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  1. Severe descending necrotizing mediastinitis: vacuum-assisted dressing did wonder
    Liew YT, Lim EY, Zulkiflee AB, Prepageran N
    Gen Thorac Cardiovasc Surg, 2017 Apr;65(4):225-228.
    PMID: 27016203 DOI: 10.1007/s11748-016-0642-3
    Descending necrotizing mediastinitis (DNM) is a rapidly progressive disease from the spread of cervical infection. Transcervical and transthoracic drainage was the recognized traditional surgical approach to achieve adequate clearance of infection. Non-invasive vacuum-assisted dressing is a new technique where applied negative pressure can help remove infective fluid and to promote wound healing. A 60-year-old man presented with odynophagia, fever and anterior neck swelling for 2 weeks. He was diagnosed to have anterior neck abscess and underwent surgical drainage. However, it did not respond well, but progressed to involve superior and inferior mediastinum. Vacuum-assisted dressing was applied for total of 2 weeks and the patient recovered without going through usual traditional transthoracic drainage. Vacuum drainage is a simple, safe and non-invasive method of managing DNM, in well selected group with small abscess cavity without airway obstruction and septicemia. This potential technique can lead to paradigm shift in treating life-threatening DNM.
    Matched MeSH terms: Negative-Pressure Wound Therapy/methods*
  2. Fulltext Prophylactic PICO◊ dressing shortens wound dressing requirements post emergency laparotomy (EL-PICO◊ trial)
    Philip EF, Rajandram R, Zuber M, Khong TL, Roslani AC
    World J Emerg Surg, 2024 Nov 22;19(1):38.
    PMID: 39578859 DOI: 10.1186/s13017-024-00560-9
    BACKGROUND: Surgical site infection (SSI) is a very common complication of emergency laparotomy and causes significant morbidity. The PICO◊ device delivers negative pressure wound therapy (NPWT) to closed incisions, with some studies suggesting a role for prevention of SSI in heterogenous surgical populations. We aimed to compare SSI rates between patients receiving PICO◊ versus conventional dressing post-emergency laparotomy. Secondary objectives were to observe seroma and dehiscence rates, length of stay, days on dressing and patients' wound experience.

    METHODS: This double blinded randomized controlled trial was conducted in University Malaya Medical Centre between October 2019 and March 2022. Patients undergoing emergency laparotomy requiring incisions less than 35 cm were included. Statistical analysis was performed using χ2 test for categorical variables, independent T-test or Mann-Whitney U were used for parametric or non-parametric data respectively besides logistic regression. P values of wound care experience, and was associated with trends towards fewer wound related complications. Cost effectiveness needs to be explored in order to further validate its use in the emergency setting, especially for patients with additional risk for SSI. Trial registration National Medical Research Registry (NMRR): NMRR-20-1975-55222.

    Matched MeSH terms: Negative-Pressure Wound Therapy/methods
  3. Fulltext eComment: Negative pressure vacuum assisted closure therapy following cardiac surgery: safe and effective
    Sachithanandan A
    Interact Cardiovasc Thorac Surg, 2011 Feb;12(2):120.
    PMID: 21257947 DOI: 10.1510/icvts.2010.252668A
    Matched MeSH terms: Negative-Pressure Wound Therapy/methods*
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