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EWMA 2013 - EP 484 - Sealing npwt dressings made easy
1.
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.
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 © Dr. med. univ. Markus Duft, WDM® / EP 484 EWMA 2013
3.
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 © Dr. med. univ. Markus Duft, WDM® / EP 484 EWMA 2013
4.
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 © Dr. med. univ. Markus Duft, WDM® / EP 484 EWMA 2013
5.
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 Arterial hypertension 28.05.2012 NPWT established 06.06.2012 dismissal, outpatient care with NPWT changes, lost of follow up © Dr. med. univ. Markus Duft, WDM® / EP 484 EWMA 2013
6.
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 © Dr. med. univ. Markus Duft, WDM® / EP 484 EWMA 2013
7.
7 Case VI: Sex: f
Age: 56 Medical diagnosis: Wound necrosis post 09.01.2013 hip endoprosthesis enucleation, transfemoral amputation dext. Arterial hypertension 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 © Dr. med. univ. Markus Duft, WDM® / EP 484 EWMA 2013
8.
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 Arterial hypertension Obesety 28.12.2012 maggot therapy for two weeks, afterwards calciumalginate Ag and foam dressing © Dr. med. univ. Markus Duft, WDM® / EP 484 EWMA 2013
9.
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 © Dr. med. univ. Markus Duft, WDM® / EP 484 EWMA 2013
10.
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® markus.duft@khgh.at © Dr. med. univ. Markus Duft, WDM® / EP 484 EWMA 2013
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