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Minimizing treatment complexity of combat-related soft tissue injuries using a dedicated tension relief system and negative pressure therapy augmented by high-dose in situ antibiotic therapy and oxygen delivery: a retrospective study

引用

Burns & Trauma 2021年第1期9卷 454-463页

作者： Moris Topaz Itamar Ashkenazi Oren Barzel Seema Biswas Dan Atar Nurit Shadmi Itzhak Siev-Ner Sheba Medical Center Ramat GanIsrael Hillel Yaffe Medical Center HaderaIsrael Rambam Medical Center HaifaIsrael Galilee Medical Center NahariyaIsrael Soroka Medical Center Beer ShevaIsrael Adi Negev Rehabilitation Hospital MerhavimIsrael

Background:Following combat-related,extensive soft tissue injury from gunshot wounds or blasts,prolonged duration from injury to full wound closure is associated with infection,increased morbidity and mortality,failure to mobilize,poor functional outcome and increased *** purpose of this study was to evaluate a novel treatment enabling early primary closure of combat ***:This was a retrospective study of 10 soldiers and civilians with extensive combat-related soft tissue limb injuries(5 gunshot wounds,5 blasts)treated using the TopClosure^(■)Tension Relief System(TRS)with simultaneous administration of regulated oxygen-enriched and irrigation negative pressure-assisted wound therapy(ROINPT)via the Vcareα^(■)***:Nine patients were treated during the acute phase of injury and one was treated following removal of a flap due to deep infection 20 years after injury and flap *** patients had upper limb injury and the rest lower limb *** the aid of the TRS and/or ROINPT,immediate primary closure during reconstruction was achieved in 6 patients and delayed primary closure in *** one patient required a skin graft to close a small area of the wound after most of the wound had been closed by delayed primary *** closure was achieved within 0–37 days(median:12.5 days,interquartile range:2.75–19.75)from ***:The TRS is a novel device for effective,early skin stretching and secure wound closure through the application of stress relaxation and mechanical creep,achieving primary closure of large defects using a simplified surgical technique and reducing the need for closure using skin grafts and flaps and the use of tissue *** supplemental oxygen to the wound by ROINPT reverses the reduced oxygen levels inherent in conventional negative pressure-assisted wound therapy,mitigating anaerobic contamination and reducing *** may accelerate the evacuation of infectious materia

关键词： Soft tissue injury Combat injuries Limb injuries Stress relaxation mechanical creep Tension relief systems

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