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The Use of NPWT in Treating Electrical Burn Wounds

  • Alexandru Ulici
  • Iulia Tevanov
  • Dan Mircea Enescu
  • Alexandru Ulici
Chapter
Part of the Recent Clinical Techniques, Results, and Research in Wounds book series

Abstract

Complex wounds represent a challenge for the wound care specialist. The aim of treatment of electrical burn wounds is to achieve skin cover of the soft-tissue defects, prevent infection, and allow a good function of the affected anatomical segment. Surgical reconstructive techniques for soft-tissue defects covering, such as muscle flaps, free flap transfers, and cross-leg techniques, are frequently used in treating sequelae after electrical burns. In some cases, when the patient cannot be a candidate for free flap surgery the use of negative-pressure wound therapy (NPWT) is an effective alternative that can minimize the traditional reconstructive surgery methods and can reduce the surface of the soft-tissue defect by filling it with new formed granulation tissue, creating a skin graft receptor bed.

This newer and simpler technique used for covering of exposed bone tissue can question the gold standard of plastic reconstructive surgery that utilizes muscle flaps as the only way to cover these defects.

References

  1. 1.
    Gajbhiye AS, Meshram MM, Gajaralwar RS, Kathod AP (2013) The management of electrical burn. Indian J Surg 75(4):278–283Google Scholar
  2. 2.
    Haberal MA (1995) An eleven-year survey of electrical burn injuries. J Burn Care Rehabil 16(1):43–48Google Scholar
  3. 3.
    Dalziel CF (1956) Effects of electric shock on man. IRE Trans Med Electron 5:44–62Google Scholar
  4. 4.
    Price T, Cooper MA, Marx J, Hockberger R, Walls R (2002) Electrical and lighting injuries Rosen's emergency medicine, 5th edn. Mosby, New York, pp 2010–2020Google Scholar
  5. 5.
    Wesner ML, Hickie J (2013) Long-term sequelae of electrical injury. Canadian Fam Phys 59(9):935–939Google Scholar
  6. 6.
    Lee RC (1997) Injury by electrical forces: pathophysiology, manifestations, and therapy. Curr Probl Surg 34(9):677–764Google Scholar
  7. 7.
    Fish RM (1999) Electric injury, part I: treatment priorities, subtle diagnostic factors, and burns. J Emerg Med 17(6):977–983Google Scholar
  8. 8.
    Rai J, Jeschke MG, Barrow RE, Herndon DN (1999) Electrical injuries: a 30-year review. J Trauma 46(5):933–936Google Scholar
  9. 9.
    Bajantri B, Bharathi RR, Sabapathy SR (2012) Wound coverage considerations for defects of the lower third of the leg. Indian J Plast Surg 45(2):283–290Google Scholar
  10. 10.
    Block L, King TW, Gosain A (2015) Debridement techniques in pediatric trauma and burn-related wounds. Adv Wound Care 4(10):596–606Google Scholar
  11. 11.
    Verbelen J, Hoeksema H, Pirayesh A, Van Landuyt K, Monstrey S (2016) Exposed tibial bone after burns: flap reconstruction versus dermal substitute. Burns 42(2):e31–e37Google Scholar
  12. 12.
    Tevanov I, Enescu DM, Bălănescu R, Sterian G, Ulici A (2016) Negative Pressure Wound Therapy (NPWT) to treat complex defect of the leg after electrical burn. Chirurgia (Bucur) 111(2):175–179Google Scholar
  13. 13.
    Parrett BM, Matros E, Pribaz JJ, Orgill DP (2006) Lower extremity trauma: trends in the management of soft-tissue reconstruction of open tibia-fibula fractures. Plast Reconstr Surg 117(4):1315–1322Google Scholar
  14. 14.
    Huang C, Leavitt T, Bayer LR, Orgill DP (2014) Effect of negative pressure wound therapy on wound healing. Curr Probl Surg 51(7):301–331Google Scholar
  15. 15.
    Siqueira MB, Ramanathan D, Klika AK, Higuera CA, Barsoum WK (2016) Role of negative pressure wound therapy in total hip and knee arthroplasty. World J Orthop 7(1):30–37Google Scholar
  16. 16.
    Glass GE, Murphy GF, Esmaeili A, Lai LM, Nanchahal J (2014) Systematic review of molecular mechanism of action of negative-pressure wound therapy. Br J Surg 101(13):1627–1636Google Scholar
  17. 17.
    Webb LX, Pape HC (2008) Current thought regarding the mechanism of action of negative pressure wound therapy with reticulated open cell foam. J Orthop Trauma 22(10 Suppl):S135–S137Google Scholar
  18. 18.
    Orgill DP, Manders EK, Sumpio BE, Lee RC, Attinger CE, Gurtner GC, Ehrlich HP (2009) The mechanisms of action of vacuum assisted closure: more to learn. Surgery 146(1):40–51Google Scholar
  19. 19.
    Scherer SS, Pietramaggior G, Mathews JC, Prsa MJ, Huang S, Orgill DP (2008) The mechanism of action of the vacuum-assisted closure device. Plast Reconstr Surg 122:786–797Google Scholar
  20. 20.
    Hasan MY, Teo R, Nather A (2015) Negative-pressure wound therapy for management of diabetic foot wounds: a review of the mechanism of action, clinical applications. Diabet Foot Ankle 6:27618Google Scholar
  21. 21.
    Mouës CM, Heule F, Hovius SER (2011) A review of topical negative pressure therapy in wound healing: sufficient evidence? Am J Surg 201:544–556Google Scholar
  22. 22.
    Borgquist O, Gustafsson L, Ingemansson R, Malmsjö M (2010) Micro- and macromechanical effects on the wound bed of negative pressure wound therapy using gauze and foam. Ann Plast Surg 64(6):789–793Google Scholar
  23. 23.
    Argenta LC, Morykwas MJ (1997) Vacuum-assisted closure: a new method for wound control and treatment: clinical experience. Ann Plast Surg 38:563–576Google Scholar
  24. 24.
    Adamkova M, Tymonova J, Zamecnikova I, Kadlcik M, Klosova H (2005) First experience with the use of vacuum assisted closure in the treatment of skin defects at the burn center. Acta Chir Plast 47:24–27Google Scholar
  25. 25.
    FDA Safety Communication: UPDATE on serious complications associated with negative pressure wound therapy systems (2017) http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm244211.htm. Accessed 15 Feb 2017
  26. 26.
    Owens BD, Wenke JC (2007) Early wound irrigation improves the ability to remove bacteria. J Bone Joint Surg Am 89(8):1723–1726Google Scholar
  27. 27.
    Nather A (2011) Role of negative pressure wound therapy in healing of diabetic foot ulcers. J Surg Tech Case Rep 3(1):10–11Google Scholar
  28. 28.
    Pham CT, Middleton P, Maddern G (2003) Vacuum-assisted closure for the management of wounds: an accelerated systematic review. ASERNIP-S Report No 37Google Scholar
  29. 29.
    Birke-Sorensen H, Malmsjo M, Rome P, Hudson D, Krug E, Berg L, Bruhin A, Caravaggi C, Chariker M, Depoorter M, Dowsett C, Dunn R, Duteille F, Ferreira F, Francos Martínez JM, Grudzien G, Ichioka S et al (2011) Evidence-based recommendations for negative pressure wound therapy: treatment variables (pressure levels, wound filler and contact layer) – steps towards an international consensus. J Plast Reconstr Aesthet Surg 64(Suppl):S1–S16Google Scholar
  30. 30.
    Excell ET (2009) Use of negative pressure wound therapy for abdominal wounds: a review of recent literature. School of Physician Assistant Studies. Paper, p 187Google Scholar
  31. 31.
    Baranoski S, Ayello EA (2008) Wound care essentials: practice principles, 2nd edn. Lippincott Williams &Wilkins, Philadelphia, p 152Google Scholar
  32. 32.
    Sachsenmaier S, Peschel A, Ipach I, Kluba T (2013) Antibacterial potency of V.A.C. GranuFoam Silver(®) dressing. Injury 44(10):1363–1367Google Scholar
  33. 33.
    Malmsjö M, Ingemansson R, Martin R, Huddleston E (2009) Negative-pressure wound therapy using gauze or open-cell polyurethane foam: similar early effects on pressure transduction and tissue contraction in an experimental porcine wound model. Wound Repair Regen 17(2):200–205Google Scholar
  34. 34.
    Karadsheh MJ, Nelson J, Wilcox R (2015) The application of skin adhesive to maintain seal in negative pressure wound therapy. Wounds 27(9):244–248Google Scholar
  35. 35.
    Handschin AE, Jung FJ, Guggenheim M, Moser V, Wedler V, Contaldo C, Kuenzi W, Giovanoli P (2007) Surgical treatment of high-voltage electrical injuries. Handchir Mikrochir Plast Chir 39(5):345–349Google Scholar
  36. 36.
    Panuncialman J, Falanga V (2009) The science of wound bed preparation. Surg Clin North Am 89(3):611–626Google Scholar
  37. 37.
    Schultz GS, Sibbald RG, Falanga V, Ayello EA, Dowsett C, Harding K, Romanelli M, Stacey MC, Teot L, Vanscheidt W (2003) Wound bed preparation: a systematic approach to wound management. Wound Repair Regen 11(Suppl 1):S1–28Google Scholar
  38. 38.
    Frykberg RG, Banks J (2015) Challenges in the treatment of chronic wounds. Adv Wound Care 4(9):560–582Google Scholar
  39. 39.
    Morykwas MJ, Argenta LC, Shelton-Brown EI, McGuirt W (1997) Vacuum-assisted closure: a new method for wound control and treatment: animal studies and basic foundation. Ann Plast Surg 38:553–562Google Scholar
  40. 40.
    Borgquist O, Ingemansson R, Malmsjö M (2011) The influence of low and high pressure levels during negative-pressure wound therapy on wound contraction and fluid evacuation. Plast Reconstr Surg 127:551–559Google Scholar
  41. 41.
    Malmsjö M, Gustafsson L, Lindstedt S, Gesslein B, Ingemansson R (2012) The effects of variable, intermittent, and continuous negative pressure wound therapy, using foam or gauze, on wound contraction, granulation tissue formation, and ingrowth into the wound filler. Eplasty 12:e5Google Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Alexandru Ulici
    • 1
    • 2
    • 3
  • Iulia Tevanov
    • 2
  • Dan Mircea Enescu
    • 4
    • 3
  • Alexandru Ulici
    • 3
  1. 1.Romanian Pediatric Orthopedic SocietyBucharestRomania
  2. 2.Department of Pediatric Orthopedic SurgeryEmergency Hospital for Children “Grigore Alexandrescu”BucharestRomania
  3. 3.Carol Davila University of Medicine and PharmacyBucharestRomania
  4. 4.President of the Romanian Burns Society, Department of Plastic and Reconstructive SurgeryEmergency Hospital for Children “Grigore Alexandrescu”BucharestRomania

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