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Case report
peer-reviewed
1 Place Winner

Negative Pressure Wound Therapy with Instillation in a Chronic Non-Healing Right Hip Trochanteric Pressure Ulcer



Abstract

Complex pressure ulcer wound sites often present with a wide scope of barriers to healing ranging from high colonization of multi-drug-resistant pathogens to tortuous internal anatomy which make the wound recalcitrant to traditional wound care including standard negative pressure wound therapy (NPWT). Negative pressure wound therapy with instillation (NPWTi-d) provides an opportunity to manage and heal wounds with indications not met by standard NPWT such as cavitating wounds with complex undermining and tunneling. In this clinical case report, a patient who presented with a chronic, non-healing Stage IV pressure ulcer underwent a tensor fascia lata flap reconstruction that was complicated by a partial flap-tip nonadherence with associated partial dehiscence of the flap incision that proved unresolvable until application of adjunctive NPWTi-d which allowed the wound to experience a robust rate of granulation, contraction, and closure.



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Case report
peer-reviewed

Negative Pressure Wound Therapy with Instillation in a Chronic Non-Healing Right Hip Trochanteric Pressure Ulcer


Author Information

Kevin W. Broder

Section of Plastic Surgery VA Healthcare - San Diego, Division of Plastic Surgery University of California San Diego

Brian Nguyen Corresponding Author

School of Medicine, University of California, San Diego

Richard M. Bodor

Section of Plastic Surgery VA Healthcare - San Diego, Division of Plastic Surgery University of California San Diego


Ethics Statement and Conflict of Interest Disclosures

Human subjects: Consent was obtained by all participants in this study. Conflicts of interest: The authors have declared that no conflicts of interest exist.


Case report
peer-reviewed

Negative Pressure Wound Therapy with Instillation in a Chronic Non-Healing Right Hip Trochanteric Pressure Ulcer


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Case report
peer-reviewed
1 Place Winner

Negative Pressure Wound Therapy with Instillation

Negative Pressure Wound Therapy with Instillation in a Chronic Non-Healing Right Hip Trochanteric Pressure Ulcer

  • Author Information
    Kevin W. Broder

    Section of Plastic Surgery VA Healthcare - San Diego, Division of Plastic Surgery University of California San Diego

    Brian Nguyen Corresponding Author

    School of Medicine, University of California, San Diego

    Richard M. Bodor

    Section of Plastic Surgery VA Healthcare - San Diego, Division of Plastic Surgery University of California San Diego


    Ethics Statement and Conflict of Interest Disclosures

    Human subjects: Consent was obtained by all participants in this study. Conflicts of interest: The authors have declared that no conflicts of interest exist.

    Acknowledgements


    Article Information

    Published: November 14, 2016

    DOI

    10.7759/cureus.877

    Cite this article as:

    Broder K W, Nguyen B, Bodor R M (November 14, 2016) Negative Pressure Wound Therapy with Instillation in a Chronic Non-Healing Right Hip Trochanteric Pressure Ulcer. Cureus 8(11): e877. doi:10.7759/cureus.877

    Publication history

    Received by Cureus: October 02, 2016
    Peer review began: October 05, 2016
    Peer review concluded: November 10, 2016
    Published: November 14, 2016

    Copyright

    © Copyright 2016
    Broder et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 3.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    License

    This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Complex pressure ulcer wound sites often present with a wide scope of barriers to healing ranging from high colonization of multi-drug-resistant pathogens to tortuous internal anatomy which make the wound recalcitrant to traditional wound care including standard negative pressure wound therapy (NPWT). Negative pressure wound therapy with instillation (NPWTi-d) provides an opportunity to manage and heal wounds with indications not met by standard NPWT such as cavitating wounds with complex undermining and tunneling. In this clinical case report, a patient who presented with a chronic, non-healing Stage IV pressure ulcer underwent a tensor fascia lata flap reconstruction that was complicated by a partial flap-tip nonadherence with associated partial dehiscence of the flap incision that proved unresolvable until application of adjunctive NPWTi-d which allowed the wound to experience a robust rate of granulation, contraction, and closure.



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Create a free account to continue reading this article.

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Kevin W. Broder

Section of Plastic Surgery VA Healthcare - San Diego, Division of Plastic Surgery University of California San Diego

Brian Nguyen

School of Medicine, University of California, San Diego

For correspondence:
bjnguyen@ucsd.edu

Richard M. Bodor

Section of Plastic Surgery VA Healthcare - San Diego, Division of Plastic Surgery University of California San Diego

Kevin W. Broder

Section of Plastic Surgery VA Healthcare - San Diego, Division of Plastic Surgery University of California San Diego

Brian Nguyen

School of Medicine, University of California, San Diego

For correspondence:
bjnguyen@ucsd.edu

Richard M. Bodor

Section of Plastic Surgery VA Healthcare - San Diego, Division of Plastic Surgery University of California San Diego