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Case Study
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Use of negative pressure wound therapy system* and drain** to treat an unusual, tunneling, lateral thigh wound Michael Miller, DO, FACOS, FAPWCA, CWS, Robert Whinney, DO, FACOS, 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 the usual negative pressure wound therapy. 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. Recent problems identified with foam based NPWT include bleeding, fragmentation of the foam in the wound and painful removal of the foam. These drawbacks mandate that alternative means of NPWT be developed. This article discusses a novel variation using both non-foam contact and non-contact application of NPWT to heal an unusualk thigh wound The patient is a 49-year-old woman who developed a non healing wound in the distal lateral right thigh with a 15-cm long subcutaneous tunnel extending to the right hip region. The etiology was not immediately identified and so aggressive surgical debridement was performed and a counter wound was created at the top of the thigh to identify the base of the tunnel. Based on the surgical findings and history, an etiology of pressure with deep tissue injury confined to the deep subcutaneous tissue layer was diagnosed. Recognizing the benefits of NPWT and based on the concern of using foam due to the severity and depth of the deep tunneling wound, the Blue Sky Medical Versatile 1 Negative Pressure Wound Therapy System and the Miller DermiVex Drain were used with rapid, excellent final healing *BlueSky Medical Versatile 1TM La Costa, CA.**Miller DermiVex Drain 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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