MODIFICATION OF THE NEGATIVE PRESSURE THERAPY TECHNIQUE FOR TREATMENT OF WOUND INFECTION AFTER SPINAL SURGERY

Martín Betancourt-Carlos,José María Jiménez-Avila,Arelhi Catalina González-Cisneros

doi:10.1590/s1808-185120191803222148

Martín Betancourt-Carlos, José María Jiménez-Avila + Show 1 more

Open Access

https://doi.org/10.1590/s1808-185120191803222148

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Abstract

ABSTRACT Objective To describe the indications and contraindications of negative pressure assisted wound therapy as well as a modification to the negative pressure technique that has been shown to shorten the number of changes of dressings and hospital stay with the early closure of the wound. Methods A review of the existing literature in the databases OVID, PubMed, Cochrane and Medigraphic was carried out in relation to the pressure-assisted closure of wounds. This is a non-invasive and active healing system that uses localized and controlled negative pressure, which consists of a specialized dressing that includes reticulated foam that removes the exudates through a tube to an airtight container. This set forms microdeformations in the wound bed, which are known to cause an important increase in fibroblastic migration and consequently of higher quality tissue, granulation tissue formation and angiogenesis. Results It was found that this method shortens the number of days of hospital stay. The technique describes the primary closure of the wound after intense cleansing and debridement of the non-viable tissue and signs of infection. Conclusions Negative pressure wound therapy is effective for the treatment of deep infections in postsurgical spinal wound, with average time of use of 1 to 4 weeks in the most severe cases. Level of evidence IV; Case Series.

Highlights

Even with knowledge of the biology of wounds and the new types of dressings available, a great number of wounds still fail to heal and become chronic.[1,2,3]Negative pressure wound therapy (NPWT) is a way to act positively in a situation where a wound is stuck in the inflammation and proliferation stage and with wounds that are in an acute state in order to reduce their complexity and avoid complications by applying subatmospheric pressure
A review of the existing literature in the databases OVID, PubMed, Cochrane and Medigraphic was carried out in relation to the pressure-assisted closure of wounds. This is a non-invasive and active healing system that uses localized and controlled negative pressure, which consists of a specialized dressing that includes reticulated foam that removes the exudates through a tube to an airtight container. This set forms microdeformations in the wound bed, which are known to cause an important increase in fibroblastic migration and of higher quality tissue, granulation tissue formation and angiogenesis
Negative pressure wound therapy is used with great success, mainly in abdominal surgery, chest surgery involving sternal opening, and in exposed fractures of the lower limbs, as through negative pressure it eliminates and absorbs edema and fluids, improving blood circulation and generating cell proliferation with granulated tissue, as well as local tissue growth factors

Summary

Introduction

Even with knowledge of the biology of wounds and the new types of dressings available, a great number of wounds still fail to heal and become chronic.[1,2,3]Negative pressure wound therapy (NPWT) is a way to act positively in a situation where a wound is stuck in the inflammation and proliferation stage and with wounds that are in an acute state in order to reduce their complexity and avoid complications by applying subatmospheric pressure. Objective: To describe the indications and contraindications of negative pressure assisted wound therapy as well as a modification to the negative pressure technique that has been shown to shorten the number of changes of dressings and hospital stay with the early closure of the wound.

Results

Conclusion