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Læknablaðið - 15.03.2012, Blaðsíða 21

Læknablaðið - 15.03.2012, Blaðsíða 21
RANNSÓKN Heimildir 1. Argenta LC, Morykwas MJ. Vacuum-assisted closure: a new method for wound control and treatment: clinical experience. Ann Plast Surg 1997; 38: 563-76. 2. Malmsjö M, Ingemansson R, Sjögren J. Mechanism goveming the effects of vacuum-assisted closure in cardiac surgery. Plast Reconstr Surg 2007; 120:1266-75. 3. Moués CM, Vös MC, van den Bemd GJ, Stijnen T, Hovius SE. Bacterial load in relation to vacuum-assisted closure wound therapy: a prospective randomized trial. Wound Repair Regen 2004; 12:11-7. 4. Borgquist O, Gustafsson L, Ingemansson R, Malmsjö M. Micro- and macromechanical effects on the wound bed of negative pressure wound therapy using gauze and foam. Ann Plast Surg 2010; 64: 789-93. 5. Blume PA, Walters J, Payne W, Ayala J, Lantis J. Comparison of negative pressure wound therapy using vacuum-assisted closure with advanced moist wound therapy in the treatment of diabetic foot ulcers. Diabetes Care 2008; 31: 631-6. 6. Braakenburg A, Obdeijn MC, Feitz R, van Rooij IA, van Griethuysen AJ, Klinkenbijl JH. The clinical efficacy and cost effectiveness of the vacuum-assisted closure technique in the management of acute and chronic wounds: a randomized controlled trial. Plast Reconstr Surg 2006; 118: 390-7. 7. Svensson S, Monsen C, Kölbel T, Acosta S. Predictors for outcome after vacuum assisted closure therapy of peri-vascular surgical site infection of the groin. Eur J Vasc Endovasc Surg 2007; 36: 84-9. 8. Vuerstaek JD, Vainas T, Wuite J, Nelemans P, Neumann MH, Veraart JC. State-of-the-art treatment of chronic leg ulcers: A randomized controlled trial comparing vacuum-assisted closure (V.A.C.) with modern wound dressing. J Vasc Surg 2006; 44:1029-37. 9. Argenta LC, Morykwas MJ, Marks MW, DeFranzo AJ, Molnar JA, David LR. Vacuum-assisted closure: State of dinic art. Plast Reconst Surg 2006; 117:127S-142S. 10. Sjögren J, Gustafsson R, Nilsson J, Lindstedt S, Nozohoor S, Ingemansson R. Negative-pressure wound therapy following cardiac surgery: bleeding complications and 30-days mortality in 176 patients with deep sternal wound infection. Interact Cardiovasc Thorac Surg 2011; 12:117-20. 11. Lambert KV, Hayes P, McCarthy M. Vacuum assisted closure: A review of development and current applications. Eur J Vasc Endovasc Surg 2005; 29:219-26. 12. Sjögren J, Malmsjö M, Gustafsson R, Ingemansson R. Poststemotomy mediastinitis: a review of conventional surgical treatments, vacuum-assisted closure therapy and presentation of the Lund University Hospital mediastinitis algorithm. Eur J Cardiothorac Surg 2006; 30: 898-905. 13. Armstrong DG, Lavery LA, Diabetic Foot Study Consortium. Negative pressure wound therapy after partial diabetic foot amputation: a multicentre, randomised controlled trial. Lancet 2005; 366:1704-10. 14. Moisidis E, Heath T, Boorer C, Ho K, Deva AK. A prospective, blinded, randomized, controlled clinical trial of topical negative pressure use in skin grafting. Plast Reconstr Surg 2004; 114:917-22. 15. Llanos S, Danilla S, Barraza C, Armijo E, Pineros JL, Quintas M, et al. Effectiveness of negative pressure closure in the intergration of split thickness skin grafts: a randomized, double-masked, controlled trial. Ann Surg 2006; 244: 700-5. 16. Apelqvist J, Armstrong DG, Lavery LA, Boulton AJ. Resource utilization and economic costs of care based on a randomized trial of vacuum-assisted closure therapy in the treatment of diabetic foot wounds. Am J Surg 2008; 195: 782-8. 17. Moues CM, van den Bemd GJ, Meerding WJ, Hovius SE. An economic evaluation of the use of TNP on full-thickness wounds. J Wound Care 2005; 5: 224-7. 18. Attinger CE, Janis JE, Steinberg J, Schwartz J, Al-Attar A, Couch K. Clinical approach to wounds: débridement and wound bed preparation including the use of dressings and wound-healing adjuvants. Plast Reconstr Surg 2006; 117: 72S-109S. 19. Petzina R, Malmsjö M, Stamm C, Hetzer R. Major complications during negative pressure wound therapy in poststemotomy mediastinitis after cardiac surgery. J Thorac Cardiovasc Surg 2010; 140:1133-6. ENGLISH SUMMARY Negative pressure wound therapy in lceland - indication and outcome Gudmundsdottir l', Steingrimsson S2, Gudbjartsson T23 Introduction: Negative pressure wound therapy (NPWT) is a recent therapeutic option in wound healing, where a vacuum source is used to create sub-atmospheric pressure in the wound bed with airtight dress- ings. The aims were to study the indications for the use of NPWT in a whole country and evaluate the outcome of treatment. Material and methods: This was a retrospective study that included all patients that were treated with NPWT in lceland between January and December 2008. Information on indication, duration and outcome of treatment was collected from patient charts. Factors that are known to affect wound healing, such as diabetes, smoking and age, were also registered. Results: During the 12 month study period a total of 65 NPWT-treatments were given to 56 patients; 35 (63%) males and 21 (37%) females, with an average age of 62 yrs (range; 8 - 93). The indications for treatment were: wound infection (40%), promotion of wound healing (42%) and keeping cavities open (19%). The lower limbs (26%) and chest area (25%) were the most common sites for treatment. Six patients died during the treatment period, none of them due to complications related to NPWT, and these patients were excluded from analysis of wound healing. In the other 59 treatments, 40 wounds (68%) healed successfully, but healing was incomplete in 19. Treatment related complications were recorded in 19 (32%) cases; wound pain (12%) and skin problems (11%) being the most common ones. Conclusion: NPWT has been used considerably in lceland, especially for infected surgical wounds and chronic wounds. In two thirds of cases a complete wound healing was achieved, which must be regarded as a favorable outcome. Key words: Negative pressure wound therapy (NPWT), wound infectons, indications, outcome, healing rate. Correspondence; Tómas Guðbjartsson, tomasgud@landspitaii.is 'Department of Vascular surgery, 2Cardiothoracic surgery, Landspitali University Hospital,3Faculty of Medicine, University of lceland. LÆKNAblaðið 2012/98 153
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