ewma 2013 - ep 484 - sealing npwt dressings made easy

Methods:

A clinical evaluation was carried

out. Eight patients with NPWT (5

gauze, 2 foam based and 1

epicutane NPWT) and four non

NPWT patients were included

and treated with the viscous

silicone sealant. Clinical- and

patientcentered outcomes were

assessed.

Aim:

Achieving and maintaining a

perfect seal is essential for

effective NPWT. Sometimes

this can be a real challenge

due to the body area where the

wound is located. Especially

wounds near the anus, the

genital region or the forefoot

are hard to seal. Additional

wound care products such as

cohesive paste are often used

to achieve a proper sealing of

the dressing. The aim of this

work is to test the lately intro-

duced liquid soft silicone seal-

ant and to discuss other indi-

cations for this new product.

1

SEALING NPWT DRESSINGS

MADE EASY

M. Duft, M. Krammel, M. Dziubanek

© Dr. med. univ. Markus Duft, WDM® / EP 484 EWMA 2013

2

Case I:

Sex: m Age: 70

Medical diagnosis: Fournier`s Gangrene/ Excision 19.06.2012

ATOMS explantation 19.06.2012

2006 Prostate cancer/ RPE pT3a, G3, Gleason Score 7, R0

2008 Rectal cancer/ DARR pT3, G2, N0, M0

2010 Leriche`s syndrom/ Axillobifemoral bypass

2008 and 2012 PU reg. sacralis Kat. IV EPUAP/ Plastic surgery

Non insulin dependent diabetes mellitus

Artterial hypertension

19.07.2012 NPWT established and dismissal, outpatient care with NPWT changes 23.07.12, 30.07.12, orchidectomie and wound closure 08.08.12


3

Case II:

Sex: m Age: 72

Medical diagnosis: DFS Wagner Amstrong 4 D dext.

19.03.2012 PTA ATP dext.

20.03.2012 transmetatarsal amputation I dext.

Non insulin dependent diabetes mellitus

2011 Bladder cancer/ TUR-B

Atrial fibrillation

Arterial hypertension

2009 Cerebrovascular accident

20.03.2012 inpatient care with NPWT changes every fifth day until dismissal 09.04.2012

Outpatient care until 03.05.2013 and reverdin transplantation was performed


4

Case III:

Sex: m Age: 34

Medical diagnosis: 4. pilonidal sinus relaps/ Excision 09.09.2012

Nicotine abuse

12.09.2012 NPWT established

15.09.2012 dismissal, outpatient care with NPWT changes weekly until wound closure


5

Case IV:

Sex: f Age: 76

Medical diagnosis: DFS Wagner Amstrong 4 D dext.

15.05.2012 surgical debridement, transmetatarsal amputation II and III dext.

24.05.2013 PTA AI dext.

Insulin dependent diabetes mellitus


28.05.2012 NPWT established

06.06.2012 dismissal, outpatient care with NPWT changes, lost of follow up


6

Case V:

Sex: m Age: 70

Medical diagnosis: PU relaps reg. ischii dext. Kat.IV EPUAP 22.06.2012 biceps femoris flap

DSSI/ Debridement, NPWT establishment

02.08.2013 extended TFL flap dext.

Chronically progredient multiple sclerosis

Spastic paraparesis

10.11.2012 epicutan NPWT established

Outpatient care with NPWT changes weekly


7

Case VI:

Sex: f Age: 56

Medical diagnosis: Wound necrosis post

09.01.2013 hip endoprosthesis enucleation, transfemoral amputation dext.


Obesety

13.02.2013 surgical debridement

15.02.2013 maggot therapy

01.03.2013 NPWT establishment

28.03.2013 dismission, outpatient care with NPWT, changes weekly until wound closure 16.04.2013


8

Case VII:

Sex: m Age: 63

Medical diagnosis: DFS Wagner Amstrong 4 D sin.

18.12.2012 PTA ATP and AI sin.

21.12.2012 amputation dig. V ped. sin.

27.12.2012 MRSA wound infection

Insulin dependent diabetes mellitus


Obesety

28.12.2012 maggot therapy for two weeks, afterwards calciumalginate Ag and foam dressing


Results:

The soft silicone sealant is easy to use and quick to

apply. It proved to be positive in terms of achieving an

ideal exsudat- and airtight seal for NPWT. The wear

time of the NPWT dressings ranged from 7-9 days and

there was no leakage. The removal of the sealant was

easy and no skin stripping was seen. The patients did

not report any pain while the silicone was removed.

9


Conclusion:

This silicone sealant overcomes the challenge of sealing NPWT. It helped to reduce the need for dressing changes and this may be helpful to save money. Beside NPWT we see further indications for this product. Used in stoma treatment to secure and seal it ensured that liquid stool is unable to damage the skin and to seal high output lymphfistulas.

10

For more information please contact:

OA Dr. med. univ. Markus Duft, WDM®

[email protected]


mailto:[email protected]

ewma 2013 - ep 484 - sealing npwt dressings made easy

Health & Medicine