Abstract
Background: The closed intra-wound continuous negative pressure and irrigation treatment reported here is a very effective method when a wound at risk of infection must be closed. However, this conventional method has the drawback of shunting, which occurs in the early stages. Uninfected areas become adherent, and the source of the infection is not adequately cleaned. Therefore, we report a new method which cleans this area intensively and reliably, and satisfactory results were obtained.
Methods: Irrigation and suction tubes with tips on each other were placed in the most desired area of the wound to be cleaned. The irrigation and suction tubes were connected to a saline bottle and a continuous suction device, respectively. As negative pressure was applied, the saline solution flows through, allowing for the pinpoint cleaning of specific areas around the irrigation tubing.
Results: This method was performed on 7 patients (4 males and 3 females; age: 34–82 years [average 64.7 years]) with infected wounds, at our institution between May 2018 and March 2019. In all the cases, the wounds healed completely without any recurrence.
Conclusions: This method can be as more reliable than the conventional method, to prevent the outbreak of infection in wounds that must be closed.
(a) Findings upon the first visit to our department (left lower leg). Skin necrosis of the left lower leg is observed (arrow), and the plate iscould be palpated under the skin. (b) Surgical findings. After debridement, the plate fixed to the tibia was exposed (arrow). (c) Implementation of method: The slit of the tube for injection was placed around the plate (arrow). (d) Findings immediately after surgery. After the tube was placed, gastrocnemius flap transplantation and split-thickness skin grafting were performed (asterisk). (e) Findings one year after surgery. The wound was completely epithelialized and walking was possible.
