Journal of the American College of Clinical Wound Specialists (2014) -, -–-
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RESEARCH PAPER
GATA Negative Pressure Wound Therapy System €nalp Uzuna, Mesut Mutluoglub, Ali Memisb,* S¸enol Yıldıza, Gu a
Department of Underwater and Hyperbaric Medicine, Gulhane Military Medical Academy, Etlik, Ankara 06010, Turkey; and b Department of Underwater and Hyperbaric Medicine, Gulhane Military Medical Academy, Haydarpasa Teaching Hospital, Uskudar, Istanbul 34668, Turkey
Introduction
Method
The use of negative pressure wound therapy (NPWT) systems has been shown to promote wound healing. Negative pressure removes excess fluid and exudate from the wound and thereby sustains an optimum moist environment, helps control bacterial burden and restores microcirculation by decreasing interstitial pressure.1 NPWT has also been shown to stimulate cells involved in the healing process and furthermore has been suggested to induce endothelial progenitor cell mobilization in diabetic patients with foot infections.2 In a multicenter, randomized controlled trial NPWT has been shown to be a relatively safe and efficient treatment modality for complex diabetic foot wounds with a faster healing rate and higher proportion of healed wounds.3 Taken together, the NPWT system promises a fast and efficient way of preparing wounds for closure by either secondary intention or delayed primary closure, as well as for skin grafting and flap covering.1 While many of its benefits are established, commercial NPWT systems are not readily available and may be extremely costly for the patient. The system developed in our center (GATA-NPWT) provides an equivalent alternative at a substantially lower cost.
The GATA-NPWT system constitutes a substitute for each of the components of the commercial NPWT system. Accordingly, the hospital vacuum system (Figure 1) is used in lieu of the original suctioning device; a surgical suction canister (Figure 2, dotted arrow) is used for the collection of the drained fluid, a 16Frg Nelathon catheter (Figure 2, regular arrow) for exudate drainage and finally a regular sponge to be connected with the catheter (Figure 2, closed arrowhead). The corresponding lid of the canister has two connections: one connected to the drain tube (Figure 2, dashed arrow) and the other to the vacuum system (Figure 2, open arrowhead). A base layer of a non-adherent antibioticimpregnated tulle wound dressing (Figure 3) is sized to fit the wound borders onto which the sponge is placed. Adhesive transparent dressings (Figure 4) are used to seal the wound
* Corresponding author. Tel.: 190 216 542 2020x3904; fax: 190 216 348 7880. E-mail address: [email protected]
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Figure 1
The hospital vacuum system.
2213-5103/$ - see front matter Ó 2014 Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.jccw.2014.09.001
FLA 5.2.0 DTD - JCCW33_proof - 29 September 2014 - 3:56 pm - ce
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Figure 4
Figure 2 Components of the GATA-NPWT system. A: Connecting tube to vacuum system; B: suction canister; C: connecting tube; D: drain tube; E: sponge.
and provide a closed environment (Figure 5). The system is checked for any leakage from any of the connections prior to covering the dressing with a second line bandage. Collapse
Adhesive transparent dressing.
of the sponge while the vacuum system is on is considered a successful sealing. The vacuum system is set at a pressure of 125 mm Hg and works on a continuous mode.
Conclusion GATA-NPWT is a safe and non-expensive alternative to the commercially available NPWT systems. Its efficiency, however, has to be evaluated and compared with established NPWT systems through well-structured randomized controlled studies.
References 1. Bollero D, et al: The role of negative pressure wound therapy in the spectrum of wound healing: a guidelines document. Ostomy Wound Q6 Manage. 2010;56(5 suppl):1–18. 2. Seo SG, Yeo JH, Kim JH, Kim JB, Cho TJ, Lee DY: Negative-pressure wound therapy induces endothelial progenitor cell mobilization in diabetic patients with foot infection or skin defects. Exp Mol Med. 2013 Nov 15;45:e62. 3. Armstrong DG, Lavery LA, Diabetic Foot Study Consortium: Negative pressure wound therapy after partial diabetic foot amputation: a multicentre, randomised controlled trial. Lancet. 2005 Nov 12;366(9498): 1704–1710.
Figure 3 Non-adherent antibiotic-impregnated tulle wound dressing placed over the wound.
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Journal of the American College of Clinical Wound Specialists, Vol -, No -
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Figure 5
GATA-NPWT system at the wound site.
FLA 5.2.0 DTD - JCCW33_proof - 29 September 2014 - 3:56 pm - ce
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Q1 Q7
9 10 11 12 13 14 Q2 15 16 17 Q3 Q4 18 Q5 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59
RESEARCH PAPER
GATA Negative Pressure Wound Therapy System €nalp Uzuna, Mesut Mutluoglub, Ali Memisb,* S¸enol Yıldıza, Gu a
Department of Underwater and Hyperbaric Medicine, Gulhane Military Medical Academy, Etlik, Ankara 06010, Turkey; and b Department of Underwater and Hyperbaric Medicine, Gulhane Military Medical Academy, Haydarpasa Teaching Hospital, Uskudar, Istanbul 34668, Turkey
Introduction
Method
The use of negative pressure wound therapy (NPWT) systems has been shown to promote wound healing. Negative pressure removes excess fluid and exudate from the wound and thereby sustains an optimum moist environment, helps control bacterial burden and restores microcirculation by decreasing interstitial pressure.1 NPWT has also been shown to stimulate cells involved in the healing process and furthermore has been suggested to induce endothelial progenitor cell mobilization in diabetic patients with foot infections.2 In a multicenter, randomized controlled trial NPWT has been shown to be a relatively safe and efficient treatment modality for complex diabetic foot wounds with a faster healing rate and higher proportion of healed wounds.3 Taken together, the NPWT system promises a fast and efficient way of preparing wounds for closure by either secondary intention or delayed primary closure, as well as for skin grafting and flap covering.1 While many of its benefits are established, commercial NPWT systems are not readily available and may be extremely costly for the patient. The system developed in our center (GATA-NPWT) provides an equivalent alternative at a substantially lower cost.
The GATA-NPWT system constitutes a substitute for each of the components of the commercial NPWT system. Accordingly, the hospital vacuum system (Figure 1) is used in lieu of the original suctioning device; a surgical suction canister (Figure 2, dotted arrow) is used for the collection of the drained fluid, a 16Frg Nelathon catheter (Figure 2, regular arrow) for exudate drainage and finally a regular sponge to be connected with the catheter (Figure 2, closed arrowhead). The corresponding lid of the canister has two connections: one connected to the drain tube (Figure 2, dashed arrow) and the other to the vacuum system (Figure 2, open arrowhead). A base layer of a non-adherent antibioticimpregnated tulle wound dressing (Figure 3) is sized to fit the wound borders onto which the sponge is placed. Adhesive transparent dressings (Figure 4) are used to seal the wound
* Corresponding author. Tel.: 190 216 542 2020x3904; fax: 190 216 348 7880. E-mail address: [email protected]
print & web 4C=FPO
1 2 3 4 5 6 7 8
Figure 1
The hospital vacuum system.
2213-5103/$ - see front matter Ó 2014 Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.jccw.2014.09.001
FLA 5.2.0 DTD - JCCW33_proof - 29 September 2014 - 3:56 pm - ce
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print & web 4C=FPO
Figure 4
Figure 2 Components of the GATA-NPWT system. A: Connecting tube to vacuum system; B: suction canister; C: connecting tube; D: drain tube; E: sponge.
and provide a closed environment (Figure 5). The system is checked for any leakage from any of the connections prior to covering the dressing with a second line bandage. Collapse
Adhesive transparent dressing.
of the sponge while the vacuum system is on is considered a successful sealing. The vacuum system is set at a pressure of 125 mm Hg and works on a continuous mode.
Conclusion GATA-NPWT is a safe and non-expensive alternative to the commercially available NPWT systems. Its efficiency, however, has to be evaluated and compared with established NPWT systems through well-structured randomized controlled studies.
References 1. Bollero D, et al: The role of negative pressure wound therapy in the spectrum of wound healing: a guidelines document. Ostomy Wound Q6 Manage. 2010;56(5 suppl):1–18. 2. Seo SG, Yeo JH, Kim JH, Kim JB, Cho TJ, Lee DY: Negative-pressure wound therapy induces endothelial progenitor cell mobilization in diabetic patients with foot infection or skin defects. Exp Mol Med. 2013 Nov 15;45:e62. 3. Armstrong DG, Lavery LA, Diabetic Foot Study Consortium: Negative pressure wound therapy after partial diabetic foot amputation: a multicentre, randomised controlled trial. Lancet. 2005 Nov 12;366(9498): 1704–1710.
Figure 3 Non-adherent antibiotic-impregnated tulle wound dressing placed over the wound.
print & web 4C=FPO
print & web 4C=FPO
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Journal of the American College of Clinical Wound Specialists, Vol -, No -
print & web 4C=FPO
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Figure 5
GATA-NPWT system at the wound site.
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