed in this paper can be obtained.Controlling the gas velocity within the stable fluidized zone ensures that the fluidized bed consistently remains in a stable fluidized state.

Negative Pressure Consolidation of Silt Inside Bucket Foundation

A series of model experiments of bucket foundations concerning suction installation and negative pressure consolidation in saturated silt were carried out in a cube steel bin at Tianjin University. The experimental results show that the silt inside the bucket has been strengthened by negative pressure, and the strengthening effect decreases with the increase of the distance from the bucket. A three-dimensional numerical model of the experiments was built by means of finite element software ABAQUS with fluid-solid coupling method. The results show that the bearing capacity of the silt inside the bucket foundation increases significantly at the former stage of negative pressure consolidation, while the increasing trend slows down over time. The rotation centers of the bucket foundation and the inner soil region tend to be closer to each other based on the consolidation. The bearing capacity of the bucket foundation is improved effectively with the increase of soil strength. The effects of negative pressure consolidation on the bearing capacity of bucket foundation were also illustrated by an actual offshore wind power project case.