Here - EWMA 2013

E-POSTER PRESENTATIONS
EP 448
E-Poster: Devices & Intervention
the treatment of difficult wound with NPWT* before surgery
Raffaele Ceccarino 1 , Antonio Scotto Di Luzio 1 , Antonino Pasquale d›Amato 1 ,
Anna Mele 1
1 Asl Na 2 Nord (Pozzuoli (Naples), Italy).
Summary: We have treated two patients with huge wound of the lower limb. Both were
treated with a combination of NPWT* therapy and free flaps.
Materials and Methods: A 64 years old patient had a huge wound of the medial portion
of the right ankle. At first we washed the wound with physiologic water and carried out a
toilette and put on it NPWT* for about one week. Then we operated him and carried out
a radial forearm free flap with end-to-end anasthomosis between radial arthery and
posterior tibial arthery and relative venae comitantes. We followed him up for 6 months
and let him walk after about 30 days. A 20 years old patient came to our observation with
a huge wound of the posterior part of the leg with lesion of achilleum tendon and lost of
soft tissue. This patient had a severe infection of the wound with Escherichia coli. We
washed the wound with physiologic water and then we put on it NPWT* for about 10
days. We operated him and carried out a plastic with antero-lateral-tigh free flap with
end-to-end anastomosis with posteriotibial arthery and venae comitantes. Also for him
we performed a follow up for 6 months.
Conclusions: The treatment of difficult wounds with NPWT* before surgery has had
better results because NPWT* let us prepare the bed for insetting the flaps. In this way
the postoperative follow-up showed us a faster healing without any complications and
infections.
*VAC
E-POSTER: DEVICES & INTERVENTION
EP 449
E-Poster: Devices & Intervention
Atmospheric Pressure Plasma Jet Treatments for Wound Healing
Applications
Ahmed Chebbi 1 , Claire Staunton 1 , Victor Law 1 , Denis Dowling 1
1 University College Dublin (Dublin, Ireland).
Aim: This project aims at investigating the wound healing potential of a novel variable
frequency atmospheric plasma system through its bactericidal effects.
Methods: Optical emission spectroscopy (OES) was initially used in order to determine
the optimal parameters for a higher production of reactive species by the plasma.
In vitro and ex vivo (pig skin) techniques were used in this project in order to
demonstrate the bactericidal properties of a novel variable frequency plasma system.
Results: During this study, it was found that a once-off plasma treatment for 120
seconds led to a 1 log reduction of bacterial load in vitro and on pig skin samples
previously inoculated by E.coli. Higher treatment times of up to 6 minutes led to a 4 log
reduction of bacterial load ex vivo (on pig skin). The damage observed in E. coli after
treatment can be attributed to an electrophysical mechanism. Electrostatic tension builds
up on the cell surface culminating in electrostatic disruption in its outer cell membrane.
The sensitivity of different bacterial strains was compared at the same plasma
processing conditions (160 kHz) and it emerged that Gram negative bacterial strains
were more sensitive to plasma treatment than Gram positive strains as follows:
Klebsielle > E. coli > P. aeruginosa > S. aureus > B. Subtilis.
Conclusions: It is thought that the plasma wound healing effect is obtained through a
reduction of the bacterial load on the wound surface. Reactive oxygen and nitrogen
species produced by the plasma are mainly responsible for this bactericidal effect.
An optimal plasma treatment regime was found to produce significant reduction in
bacterial colonisation in vitro and ex vivo, which indicates that such a plasma treatment
could lead to faster wound healing in vivo. Current research is now focusing on showing
a cell proliferative effect of atmospheric plasma which could contribute further to wound
healing.
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