Murad Karadsheh has completed his M.D. at the age of 26 from Michigan State University College of Human Medicine. He completed his intern year in general surgery at UCSF medical center and is currently completing his residency in surgery.
Background. Optimal wound healing in negative pressure wound therapy (NPWT) depends on a properly sealed vacuum system. Anatomically difficult wounds disrupt the adhesive dressing, resulting in air leaks that impair the integrity of this system. Several techniques have been used in previous reports to prevent air leaks, including the addition of skin adhesives (eg, Skin-Prep or compound tincture of benzoin), hydrocolloid dressings, silicone, and stoma paste. The purpose of this case report is to demonstrate the effectiveness of using a cyanoacrylate tissue adhesive, Dermflex, in maintaining an airtight, durable seal in NPWT. Materials and Methods. The authors present a patient with a difficult to manage anogenital wound where efforts to maintain an airtight seal in NPWT proved difficult. It was decided during the course of treatment to use the cyanoacrylate tissue adhesive to create an airtight, durable seal. The tissue adhesive was applied circumferentially to the skin surrounding the wound edge. After placement of vacuum-assisted closure foam over the wound, the adhesive dressing was applied with its edges overlapping the skin area where the tissue adhesive was applied. Results. The size of the wound was visibly reduced at each dressing change. An airtight seal was consistently maintained for 3 days at a time, surviving the difficult environment of the wound and maximizing the life of each adhesive dressing. Conclusion. For wounds in anatomically challenging locations, the use of the tissue adhesive appears to be a safe and viable option in creating a durable seal in NPWT
Alireza Nasoori is a PhD. Student at Wildlife Biology Group, Veterinary School, Hokkaido University, Japan with a background on tissue preparation and tissue regeneration, maggot therapy, and integrative medicine
Burn wounds are of critical injuries that can culminate in considerable morbidities and mortalities, which in turn impose huge economic and psychological burdens on the patients and society. Unfortunately, low and middle-income countries, which hold over 5 billion people of the world population, are more affected by the burn injuries than those of the developed countries. Electrical burns are one of the frequent burn incidents, and they usually remain thick eschars which are difficult to debride surgically. Lack of appropriate debridement results in more necrosis and infection, and thus limb dysfunction. Maggot debridement therapy (MDT) has shown its efficacy for wound treatment in the recent years. In this study, we used an open pack method which increases the survival of the larvae in delivery, and eases the use of the larvae on the wound. Also, this is the first report of MDT in a patient with severe and extensive electrical burn. The patients’ wounds were fully debrided in 16 days, followed by a successful skin auto graft. MDT proved its rapid effectiveness, lack of any interactions with typical treatments, and a suitable debridement prior skin graft. The cost-effectiveness of this method, and the worldwide distribution of Lucilia sericata (blow fly), make MDT be a great medication that can even be simply practiced in non-developed countries