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...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.展开更多
Background: Septic open abdomens occur in trauma, burn and surgery. Currently, multiple concentrations of hypochlorous acid solutions have effectively decreased the microbiotic burden in wounds. We hypothesized that V...Background: Septic open abdomens occur in trauma, burn and surgery. Currently, multiple concentrations of hypochlorous acid solutions have effectively decreased the microbiotic burden in wounds. We hypothesized that Vashe?, a neutral hypochlorous acid solution (V-HOCL), would be safe as an intraperitoneal irrigation or washout disinfectant for septic open abdomens utilizing negative pressure wound therapy. Methods: This is a retrospective observational review of patients who required delayed abdominal closures after exploratory laparotomies. Group A (n = 8) had cyclical V-HOCL irrigation to their open abdomens combining AbtheraTM and V.A.C. Dressing System for negative pressure wound therapy with irrigation (NPWT-i) and Group B (n = 9) had intra-abdominal V-HOCL washouts. Results: Fifty percent of both groups had either septic or hemorrhagic shock on admission. Compared to Group B, Group A patients were older (median 50 vs 37 years), and had a median hospitalization of 28 vs 8 days, 4 times as many operations, more acute renal failure and co-morbidities. No statistically significant differences were detected be-tween the two treatment methods with the V-HOCL delivery and removal. Conclusion: There were no episodes of electrolyte imbalance, hypotension, hypertension, anaphylaxis, hemorrhage, visceral injury or systemic toxicity. V-HOCL with/without NPWT-i irrigation was a safe modality and tolerated well in this study.展开更多
The so-called 'burst abdomen' has been described for many years and is a well-known clinical condition, whereas the concept of the 'open abdomen' is relatively new. In clinical practice, both nosologic...The so-called 'burst abdomen' has been described for many years and is a well-known clinical condition, whereas the concept of the 'open abdomen' is relatively new. In clinical practice, both nosological entities are characterized by a complex spectrum of symptoms apparently disconnected, which in many cases poses a great challenge for surgical repair. In order to assess the management of these disorders in a more comprehensive and integral fashion, the concept of 'acute postoperative open abdominal wall'(acute POAW) is presented, which in turn can be divided into 'intentional' or planned acute POAW and 'unintentional' or unplanned POAW. The understanding of the acute POAW as a single clinical process not only allows a better optimization of the ther-apeutic approach in the surgical repair of abdominal wallrelated disorders, but also the stratification and collection of data in different patient subsets, favoring a better knowledge of the wide spectrum of conditions involved in the surgical reconstruction of the abdominal wall.展开更多
The use of open abdomen(OA) as a technique in the treatment of exsanguinating trauma patients was first described in the mid-19 th century. Since the 1980 s, OA has become a relatively new and increasingly common stra...The use of open abdomen(OA) as a technique in the treatment of exsanguinating trauma patients was first described in the mid-19 th century. Since the 1980 s, OA has become a relatively new and increasingly common strategy to manage massive trauma and abdominal catastrophes. OA has been proven to help reduce the mortality of trauma. Nevertheless, the OA method may be associated with terrible and devastating complications such as enteroatmospheric fistula(EAF). As a result, OA should not be overused, and attention should be given to critical care as well as special management. The temporary abdominal closure(TAC) technique after abbreviated laparotomy was used to improve wound healing and facilitate final fascial closure of OA. Negative pressure therapy(NPT) is the most commonly used TAC method.展开更多
目的观察不同负压值的伤口负压吸引术(negative pressure wound therapy,NPWT)应用于开放性腹部伤口治疗中小肠壁出血面积变化。方法将12头家猪做正中切口,采用随机数字表法分为3组。分别行负压值为-50 mm Hg(A组)、-125 mm Hg(B组)及-2...目的观察不同负压值的伤口负压吸引术(negative pressure wound therapy,NPWT)应用于开放性腹部伤口治疗中小肠壁出血面积变化。方法将12头家猪做正中切口,采用随机数字表法分为3组。分别行负压值为-50 mm Hg(A组)、-125 mm Hg(B组)及-200 mm Hg(C组)的NPWT,持续NPWT 12、24、48 h后对小肠壁出血面积的变化分别进行拍照和量化。结果持续NPWT 12、24和48 h后小肠表面出血面积C组>B组>A组,差异有统计学意义(P<0.05﹚。结论负压值的大小与小肠壁出血面积的大小呈正向直线相关,实验中三组比较得出负压值为-125 mm Hg的NPWT具有较好的引流效果时,对小肠损伤较小。展开更多
基金the Review Committee of Fuzhou Medical College of Nanchang University(Approval No.4445644).
文摘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.
文摘Background: Septic open abdomens occur in trauma, burn and surgery. Currently, multiple concentrations of hypochlorous acid solutions have effectively decreased the microbiotic burden in wounds. We hypothesized that Vashe?, a neutral hypochlorous acid solution (V-HOCL), would be safe as an intraperitoneal irrigation or washout disinfectant for septic open abdomens utilizing negative pressure wound therapy. Methods: This is a retrospective observational review of patients who required delayed abdominal closures after exploratory laparotomies. Group A (n = 8) had cyclical V-HOCL irrigation to their open abdomens combining AbtheraTM and V.A.C. Dressing System for negative pressure wound therapy with irrigation (NPWT-i) and Group B (n = 9) had intra-abdominal V-HOCL washouts. Results: Fifty percent of both groups had either septic or hemorrhagic shock on admission. Compared to Group B, Group A patients were older (median 50 vs 37 years), and had a median hospitalization of 28 vs 8 days, 4 times as many operations, more acute renal failure and co-morbidities. No statistically significant differences were detected be-tween the two treatment methods with the V-HOCL delivery and removal. Conclusion: There were no episodes of electrolyte imbalance, hypotension, hypertension, anaphylaxis, hemorrhage, visceral injury or systemic toxicity. V-HOCL with/without NPWT-i irrigation was a safe modality and tolerated well in this study.
文摘The so-called 'burst abdomen' has been described for many years and is a well-known clinical condition, whereas the concept of the 'open abdomen' is relatively new. In clinical practice, both nosological entities are characterized by a complex spectrum of symptoms apparently disconnected, which in many cases poses a great challenge for surgical repair. In order to assess the management of these disorders in a more comprehensive and integral fashion, the concept of 'acute postoperative open abdominal wall'(acute POAW) is presented, which in turn can be divided into 'intentional' or planned acute POAW and 'unintentional' or unplanned POAW. The understanding of the acute POAW as a single clinical process not only allows a better optimization of the ther-apeutic approach in the surgical repair of abdominal wallrelated disorders, but also the stratification and collection of data in different patient subsets, favoring a better knowledge of the wide spectrum of conditions involved in the surgical reconstruction of the abdominal wall.
文摘The use of open abdomen(OA) as a technique in the treatment of exsanguinating trauma patients was first described in the mid-19 th century. Since the 1980 s, OA has become a relatively new and increasingly common strategy to manage massive trauma and abdominal catastrophes. OA has been proven to help reduce the mortality of trauma. Nevertheless, the OA method may be associated with terrible and devastating complications such as enteroatmospheric fistula(EAF). As a result, OA should not be overused, and attention should be given to critical care as well as special management. The temporary abdominal closure(TAC) technique after abbreviated laparotomy was used to improve wound healing and facilitate final fascial closure of OA. Negative pressure therapy(NPT) is the most commonly used TAC method.
文摘目的观察不同负压值的伤口负压吸引术(negative pressure wound therapy,NPWT)应用于开放性腹部伤口治疗中小肠壁出血面积变化。方法将12头家猪做正中切口,采用随机数字表法分为3组。分别行负压值为-50 mm Hg(A组)、-125 mm Hg(B组)及-200 mm Hg(C组)的NPWT,持续NPWT 12、24、48 h后对小肠壁出血面积的变化分别进行拍照和量化。结果持续NPWT 12、24和48 h后小肠表面出血面积C组>B组>A组,差异有统计学意义(P<0.05﹚。结论负压值的大小与小肠壁出血面积的大小呈正向直线相关,实验中三组比较得出负压值为-125 mm Hg的NPWT具有较好的引流效果时,对小肠损伤较小。
