Minimizing treatment complexity of combat-related soft tissue injuries using a dedicated tension relief system and negative pressure therapy augmented by high-dose in situ antibiotic therapy and oxygen delivery: a retrospective study

Moris Topaz; Itamar Ashkenazi; Oren Barzel; Seema Biswas; Dan Atar; Nurit Shadmi; Itzhak Siev-Ner

doi:10.1093/burnst/tkab007

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Minimizing treatment complexity of combat-related soft tissue injuries using a dedicated tension relief system and negative pressure therapy augmented by high-dose in situ antibiotic therapy and oxygen delivery: a retrospective study

更新时间：2022-06-14

- Minimizing treatment complexity of combat-related soft tissue injuries using a dedicated tension relief system and negative pressure therapy augmented by high-dose in situ antibiotic therapy and oxygen delivery: a retrospective study
- Minimizing treatment complexity of combat-related soft tissue injuries using a dedicated tension relief system and negative pressure therapy augmented by high-dose in situ antibiotic therapy and oxygen delivery: a retrospective study
- Burns & Trauma 2021年9卷第1期
- 作者机构：
  
  1. Sheba Medical Center
  2. Hillel Yaffe Medical Center
  3. Rambam Medical Center
  4. Galilee Medical Center
  5. Soroka Medical Center
  6. Adi Negev Rehabilitation Hospital
- 作者简介：
- 基金信息：
  
  None to declare.
- DOI：10.1093/burnst/tkab007
  中图分类号：
- 纸质出版日期：2021，
  
  网络出版日期：2021-5-25，
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Moris Topaz, Itamar Ashkenazi, Oren Barzel, 等. Minimizing treatment complexity of combat-related soft tissue injuries using a dedicated tension relief system and negative pressure therapy augmented by high-dose in situ antibiotic therapy and oxygen delivery: a retrospective study[J]. Burns & Trauma, 2021,9(1).

Moris Topaz, Itamar Ashkenazi, Oren Barzel, Seema Biswas, Dan Atar, Nurit Shadmi, Itzhak Siev-Ner, Minimizing treatment complexity of combat-related soft tissue injuries using a dedicated tension relief system and negative pressure therapy augmented by high-dose in situ antibiotic therapy and oxygen delivery: a retrospective study, Burns & Trauma, Volume 9, 2021, tkab007, https://doi.org/10.1093/burnst/tkab007
Moris Topaz, Itamar Ashkenazi, Oren Barzel, 等. Minimizing treatment complexity of combat-related soft tissue injuries using a dedicated tension relief system and negative pressure therapy augmented by high-dose in situ antibiotic therapy and oxygen delivery: a retrospective study[J]. Burns & Trauma, 2021,9(1). DOI： 10.1093/burnst/tkab007.

Moris Topaz, Itamar Ashkenazi, Oren Barzel, Seema Biswas, Dan Atar, Nurit Shadmi, Itzhak Siev-Ner, Minimizing treatment complexity of combat-related soft tissue injuries using a dedicated tension relief system and negative pressure therapy augmented by high-dose in situ antibiotic therapy and oxygen delivery: a retrospective study, Burns & Trauma, Volume 9, 2021, tkab007, https://doi.org/10.1093/burnst/tkab007 DOI：

摘要

Abstract

BackgroundFollowing combat-related

extensive soft tissue injury from gunshot wounds or blasts

prolonged duration from injury to full wound closure is associated with infection

increased morbidity and mortality

failure to mobilize

poor functional outcome and increased cost. The purpose of this study was to evaluate a novel treatment enabling early primary closure of combat wounds.MethodsThis was a retrospective study of 10 soldiers and civilians with extensive combat-related soft tissue limb injuries (5 gunshot wounds

5 blasts) treated using the TopClosure® Tension Relief System (TRS) with simultaneous administration of regulated oxygen-enriched and irrigation negative pressure-assisted wound therapy (ROINPT) via the Vcare α® device.ResultsNine patients were treated during the acute phase of injury and one was treated following removal of a flap due to deep infection 20 years after injury and flap reconstruction. Two patients had upper limb injury and the rest lower limb injury. With the aid of the TRS and/or ROINPT

immediate primary closure during reconstruction was achieved in 6 patients and delayed primary closure in three. Only one patient required a skin graft to close a small area of the wound after most of the wound had been closed by delayed primary closure. Wound closure was achieved within 0–37 days (median: 12.5 days

interquartile range: 2.75–19.75) from injury.ConclusionsThe TRS is a novel device for effective

early skin stretching and secure wound closure through the application of stress relaxation and mechanical creep

achieving primary closure of large defects using a simplified surgical technique and reducing the need for closure using skin grafts and flaps and the use of tissue expanders. Delivering supplemental oxygen to the wound by ROINPT reverses the reduced oxygen levels inherent in conventional negative pressure-assisted wound therapy

mitigating anaerobic contamination and reducing infection. Irrigation may accelerate the evacuation of infectious material from the wound and provide a novel method for antibiotic administration. The combination of TRS and ROINPT devices allow for early primary closure with improved functionality of combat-related limb injuries.

关键词

Keywords

Soft tissue injuryCombat injuriesLimb injuriesStress relaxationMechanical creepTension relief systems

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