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Informational/Educational Report
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Use of negative pressure wound therapy* and antimicrobial wound dressing** to heal a large post-operative diabetic foot wound Michael S. Miller DO, FACOS, FAPWCA, CWS, Susan Girolami, RN, BSN, CWOCN, Kevin J. Powers, DPM, Cheryl McDaniel, LPN The use of negative pressure to promote healing of open wounds has considerable literature support for efficacy, cost effectiveness and ease of use. A new product concept called The Versatile 1TM by Blue Sky Medical of La Costa, CA offers a variation on negative pressure wound therapy through the use of easily available constituents such as rubber/plastic tubing, gauze and clear, semi-permeable dressings and overlaying funnel dressings. This product and the conceptual variation on the current NPWT are based on extensive experience which is well documented in the Russian literature. It differs from the conventional product in multiple parameter recommendations including strength of suction, timing of therapy and length of therapy. Silver impregnated products such as Silverderm7 have become an integral part of bacterial bio-burden reduction in an effort to promote healing. The combination of these two modalities represents a significant advance in healing wounds that are recalcitrant to other more commonly used therapies. The potential benefits of combinionb these two novel approaches is explored A case is presented of a 62-year-old man with Type II diabetes and neuropathy who experienced a non healing gangrenous wound of the left foot due to ill fitting shoes. The injury extended to deep structures requiring surgical intervention in which the third toe ande metatarsal was removed. Because of concerns over bacterial bioburden and a significant residual non-healing wound, a combination of a topical Silver dressing and Negative Pressure Wound Therapy was implemented with excellent, rapid healing noted *BlueSky Medical Versatile 1TM La Costa, CA..**DermaRite Industries, Paterson, NJ Chariker ME, Jeter KF, et al. Effective management of incisional and cutaneous fistulae with closed suction wound drainage. Contemp Surg. 1989:34:59Ð63 Argenta LC, Morykwas MJ. Vacuum assisted closure: a new method for wound control and treatment: Clinical experience. Ann Plast Surg. 1997;38:563Ð576 Mullner T, Mrkonjic L, Kwasny O, Vecsei V. The use of negative pressure to promote the healing of tissue defects: a clinical trial using the vacuum sealing technique. Br J Plast Surg. 1997;50(3):194Ð199. Miller MS, Lowery CA. Negative pressure wound therapy: a rose by any other name. Ostomy Wound Manage. 2005;51(3):44Ð49. |
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