Abstract
PurposeThe last two decades witnessed the development of numerous innovative regimens for the management of patients with abnormally healing and infected wounds. Growth factors, negative pressure wound therapy (NPWT) and antiseptic dressings containing silver are examples of methods with best documented efficacy, being widely used in the treatment of acute and chronic post-traumatic wounds, burns and ulcers of various etiology. As far as obstetrics and gynecology are concerned, prevention and treatment of infected, hard-to-heal postoperative wounds is of crucial importance. This article reviews the available literature to discuss the possibilities for use, efficacy and cost-effectiveness of growth factors, NPWT and silver dressings in the treatment of difficult-to-heal postsurgical wounds in obstetrics and gynecology.Materials and methodsAn extensive search of the English and Polish literature via PubMed and EMBASE databases was undertaken for articles published between January 1960 and April 30, 2014 to identify articles that described and assessed use, efficacy and cost-effectiveness of growth factors, silver dressings and NPWT in patients with hard-to-heal postoperative wounds following obstetric or gynecological surgery.ConclusionsLiterature review regarding the use of growth factors, NPWT and silver dressings suggests that these methods may play an important role in the management of wounds after invasive obstetric and gynecological procedures. Obese patients, patients after vulvectomy or prior radiation therapy may benefit most, however, due to non-numerous randomized reports, prospective studies on the use of above-mentioned methods in the treatment of postsurgical wounds following obstetric and gynecological interventions are required.
Highlights
Postoperative wound healing complications constitute an important medical and socioeconomic problem worldwide
A review of the English and Polish literature was undertaken for articles published between January 1960 and April 30, 2014 to identify articles that described and assessed use, efficacy and cost-effectiveness of growth factors, silver dressings and negative pressure wound therapy in patients with hard-to-heal postoperative wounds following obstetric or gynecological surgery
Studies were identified via PubMed and EMBASE databases using keywords: ‘‘growth factor,’’ ‘‘platelet rich plasma,’’ ‘‘platelet gel,’’ ‘‘silver dressing,’’ ‘‘negative pressure wound therapy’’ or ‘‘vacuum assisted closure’’ combined with ‘‘wound’’ and ‘‘obstetrics,’’ ‘‘gynecology,’’ ‘‘hysterectomy,’’ ‘‘vulvectomy’’ or ‘‘cesarean section’’ by two authors (PS, AW) independently
Summary
Postoperative wound healing complications constitute an important medical and socioeconomic problem worldwide. Despite the fact that the risk factors responsible for the impaired healing process were identified and the continuously increasing medical knowledge in the fields of tissue engineering, molecular biology and microbiology facilitated the development of numerous new recommendations and methods for management, in many cases the available options for successful treatment of postoperative wounds remain limited. As far as obstetrics and gynecology are concerned, the number of published studies on the usefulness of the growth factors, NPWT and silver dressings in the treatment of hard-to-heal and infected wounds is still very low and insufficient. Considering the number of procedures performed within the pelvis minor region in females as well as the continuously increasing number of patients undergoing cesarean section, analysis of the usefulness, efficacy and costeffectiveness of these methods for the treatment of postoperative wounds in obstetrics and gynecology appears to be justified
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