Vacuum-Assisted Wound Closure Therapy in Pediatric Lower Limb Trauma

Negative pressure wound therapy in the management of postoperative spinal wound infections: a systematic review

INTRODUCTION

Postoperative wound infection after spinal surgery might be a challenge to manage. A wide range of procedures have been described for managing infected spinal wounds. An increasingly common procedure in the management of surgical site infections (SSI) is negative pressure wound therapy (NPWT), also known as vacuum-assisted closure. As there is a paucity of clear clinical advice the present investigation aims to update current evidence on the use of NPWT to manage postoperative SSI occurring after instrumented spine surgery.

METHODS

This systematic review was conducted according to the preferred reporting Items for systematic reviews and meta-analyses: the 2020 PRISMA statement. In January 2024, the following databases were accessed: PubMed, Web of Science, and Google Scholar. No time constraint was set for the search. All the clinical studies investigating the unique use of NPWT in treating postoperative spinal wound infections were accessed.

RESULTS

A total of 381 patients were included in the present study. Of them 52.5% (200 of 381 patients) were women. The mean age was 52.2 ± 15.2 years. The average length of the NPWT was 21.2 days (range 7-90 days).

CONCLUSION

NPWT could be a valuable adjuvant therapy for the management of SSI after spine surgery. Additional high-quality investigations are required to assess the efficacy and safety of NPWT in SSI after spine surgery, especially if combined with contraindications or risk factors, such as the presence of intraoperative CSF leak.

LEVEL OF EVIDENCE

Level IV, Systematic review.

Negative Pressure Wound Therapy With Flap Reconstruction for Extensive Soft Tissue Loss in the Foot: A Case Report

Negative pressure wound therapy (NPWT) can create the healing granulation tissue that will form a wound bed for the skin graft, thereby reducing the volume of the soft tissue defect. The application of uniform negative pressure, which is delivered by vacuum-assisted closure (VAC) therapy, induces a physical response (macrostrain) and a biological response (microstrain). The patient in the current case report presented with an alleged history of a road traffic accident, sustaining a crush injury to his right heel pad, resulting in an open comminuted fracture of the right calcaneum with bone loss. A total of seven days of NPWT was allowed. Negative pressure sponge dressing was then applied in this region and adhesive drapes were sealed. Once sealed, suction was set at the continuous pressure of -125 mm Hg. The authors noted that the benefits significantly outweigh the costs of the VAC system, making it an essential treatment option for patients similar to the one presented in this case report.