שנה שפה:

Early Closure of Dehisced Infected Amputation Wounds, is it Possible?



Oren Barzel1, Oren Gross1, Itzhak Siev-Ner1, Sigal Ezra1, Moris Topaz2
1 Orthopedic Rehabilitation, Sheba Medical Center, Ramat Gan, Israel
2 Plastic Surgery Unit, Hillel Yaffe Medical Center, Hadera, Israel

Primary wound closure of amputated limbs is crucial for better functionality and early ambulation. Wound infection and high tension closure restrict wound edge approximation delay wound healing and results in delayed wound closure. Simultaneous administration of supplemental oxygen and wound irrigation as in Regulated Oxygen-Enriched and Irrigation Negative Pressure-Assisted Wound Therapy (ROI-NPT) was applied to synergistically combat anaerobic infection, reduce wound’s bacterial load and promote wound healing.

The TopClosure® Tension Relief System (TRS) is a novel device for wound stretching, closure and secure. It applies controlled, incremental, and evenly-distributed tension relief, over a wide area of attachment away from wound margins. The TopClosure® TRS attaches to the skin both invasively and noninvasively, in a dynamic, adjustable, reversible, zipper-like manner allowing skin stretching by both mechanical creep and stress relaxation.

We present a diverse series of infected limb amputation due to diabetes, peripheral vascular daisies and trauma where combined ROI-NPT and TRS were applied for early resolution of infection and primary closure of the stump, substituting for skin grafts or flaps with improved fitting of prosthetics and better functionality.

The combination of TRS and ROI-NPT alters the three phases of wound healing by reducing inflammation, eliminating the need for lengthy proliferation of granulation tissue, reaching early maturation and enabling improved functionality. This unique synergistic effect provides a totally new concept of wound management that changes perceptions of infected amputation wound closure, and instituting new standards of care for optimizing wound healing and functionality.

העלאת קובץ המאמר או המצגת

Dr Oren Barzel