Negative pressure wound therapy for soft tissue injuries around the foot and ankle

Hyun-Joo Lee,Byung-Chul Park,Chang-Wug Oh,Oog-Jin Shon,Jong-Keon Oh,Joo-Chul Ihn,Woo-Kie Min,Joon-Woo Kim

doi:10.1186/1749-799x-4-14

Abstract

BackgroundThis study was performed to evaluate the results of negative pressure wound therapy (NPWT) in patients with open wounds in the foot and ankle region.Materials and methodsUsing a NPWT device, 16 patients were prospectively treated for soft tissue injuries around the foot and ankle. Mean patient age was 32.8 years (range, 3–67 years). All patients had suffered an acute trauma, due to a traffic accident, a fall, or a crush injury, and all had wounds with underlying tendon or bone exposure. Necrotic tissues were debrided before applying NPWT. Dressings were changed every 3 or 4 days and treatment was continued for 18.4 days on average (range, 11–29 days).ResultsExposed tendons and bone were successfully covered with healthy granulation tissue in all cases except one. The sizes of soft tissue defects reduced from 56.4 cm2 to 42.9 cm2 after NPWT (mean decrease of 24%). In 15 of the 16 cases, coverage with granulation tissue was achieved and followed by a skin graft. A free flap was needed to cover exposed bone and tendon in one case. No major complication occurred that was directly attributable to treatment. In terms of minor complications, two patients suffered scar contracture of grafted skin.ConclusionNPWT was found to facilitate the rapid formation of healthy granulation tissue on open wounds in the foot and ankle region, and thus, to shorten healing time and minimize secondary soft tissue defect coverage procedures.

Highlights

negative pressure wound therapy (NPWT) was found to facilitate the rapid formation of healthy granulation tissue on open wounds in the foot and ankle region, and to shorten healing time and minimize secondary soft tissue defect coverage procedures
Tendon and/or bone exposure commonly occurs in the foot and ankle region after acute trauma [1]
Reports regarding its use in the foot and ankle region are limited, though in this region tendon and bone exposures frequently occur after external injury or due to chronic ulcerative disease

Summary

Introduction

Tendon and/or bone exposure commonly occurs in the foot and ankle region after acute trauma [1]. The conventional treatment method used for these uncovered, open wounds in the foot and ankle is skin grafting after the formation of healthy granulation tissue by wet dressing [2]. Negative pressure wound therapy (NPWT) was first described by Argenta and Morykwas [2] This technique can be used to cover exposed bone or soft tissue defects without frequent dressing changes, and reduces chronic edema and increases local blood supply, which enhances the formation of healthy granulation tissue. The purpose of this study was to determine how NPWT helps healing and whether the technique can reduce the need for flap surgery for the treatment of acute or chronic open wounds in the foot and ankle region. This study was performed to evaluate the results of negative pressure wound therapy (NPWT) in patients with open wounds in the foot and ankle region

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Methods

Results

Conclusion