Cargando…

Negative Pressure Wound Therapy (NPWT): Our Experience in Pakistan With Locally Made Dressing

Introduction Worldwide numbers of patients suffering from complex wounds appear to increase annually. These patients present with acute, sub-acute and chronic wounds which can be difficult to manage. Management of these patients typically requires a multi-disciplinary approach by a plastic surgeon,...

Descripción completa

Detalles Bibliográficos
Autores principales: Ur Rashid, Haroon, Rashid, Mamoon, Ur Rehman Sarwar, Saad, Khan, Ibrahim, Khan, Nasir, Bibi, Noshi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7457887/
https://www.ncbi.nlm.nih.gov/pubmed/32879811
http://dx.doi.org/10.7759/cureus.9464
_version_ 1783576087960223744
author Ur Rashid, Haroon
Rashid, Mamoon
Ur Rehman Sarwar, Saad
Khan, Ibrahim
Khan, Nasir
Bibi, Noshi
author_facet Ur Rashid, Haroon
Rashid, Mamoon
Ur Rehman Sarwar, Saad
Khan, Ibrahim
Khan, Nasir
Bibi, Noshi
author_sort Ur Rashid, Haroon
collection PubMed
description Introduction Worldwide numbers of patients suffering from complex wounds appear to increase annually. These patients present with acute, sub-acute and chronic wounds which can be difficult to manage. Management of these patients typically requires a multi-disciplinary approach by a plastic surgeon, orthopaedic surgeon and infectious disease control team. Despite the advent of numerous new techniques and technologies, negative pressure wound therapy (NPWT) remains a cornerstone to the management of complex wounds. We present our experience with NPWT in this study. Methods This is a retrospective study of 380 patients who were treated with NPWT in the last 10 years at a single center. We receive hundreds of infected wounds of limbs each year which are either post-traumatic or post-debridement. Frequency of dressing change, C-reactive protein levels, bacterial cultures, complication rate and cost of apparatus in each case were noted. All patients received systemic antibiotics during the treatment. Results We reviewed hospital data of 520 patients in which debridement was performed. Of the 520 patients derided, 380 patients were treated with NPWT, and included in study. Number of NPWT sessions was decided on the basis of wound status (adequate healthy granulation tissue, clinically improved circulation). A single session of NPWT dressing was applied in 84% (n = 320) patients, 8% (n = 31) patients needed two sessions of NPWT dressing, 6% (n = 24) patients had three sessions of NPWT dressing and only 1% (n = 5) patients did not respond to NPWT dressing. 78% (n = 297) patients had reduced levels of C-reactive protein levels and wound cultures were negative in 54% (n = 208) patients after application of NPWT dressing. Minor complications occurred in 0.7% (n = 3) patients due to occult osteomyelitis. In 0.5% (n = 2) patients, NPWT dressing was discontinued due to persistent leakage near a natural orifice. Sinus formation was seen in 6% (n = 23) patients who were treated with curettage and conventional dressings. The mean pain score on the verbal analogue scale was 3 out of 10. The mean cost of an NPWT dressing apparatus was 90 dollars. Conclusion We conclude from this study that NPWT dressing can be easily applied to any region of the body and it can be customized to the needs of patients from different socio-economic status.
format Online
Article
Text
id pubmed-7457887
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Cureus
record_format MEDLINE/PubMed
spelling pubmed-74578872020-09-01 Negative Pressure Wound Therapy (NPWT): Our Experience in Pakistan With Locally Made Dressing Ur Rashid, Haroon Rashid, Mamoon Ur Rehman Sarwar, Saad Khan, Ibrahim Khan, Nasir Bibi, Noshi Cureus Medical Education Introduction Worldwide numbers of patients suffering from complex wounds appear to increase annually. These patients present with acute, sub-acute and chronic wounds which can be difficult to manage. Management of these patients typically requires a multi-disciplinary approach by a plastic surgeon, orthopaedic surgeon and infectious disease control team. Despite the advent of numerous new techniques and technologies, negative pressure wound therapy (NPWT) remains a cornerstone to the management of complex wounds. We present our experience with NPWT in this study. Methods This is a retrospective study of 380 patients who were treated with NPWT in the last 10 years at a single center. We receive hundreds of infected wounds of limbs each year which are either post-traumatic or post-debridement. Frequency of dressing change, C-reactive protein levels, bacterial cultures, complication rate and cost of apparatus in each case were noted. All patients received systemic antibiotics during the treatment. Results We reviewed hospital data of 520 patients in which debridement was performed. Of the 520 patients derided, 380 patients were treated with NPWT, and included in study. Number of NPWT sessions was decided on the basis of wound status (adequate healthy granulation tissue, clinically improved circulation). A single session of NPWT dressing was applied in 84% (n = 320) patients, 8% (n = 31) patients needed two sessions of NPWT dressing, 6% (n = 24) patients had three sessions of NPWT dressing and only 1% (n = 5) patients did not respond to NPWT dressing. 78% (n = 297) patients had reduced levels of C-reactive protein levels and wound cultures were negative in 54% (n = 208) patients after application of NPWT dressing. Minor complications occurred in 0.7% (n = 3) patients due to occult osteomyelitis. In 0.5% (n = 2) patients, NPWT dressing was discontinued due to persistent leakage near a natural orifice. Sinus formation was seen in 6% (n = 23) patients who were treated with curettage and conventional dressings. The mean pain score on the verbal analogue scale was 3 out of 10. The mean cost of an NPWT dressing apparatus was 90 dollars. Conclusion We conclude from this study that NPWT dressing can be easily applied to any region of the body and it can be customized to the needs of patients from different socio-economic status. Cureus 2020-07-29 /pmc/articles/PMC7457887/ /pubmed/32879811 http://dx.doi.org/10.7759/cureus.9464 Text en Copyright © 2020, Ur Rashid et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Medical Education
Ur Rashid, Haroon
Rashid, Mamoon
Ur Rehman Sarwar, Saad
Khan, Ibrahim
Khan, Nasir
Bibi, Noshi
Negative Pressure Wound Therapy (NPWT): Our Experience in Pakistan With Locally Made Dressing
title Negative Pressure Wound Therapy (NPWT): Our Experience in Pakistan With Locally Made Dressing
title_full Negative Pressure Wound Therapy (NPWT): Our Experience in Pakistan With Locally Made Dressing
title_fullStr Negative Pressure Wound Therapy (NPWT): Our Experience in Pakistan With Locally Made Dressing
title_full_unstemmed Negative Pressure Wound Therapy (NPWT): Our Experience in Pakistan With Locally Made Dressing
title_short Negative Pressure Wound Therapy (NPWT): Our Experience in Pakistan With Locally Made Dressing
title_sort negative pressure wound therapy (npwt): our experience in pakistan with locally made dressing
topic Medical Education
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7457887/
https://www.ncbi.nlm.nih.gov/pubmed/32879811
http://dx.doi.org/10.7759/cureus.9464
work_keys_str_mv AT urrashidharoon negativepressurewoundtherapynpwtourexperienceinpakistanwithlocallymadedressing
AT rashidmamoon negativepressurewoundtherapynpwtourexperienceinpakistanwithlocallymadedressing
AT urrehmansarwarsaad negativepressurewoundtherapynpwtourexperienceinpakistanwithlocallymadedressing
AT khanibrahim negativepressurewoundtherapynpwtourexperienceinpakistanwithlocallymadedressing
AT khannasir negativepressurewoundtherapynpwtourexperienceinpakistanwithlocallymadedressing
AT bibinoshi negativepressurewoundtherapynpwtourexperienceinpakistanwithlocallymadedressing