Negative pressure therapy in complex limb wounds, prior to definitive wound closure

Abstract

Abstract: 

Negative pressure therapy in complex limb wounds, prior to definitive wound closure
Introduction
Negative pressure suction systems are used in the treatment of soft tissue wounds to
progressively reduce their size and depth. By providing a closed and moist environment suitable
for wound healing, it favors the elimination of exudates that can inhibit or delay healing, helps
eliminate edema and stimulates granulation. These favorable conditions and evolution of the
wound, reduces the incidence of infection.
objective
Description where negative pressure suction system was used in extensive traumatic injuries to
the extremities.
Material and methods
Retrospective, descriptive, observational study, included extensive traumatic injuries of the
extremities (upper limb and / or lower limb), treated with the negative aspiration system, prior to
the definitive surgical treatment of the lesion, in the present study they were not taken into
account bone injuries (fracture or bone exposure) since the population to be studied did not
present injuries of this type. The period recorded was 4 years (January 2015 to December 2019).
The evolution of the wound with this therapy was observed and described.
Results
25 cases were analyzed (19 male and 6 female), with lower limb (84%) and upper limb (16%)
involvement. The average age is 59 years (range 22 - 71). In 44% (11 patients) received a skin graft
as definitive treatment, 24% (6 patients) had a second intention closure after treatment due to
reduced wound dimensions, 16% (4 patients) were amputated due to septic complication, being
these patients who did not respond favorably to the combined antibiotic / vaac therapy and
wounds that did not have good irrigation due to the extent of the damage (all supracondylar lower
limb amputations). Four patients (16%) died from systemic complications.
Conclusions
These injuries usually occur under a traumatic environment of extreme severity, although using a
negative suction system is not initially a definitive treatment, we observe a favorable evolution
with this therapy, being an alternative that conditions a wound for definitive treatment.