Negative Pressure Wound Therapy as a Salvage Procedure in Venous Congestion of Microsurgical Procedures

Negative Pressure Wound Therapy: Supra-Physiological or Just Physical Effects of Positive Pressure?

This communication provides a new insight into the unexplained physiology of beneficial effects of negative pressure wound therapy (NPWT). Possible mechanisms of beneficial effects of NPWT in failing replantation and free tissue transfer are discussed. Positive pressure generated by NPWT as well as its draining action creates exudate-free tight tissue-to-tissue interface, which may enhance neovascularization.

Microsurgical Complications after Finger Reimplantation Treated with Negative Pressure Wound Therapy: A Case Report

Venous congestion is the most critical complication following microsurgical finger replantation and can present within the first postoperative days or even in the immediate postoperative period. This is a case series of three patients who underwent digit replantation. The postoperative complication was venous congestion, and immediately, negative pressure wound therapy (NPWT) was applied to reduce the risk of failure. Three patients with a range of 35 years of age were included. One index finger, one thumb, and one ring finger were the fingers amputated; the surgical technique was described; our anticoagulant protocol was demonstrated; and finally, standardization of the NPWT was established. At the end of the therapy, all fingers survived. We concluded that NPWT is an excellent treatment option following the identification of venous congestion in digit replantation.