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0:00
Hello, I'm Doctor Dennis
Orgill, and today I'd
like to talk about negative pressure
wound therapy, mechanism of action,
and clinical uses.
0:11
For financial disclosures, I've
had passed research funding
and have been a consultant
and an expert witness for KCI.
0:20
Today we'll begin by discussing
the history and technology transfer
of negative pressure
wound therapy devices,
we'll review the biology
of skin stretching,
and we'll talk about the
four primary mechanisms
of negative pressure wound therapy,
which include macrodeformation,
microdeformation, fluid removal,
and a moist wound environment.
We'll then discuss secondary
mechanisms which include,
angiogenesis, inflammation,
regulation of matrix
metalloproteinases, and their
effect on peripheral nerves.
Finally, we'll go over some case
examples including sternal wounds,
open abdomens, groin
wounds, and skin grafts
following a brief discussion.
1:05
When clinicians started using
negative pressure wound therapy
devices, they had
some amazing results.
On the left you see a patient of
ours who came into the hospital
with necrotizing faciitis.
She had peripheral vascular
disease and diabetes,
and this required a
hip disarticulation.
We placed the vac device on
and changed it over 30 days.
Normally we would have
put a large flap on this,
but she was too sick in the ICU.
This could eventually be
covered with a skin graft
to close the wound.
On the right, we commonly use a
vac device to cover skin grafts,
and this shows how this is
applied to a lower leg wound.
