Efficacy of Negative Pressure Wound Therapy in Treatment of Infected and Traumatic Wounds of the Upper Extremity

P. Zwolak, M. A. König, G. Osterhoff, V. Wilzeck, H.-P. Simmen, G. Jukema

Objective

The presented study reviews results of the treatment of infected and traumatic wounds of the upper extremity using negative pressure wound therapy.

Methods

In university hospital 38 patients with infected or traumatic wounds were treated in the period between January to December 2011, using negative pressure wound therapy. Our protocol of the therapy consisted of repeated debridements, irrigation and temporary closure with negative pressure wound therapy. There were 38 patients (6 women and 32 men; mean age 41.5, range 16-76 years); 21 patients with infected wounds and 17 patients with traumatic wounds.

Results

The time from begin of infection to surgery and treatment with negative pressure wound therapy in patients with infections in upper extremity was mean 9.1, range 1-62 days. The total number of debridements, irrigation, and negative pressure wound therapy changes, in the group of patients with infected wounds was mean 1.3, range 1-5 and in the group of patients with traumatic wounds was mean 1.4, range 1-3. All surgical debridements and negative pressure therapy changes have been performed in operating room. The hospital stay for patients with infected wounds was mean 10.9, range 5-51 days, and for patients with traumatic wounds was mean 9.8, range 3-17 days. The mean duration of antibiotic therapy after initial debridement was 16.9, range 4-46 days for patients with infected wounds, and 10.3, range 1-26 days for patients with traumatic wounds. In group of patients with infected wounds we could achieve the secondary wound closure in 19 patients, and in ten patients with traumatic wounds. The skin graft was used in two patients with infected wounds and in six patients with traumatic wounds. In one patient with traumatic wound we used the biceps fascia flap with skin graft for closure.

Conclusion

Our study reviewed the role of negative pressure wound therapy in treatment of infected and traumatic wounds of the upper extremity without hand. This data shows that this approach is a very effective mode of treatment in both patients’ populations.

Level of evidence: Therapeutic study. Level IV.