Here - EWMA 2013

POSTER PRESENTATIONS
P 242
Poster: Devices & Intervention
SINGLE USE NEGATIVE PRESSURE WOUND THERAPY (SU-NPWT) FOR THE
MANAGEMENT OF SPLIT THICKNESS SKIN GRAFT (STSG) DONOR SITES
John Lantis 1 , Jamie Schwartz 1 , Ema Avdagic 1 , Cynthia Gendics 1
1 St Luke’s-Roosevelt Hospital; Columbia University (New York, United States).
Aim: STSG donor sites usually do quite well with near complete epithelialization at 7-14
days. Donor site management entails maintaining a moist wound healing environment.
Polyurethane films are better than mesh gauze but do not handle exudate well and in
donor sites there is level I evidence that moist wound healing products are superior to
dry products. We undertook a study of standard of care polyurethane dressing (PUD) to
a single use, disposable NPWT system (SU-NPWT).
Methods: 10 patients acted as their own control with 50% of the donor site being
covered with a PUD and the other half being covered with the silicone interface of the
SU-NPWT. The wound closure rate, pain at removal, amount of granulation vs
epithelialization and periwound skin integrity was measures at post op day 4,7,14 and
28.
Results: The SUD- NPWT was associated with similar pain to the PUD. However,
exudate management was superior with the SU-NPWT. In general the SU-NPWT only
needed to be changed at the designated interval while the PUD required much more
frequent re-enforcement.
Conclusion: Consensus documents have previously supported some form of positive
pressure to the donor wound for 48 hours, a dressing that should remain intact as long
as possible, and a dressing that controls wound exudate. The SU –NPWT fit all of these
criteria; providing positive pressure by way of a very tight interface with a space
occupying dressing, controlling for exudate and being able to stay in place for 7 days.
POSTER: DEVICES & INTERVENTION
P 243
Poster: Devices & Intervention
SINGLE USE NEGATIVE PRESSURE WOUND THERAPY (SU-NPWT) FOR THE
MANAGEMENT OF VASCULAR SURGERY INCISIONS
John Lantis 1 , Joseph Wuamett 1 , Jamie Schwartz 1 , Ema Avdagic 1 , Cynthia Gendics 1
1 St Luke’s-Roosevelt Hospital; Columbia University (New York, United States).
Aim: The ideal surgical dressing has been described as providing a moist wound
environment to promote optimal healing, while allowing high water vapor permeability
and absorbency, while providing protection from external trauma and contaminates.
NPWT has been advanced as a way of addressing the above ideal surgical dressing
needs.
Methods: Using a high risk population as defined by SENIC and others we undertook a
prospective study of the use of SU-NPWT on leg incisions in patients undergoing
vascular surgical procedures. Wound complications rates were assessed at 4, 14, 28
and 90 days. The control group was a historic cohort of similar patients. SU-NPWT was
terminated after 14 days in all patients
Results: Incisions and demographic s was representative of this population. The
average length of the incision was 19.5 cm. Distal targets were above knee in 20%,
below knee in 60%, 10% ileofemoral and 10% popliteal aneurysm repair. In 30% the
dressing was saturated prior to the first change, there were no infections at day 7, while
20% appeared inflamed. At the time of SU-NPWT termination 30% of the wounds were
closed, 60% had the dressing changed to non-stick gauze and a polyurethane
membrane. In 60% of wounds the dressing exceeded expectations, in 100% it was
graded as better than standard of care.
Discussion: The SUD-NPWT appeared to meet many of the requirements outlined as
components of the ideal dressing for high risk leg incisions. It appears to have the best
outcomes if used for 14 days.
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