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      Aplicación de terapia de presión negativa en el manejo de pacientes con heridas complejas Translated title: Negative-pressure wound therapy for treating complex wound patients

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          Abstract

          Resumen Una herida compleja es aquella que no cicatriza a la velocidad esperada ni con el tratamiento convencional o que recurre una vez cicatrizada. La siguiente investigación se plantea como objetivo aplicar la terapia de presión negativa en el manejo de pacientes con heridas complejas. Materiales y Métodos: Estudio de cohorte observacional, incluyó nueve pacientes con heridas complejas que ingresaron al Hospital Lic. José María Benítez en el periodo comprendido entre febrero-julio de 2019. De los individuos estudiados seis fueron masculinos y tres femeninos, con una media de edad de 50 años, comorbilidades asociadas desnutrición y diabetes mellitus; en cuanto al tipo de herida según el diagrama de C. Leal, la más frecuente fue tipo 4 (55,6%), con diámetro de 11 a 20cm, una profundidad >3 cm, y presencia de abundante exudado purulento; los gérmenes causales más comunes cultivados fueron E.coli (44,4%) y S. aureus (44,4%); En la totalidad de los individuos estudiados se observó la mejoría clínica de la herida en todas sus características, y la iniciación en tres días promedio del tejido de granulación. Concluyendo que con la aplicación del método en estudio hubo aceleración del proceso de cicatrización, control de la infección y disminución de la estancia hospitalaria.

          Translated abstract

          Abstract A complex wound is the type of wound that has a slow healing process even with standard treatments or tends to recur once it was healed. The aim of this research is to apply negative-pressure wound therapy in the treatment of acute conflict-related wound patients. Materials and Methods: The cohort study included nine patients with complex wounds who were admitted to Hospital Lic. José María Benítez from February to July 2019. Six of the patients on study were male and three female patients whose average age was 50, with comorbidities associated to malnourishment and diabetes mellitus. According to diagram C. Leal, the type of wound mostly found was type 4 (55.6%), ranging from 11-20 cm in diameter, >3 cm depth, with excessive purulent exudate (drainage). The most common cultivated germs found were E. coli (44.4%) and S. aureus (44.4%). All of the patients on study reported clinical improvement of their wounds in all aspects, and an evidence of a 3-day average for the development of the granulation tissue. Concluding that the applying this method evidenced acceleration of wound healing, control of the risk of infection, and reduction of the length of stay in the hospital.

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          Most cited references20

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          Vacuum-assisted closure: a new method for wound control and treatment: clinical experience.

          Despite numerous advances, chronic and other difficult-to-manage wounds continue to be a treatment challenge. Presented is a new subatmospheric pressure technique: vacuum-assisted closure (The V.A.C.). The V.A.C. technique entails placing an open-cell foam dressing into the wound cavity and applying a controlled subatmospheric pressure (125 mmHg below ambient pressure). Three hundred wounds were treated: 175 chronic wounds, 94 subacute wounds, and 31 acute wounds. Two hundred ninety-six wounds responded favorably to subatmospheric pressure treatment, with an increased rate of granulation tissue formation. Wounds were treated until completely closed, were covered with a split-thickness skin graft, or a flap was rotated into the health, granulating would bed. The technique removes chronic edema, leading to increased localized blood flow, and the applied forces result in the enhanced formation of granulation tissue. Vacuum-assisted closure is an extremely efficacious modality for treating chronic and difficult wounds.
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            Hyperbaric oxygen therapy for chronic wounds

            Chronic wounds are common and present a health problem with significant effect on quality of life. Various pathologies may cause tissue breakdown, including poor blood supply resulting in inadequate oxygenation of the wound bed. Hyperbaric oxygen therapy (HBOT) has been suggested to improve oxygen supply to wounds and therefore improve their healing.
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              Negative pressure wound therapy versus conventional wound dressings in treatment of open fractures: A systematic review and meta-analysis

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                Author and article information

                Journal
                jonnpr
                Journal of Negative and No Positive Results
                JONNPR
                Research and Science S.L. (Madrid, Madrid, Spain )
                2529-850X
                2020
                : 5
                : 12
                : 1490-1503
                Affiliations
                [2] orgnameSociedad Venezolana de Cirugía, Venezuela
                [1] La Victoria orgnameUniversidad de Carabobo orgdiv1Facultad de Ciencias de la Salud- Sede Aragua orgdiv2Departamento Clínico Integral La Victoria Venezuela
                Article
                S2529-850X2020001200004 S2529-850X(20)00501200004
                10.19230/jonnpr.3827
                b04a5751-3497-4faa-8c0e-a331ad81e877

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 26 August 2020
                : 16 June 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 20, Pages: 14
                Product

                SciELO Spain

                Categories
                Original

                VAC,Presión negativa,heridas complejas,Negative-pressure,complex wounds

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