Here - EWMA 2013

POSTER: DEVICES & INTERVENTION
Poster: Devices & Intervention
P 244
Silver impregnated wound interface in negative pressure wound
therapy
Jan Koller 1 , P Bukovcan 1 , M Orsag 1
1 Comenius University Bratislava (Bratislava, Slovakia).
Aim: Negative pressure wound therapy (NPWT) became a routine method in treatment
of problem wounds in the last decade. In all the NPWT systems several types of wound
contact materials are used to transmit negative pressure evenly to the wound surface.
Most of the materials used so far (sponges with different porosity, gauze etc.) do not
have any antibacterial action. In order to decrease the bacterial contamination in the
NPWT systems and modify the granulation tissue formation we started to use silver
impregnated mesh gauze material as a wound contact layer.
Methods: In NPWT system using polyurethane (black) sponge we used silver
impregnated commercially produced mesh gauze* as interface between the wound
surface and the sponge. NPWT was applied to both acute and chronic wounds
following surgical debridement in 15 patients. The NPWT system was changed in
intervals from 3 to 6 days until the wound was ready for final closure in most of the
cases by split thickness skin grafts (STSG). During each NPWT system change the
progress of wound healing and bacterial contamination have been evaluated.
Results: In all except one patients the tretment results have been rated as excellent or
good. The final wound closure was performed by STSG in 11 patients and local flap
plasty in 3 cases. The only one treatment failure was attributed to vascular origin.
Conclusions/Discussion: The use of silver impregnated mesh interface proved to be
a safe and efective method in enhancing granulation formation and reducing wound
contamination in NPWT system.
* AtraumanAg
P 245
Poster: Devices & Intervention
FOUR YEARS EXPERIENCE OF EFFECTIVELY TREATING COMPARTMENT
SYNDROME BY COMBINING NPWT WITH A POLYMERIC MEMBRANE INTERFACE
LAYER
Geert Vanwalleghem 1
1 H.-Hartziekenhuis Roeselare-Menen vzw (Roeselare, Belgium).
Introduction: Compartment syndrome is a painful condition leading to dangerous buildup
of pressure within the muscles causing decreased blood flow and tissue necrosis.
Acute cases are treated with fasciotomy in combination with negative pressure wound
therapy (NPWT) to encourage rapid reduction of swelling. Dressing changes are often
painful and time-consuming due to ingrowth of granulation tissue into the foam used with
the suction device.
Aim: To reduce operating theater time, improve healing outcomes and reduce painful
dressing changes.
Method: Polymeric membrane dressings (PMDs) were placed as an interface layer prior
to NPWT after the fasciotomy. Dressing changes twice a week at the patients’ bedside.
No additional cleansing was needed due to the PMDs. After 4-5 dressing changes
NPWT is terminated and PMDs are used until full closure or skin grafting.
Results: With PMDs as an interface there was no ingrowth of granulation tissue. None
of the patients needed to be sedated or have their changes done at the operating
theater. The wounds treated with PMDs till closer had a better cosmetic appearance than
those that were skin grafted.
Conclusions: Prior to using PMDs as an interface most dressing changes were
performed in the OR under full anesthesia due to painful granulation ingrowth into the
NPWT foam. With PMDs as interface layer this never happened. We have not calculated
the exact cost savings but it is obvious that there have been huge savings not only for
the hospital but also for the insurance companies involved.
EWMA 2013
COPENHAGEN
15-17 May · 2013
Danish Wound
Healing Society
151