Negative Pressure Wound Therapy Journal 2019-02-17T23:59:14+01:00 Wojciech Francuzik Open Journal Systems <p>Diamond Open Access, peer-reviewed academic journal focused on the use of vacuum therapy.&nbsp;</p> <p>&nbsp;</p> Applying NPWT to bleeding open wounds after forefoot amputation in diabetic foot patients - a case report 2019-02-17T23:59:14+01:00 Jacek Białecki Przemysław Pyda Anna Kołodziejska Anna Rybak Sebastian Sowier <p><span style="font-weight: 400;">NPWT is increasingly used in patients with diabetic foot.</span><span style="font-weight: 400;"> The protocol for performing NPWT is subject to debate. Main concerns regard the type of suction to use (continuous, intermittent, or variable), the wound-packing material, or the exact pressure to apply. Typically, an optimum pressure range of –80 to –125 mmHg is indicated. </span><span style="font-weight: 400;">Following bone resection in diabetic foot patients, the surgical wound is left open, which often entails bleeding from the resection site. In these cases, the start of NPWT was typically delayed by 24–48 hours – during that time a pressure dressing was applied – and NPWT was only started once bleeding had ceased. In order to initiate NPWT as soon as possible, we decided to start it at a higher negative pressure than usual, i.e. –180 mmHg, expecting that this would stop the bleeding. Only then would we reduce the negative pressure. This paper presents the course of NPWT with high negative pressure values after an amputation in 2 diabetic foot patients. In both cases, our assumptions were confirmed. The patients did not bleed, the drained volume did not exceed 30 ml (which seems clinically insignificant) in the first 40 minutes of treatment. Later, with negative pressure at –120 mmHg, no bleeding into the dressing was observed. Following the treatment (which lasted for 9 days), the wounds granulated normally, with no signs of inflammation. Applying VAC dressing using</span> <span style="font-weight: 400;">high negative pressure values to bleeding wounds immediately after surgery may stop the bleeding, enabling immediate initiation of NPWT.</span></p> 2018-12-22T00:00:00+01:00 ##submission.copyrightStatement## New perspectives in the treatment of hard-to-heal wound 2019-02-17T23:59:14+01:00 Jarosław Cwaliński Jacek Paszkowski Tomasz Banasiewicz <p><span style="font-weight: 400;">Hard-to-heal wounds continue to be a challenge in the everyday surgical practice. Their treatment is time-consuming, expensive and in many cases requires interdisciplinary assessment. Therapy option include properly selected surgical procedures and dressings combined with systemic antibiotherapy. Application of &nbsp;vacuum assisted closure (VAC) facilitates the evacuation of pathological discharge, reduces tissue oedema and eliminates bacterial biofilm. Complementary administration of antibiotics to control chronic infection relies today in most cases on vancomycin, ciprofloxacin or piperacillin with tazobactam, with good clinical effect. </span></p> <p><span style="font-weight: 400;">An alternative to antibiotics against MRSA, administered at hospitals might be dalbavancin, a new generation </span><a href=""><span style="font-weight: 400;">lipoglycopeptide</span></a><span style="font-weight: 400;">, which belongs to the same class as vancomycin. Introduction of dalbavancin and VAC might be an alternative to traditional methods of therapy</span><span style="font-weight: 400;">.</span></p> 2018-12-22T00:00:00+01:00 ##submission.copyrightStatement##