Jozef Verbelen1, Henk Hoeksema2, Alexander Heyneman2, Ali Pirayesh2, Stan Monstrey3. 1. Department of Plastic and Reconstructive Surgery, Wound Healing and Tissue Engineering Unit, Gent University Hospital, Gent, Belgium. 2. Department of Plastic and Reconstructive Surgery, Wound Healing and Tissue Engineering Unit, Gent University Hospital, Gent, Belgium. 3. Department of Plastic and Reconstructive Surgery, Wound Healing and Tissue Engineering Unit, Gent University Hospital, Gent, Belgium; E-mail: Stan.monstrey@ugent.be.
Abstract
UNLABELLED: Fournier's gangrene (FG) is a complex condition that requires surgical debridement, hemodynamic support, antibiotics, and appro- priate wound management. This study is the first to assess the use of a low-vacuum negative pressure wound therapy (LV-NPWT) system with low-adherent contact surface in two cases of FG. METHODS: The protocol-of-care included twice weekly dressing changes and irrigation with a povidone-iodine-water mixture. Assessments included wound progression (% granulation tissue), ratings of dressing ingrowth, pain during treatment and at dressing changes, patient comfort, and ease- of-use. RESULTS: A 51-year-old man (Patient A) developed FG after sur- gical removal of a perianal abscess. He received 16 days of LV-NPWT with five dressing changes. A 64-year-old man (Patient B) with multiple comorbidities, developed FG after traumatic injury. He received 20 days of LV-NPWT with six dressing changes. In both patients, LV-NPWT promoted rapid granulation tissue formation. Pain scores averaged low-to-moderate during treatment and dressing changes, and tissue ingrowth was minimal. CONCLUSION: Overall, ratings were favorable for LV-NPWT ease-of-use and patient comfort. Despite the complexity of these wounds, with the use of LV-NPWT, both wounds progressed to a point where they were able to successfully receive surgical closure with skin grafts and/or flaps. These cases may suggest that LV-NPWT may have a potential role in complex wound management.
UNLABELLED: Fournier's gangrene (FG) is a complex condition that requires surgical debridement, hemodynamic support, antibiotics, and appro- priate wound management. This study is the first to assess the use of a low-vacuum negative pressure wound therapy (LV-NPWT) system with low-adherent contact surface in two cases of FG. METHODS: The protocol-of-care included twice weekly dressing changes and irrigation with a povidone-iodine-water mixture. Assessments included wound progression (% granulation tissue), ratings of dressing ingrowth, pain during treatment and at dressing changes, patient comfort, and ease- of-use. RESULTS: A 51-year-old man (Patient A) developed FG after sur- gical removal of a perianal abscess. He received 16 days of LV-NPWT with five dressing changes. A 64-year-old man (Patient B) with multiple comorbidities, developed FG after traumatic injury. He received 20 days of LV-NPWT with six dressing changes. In both patients, LV-NPWT promoted rapid granulation tissue formation. Pain scores averaged low-to-moderate during treatment and dressing changes, and tissue ingrowth was minimal. CONCLUSION: Overall, ratings were favorable for LV-NPWT ease-of-use and patient comfort. Despite the complexity of these wounds, with the use of LV-NPWT, both wounds progressed to a point where they were able to successfully receive surgical closure with skin grafts and/or flaps. These cases may suggest that LV-NPWT may have a potential role in complex wound management.