Abstract
We report our experience with next-generation incisional negative pressure wound therapy (iNPWT) applied after major limb amputation or amputation revision. In this high-risk patient population, the need for reliable post-operative soft tissue management is imperative. In both cases reported, healing was uncomplicated. Using the next generation iNPWT in this unique way optimizes the post-operative residual limb by improved incision healing, residual limb edema reduction, and reduced risk of surgical site infection (SSI). This is the first case report of its kind reporting a novel use of next-generation iNPWT, and it demonstrates a need to examine this particular use further.
Highlights
Major extremity amputation is a life-altering event
Factors that commonly contribute to an increased mortality for this specific patient population include peripheral vascular disease, diabetes, infection, smoking history, and re-operation and/or soft tissue injuries [10]
Post-operative wound complication rates vary from 12% to 34% in patients undergoing a below knee amputation (BKA) and the incidence of wound complications increases the length of post-operative hospitalization [10,11]
Summary
Major extremity amputation is a life-altering event. In the United States, there are an estimated 2 million Americans living with limb loss, and this figure is projected to double by the year 2050 [1]. In the acute post-operative period, amputation site healing can be complicated by surgical site infections (SSI) and wound dehiscence, each posing significant risks to patients and the healthcare system [2]. Given his comorbidities and prior wound healing difficulties, the patient progressed through the postoperative period without complication He transitioned into a residual limb compression sleeve as directed by his prosthetist and eight weeks after amputation, he began wearing his prosthetic. A 40-year-old male with a history of type 1 neurofibromatosis who had undergone a left BKA with TMR and iNPWT placement one year prior, presented with significant soft tissue changes in his residual limb rendering him unable to wear his prosthetic His prosthetist had performed socket modifications and he was using multiple layers of socks to keep on the prosthesis. His prosthetist was able to re-fit his socket and he began ambulating at the 6-week mark
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