Closed incision negative pressure therapy: international multidisciplinary consensus recommendations

Abstract Surgical site occurrences (SSOs) affect up to or over 25% of patients undergoing operative procedures, with the subset of surgical site infections (SSIs) being the most common. Commercially available closed incision negative pressure therapy (ciNPT) may offer surgeons an additional option to manage clean, closed surgical incisions. We conducted an extensive literature search for studies describing ciNPT use and assembled a diverse panel of experts to create consensus recommendations for when using ciNPT may be appropriate. A literature search of MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials using key words ‘prevention’, ‘negative pressure wound therapy (NPWT)’, ‘active incisional management’, ‘incisional vacuum therapy’, ‘incisional NPWT’, ‘incisional wound VAC’, ‘closed incisional NPWT’, ‘wound infection’, and ‘SSIs’ identified peer‐reviewed studies published from 2000 to 2015. During a multidisciplinary consensus meeting, the 12 experts reviewed the literature, presented their own ciNPT experiences, identified risk factors for SSOs and developed comprehensive consensus recommendations. A total of 100 publications satisfied the search requirements for ciNPT use. A majority presented data supporting ciNPT use. Numerous publications reported SSI risk factors, with the most common including obesity (body mass index ≥30 kg/m2);...
Source: International Wound Journal - Category: Surgery Authors: Tags: ORIGINAL ARTICLE Source Type: research

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Background: In US cystic fibrosis (CF) patients, methicillin-resistant Staphylococcus aureus (MRSA) rates have tripled in the past 2 decades. Known clinical risk factors include exposure to a healthcare setting, Pseudomonas aeruginosa and CF-related diabetes. Area-level socio-environmental exposures have not been evaluated. We explored the association of area-level deprivation with MRSA prevalence in a pediatric CF Center in the Southeastern United States. Methods: Patients’ residential addresses were geocoded and linked to a composite Area Deprivation Index and Rural-Urban Commuting Area scores. The association...
Source: The Pediatric Infectious Disease Journal - Category: Infectious Diseases Tags: Original Studies Source Type: research
Our world is amidst a crucial overweight and obesity pandemic that continues to grow, with 2 billion of the world ’s population overweight and approximately 700 million adults with obesity.1 Once thought to be a disease of the rich and affluent, weight-related and metabolic diseases are on the rise across all socioeconomic classes and residential settings. The enduring physiologic and hormonal changes that oc cur with weight gain make sustainable weight loss with just diet and exercise, commonly known as lifestyle modification, not feasible for most people.
Source: Gastrointestinal Endoscopy - Category: Gastroenterology Authors: Tags: Original article Source Type: research
GENERAL PURPOSE To provide information on a 60-second General Foot Screen to assist in the prevention and/or identification and management of common foot problems. TARGET AUDIENCE This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES After participating in this educational activity, the participant should be better able to: 1. Use the 60-second General Foot Screen to assist healthcare professionals in the recognition of common foot problems. 2. Identify risk factors, causes, and tre...
Source: Advances in Skin and Wound Care - Category: Dermatology Tags: FEATURES: CLINICAL MANAGEMENT EXTRA Source Type: research
CONCLUSIONS: Investigators failed to find ample support for routine use of NPWT as a “bridge to reconstruction.” Serious complications related to the use of NPWT including right ventricular rupture, atrial fibrillation, respiratory arrest, recurrent infection, and a retained sponge were reported in this group of studies. Rigorous evaluative studies that assess the true effectiveness of NPWT as a “bridge to reconstruction” must precede its adoption.
Source: Advances in Skin and Wound Care - Category: Dermatology Tags: FEATURES: LITERATURE REVIEW Source Type: research
CONCLUSIONS Beyond a risk assessment scale, providers should consider other factors, such as comorbidities, which can predispose patients to HPI development.
Source: Advances in Skin and Wound Care - Category: Dermatology Tags: FEATURES: ORIGINAL INVESTIGATION Source Type: research
​BY HABIR MANDAIR; KEYUR KURANI; &KHALID MALIK, MDA 62-year-old obese woman with end-stage renal disease (ESRD) who was on hemodialysis, hypertension, diabetes mellitus, and chronically elevated serum calcium levels presented to the ED with altered mental status. Nursing home staff stated that she was unable to answer questions coherently and seemed confused.Her vitals were within normal limits except for a body temperature of 99.9°F. Several necrotic lesions of various sizes were found on her left and right buttocks and the medial aspects of both thighs. The patient also had severe necrosis of the third finger o...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research
CONCLUSION: In view of the fact that one out of nine care recipients receiving assistance from home care services is affected by at least one non-healing wound, special attention should be paid to the prevention, detection and treatment of chronic wounds. Furthermore, it seems particularly necessary to identify the relevant risk groups in order to be able to initiate adequate and preventive measures at an early stage. PMID: 30777680 [PubMed - as supplied by publisher]
Source: Zeitschrift fur Evidenz, Fortbildung und Qualitat im Gesundheitswesen - Category: Health Management Tags: Z Evid Fortbild Qual Gesundhwes Source Type: research
This article discusses the assessment and treatment of non-healing chronic wounds. It examines the normal wound-healing process and the management of chronic wounds, including advanced interventions such as electrical stimulation therapy, negative pressure wound therapy and various dressings. This article does not focus on specific wound types; instead, it provides an overview of the factors that can lead to the development of chronic wounds and how these wounds can be managed in clinical practice. PMID: 29537760 [PubMed - in process]
Source: Nursing Standard - Category: Nursing Authors: Tags: Nurs Stand Source Type: research
Abstract Surgical site occurrences are observed in up to 60% of inpatient surgical procedures in industrialised countries. The most relevant postoperative complication is surgical site infection (SSI) because of its impact on patient outcomes and enormous treatment costs. Literature reviews (‘SSI’, ‘deep sternal wound infections’ (DSWI), ‘closed incision negative pressure wound therapy’ (ciNPT) were performed by electronically searching MEDLINE (PubMed) and subsequently using a ‘snowball’ method of continued searches of the references in the identified publications. Search cr...
Source: International Wound Journal - Category: Surgery Authors: Tags: ORIGINAL ARTICLE Source Type: research
Abstract Reconstruction of trochanteric pressure sores continues to challenge reconstructive surgeons because recurrence is not uncommon and patients typically have undergone previous surgery. We herein report on the use of a large adipocutaneous TFLPP rotated for 180° facilitating reconstruction of a recurring trochanteric decubital ulcer in a 37-year-old male morbidly obese patient with diabetes mellitus. The postoperative period showed no adverse events, and no recurrence was observed to date. The TFLPP is a valuable option because skin grafts are usually not needed for donor-site closure, the muscle is spa...
Source: European Journal of Plastic Surgery - Category: Cosmetic Surgery Source Type: research
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