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CASE STUDY

Dehisced Lower Limb – 16-day Treatment

Patient
  • 66-year-old male.
  • Presented with the following co-morbidities: philiarisis, chronic regional pain syndrome, chronic kidney disease, osteoarthritis, pulmonary embolism and Waldestrom’s macroglobulinaemia.
Wound
  • The wound was the result of a traumatic injury which, following the formation of a haematoma, required surgical debridement and closure by suturing. Post-surgery, the wound dehisced resulting in the need for skin grafting, which failed. A second graft also resulted in failed.
  • On initial assessment, the wound measured 23cm x 4cm x 0.5cm. The wound bed consisted of approximately 95% granulation and 5% slough (Figure 1).
  • The patient reported wound-associated pain as measuring a 6 (using a scale of 0–10 where 0= no pain and 10 the worst pain possible).
Management & Results
  • The patient received a total of 16 days of NPWT during which time the wound made progress and the patient’s pain levels decreased in line with healing; from 6 to 2. Only one pump was needed for the duration of treatment, presenting an advantage over other single-use disposable NPWT systems available.
  • The wound responded rapidly with a marked reduction in depth.
  • Despite multiple co-morbidities, the wound healed from the base upwards and the wound edges advanced rapidly.
  • The Avelle™ NPWT System supported the healing of a complex static wound of a patient with multiple comorbidities.
  • The Hydrofiber® Technology wound contact layer in the Avelle™ NPWT Dressing provided fluid handling that prevented lateral spread of exudate on the peri-wound skin

Figure 1: Wound on day 1

Figure 2: Wound on day 7

Figure 3: Wound on day 18 following break in NPWT

Next case study: Dehisced Surgical Incision – 28 Day Treatment
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References

*Battery change may be required during pump lifetime.
 +As demonstrated in-vitro

  • 1. AvelleTM NPWT System Post Market Evaluation Report. Data on file. 2018. ConvaTec.
  • 2. Bowler P, Jones S, Towers V, Booth R, Parsons D, Walker M, 2010. Dressing conformability and silver-containing wound dressings. Wounds UK; 6: 14-20.
  • 3. Walker M, Jones S, Parsons D, Booth R, Cochrane C, Bowler P, 2011. Evaluation of low-adherent antimicrobial dressings. Wounds UK; 7: 32-45.
  • 4. Waring MJ, Parsons D. Physico-chemical characterisation of carboxymethylated spun cellulose fibres. Biomaterials. 2001; 22:903-912.
  • 5. Newman, G.R., et al., Visualisation of bacterial sequestration and bactericidal activity within hydrating Hydrofiber wound dressings. Biomaterials, 2006. 27(7):1129-39.
  • 6. Walker M, Hobot JA, Newman GR, Bowler PG. Scanning electron microscopic examination of bacterial immobilisation in a carboxymethylcellulose (Aquacel) and alginate dressings. Biomaterials. 2003; 24(5):883-890. 7. Coutts P, Sibbald RG. The effect of asilvercontaining Hydrofi ber dressing on superficial wound bed and bacterial balance of chronic wounds. Int Wound J. 2005; 2(4): 348-356.
  • 8. Robinson BJ. The use of a hydrofiber dressing in wound management. J Wound Care. 2000; 9(1):32-34.
  • 9. Jones S, Bowler PG, Walker M. Antimicrobial activity of silver-containing dressings is influenced by dressing conformability with a wound surface. WOUNDS. 2005; 17(9): 263-270.
  • 10. Barnea Y, Amir A, Leshem D, et al. Clinical comparative study of Aquacel and paraffin gauze dressing for split-skin donor site treatment. Ann Plast Surg. 2004;53(2):132-136.
  • 11. Kogan L, Moldavsky M, Szvalb S, Govrin- Yehudain J. Comparative study of Aquacel and Silverol treatment in burns. Ann Burns Fire Disasters. 2004;17(4):201-207.
  • 12. DM, Foster KN, Hermans MHE, Rick C, 2004. AQUACEL® Ag in the management of partial-thickness burns: Results of a Clinical Trial. J. Burn Care Rehabil; 25:89-97.
  • 13. Bishop SM, Walker M, Rogers AA, Chen WYJ. Moisture balance: optimising the wound-dressing interface. J Wound Care. 2003; 12:125-128.
  • 14. Assessment of the in-vitro properties Avelle™ Negative Pressure Wound Therapy Dressing. WHRI4520 MS128. Data on fi le. 2015. ConvaTec.
  • 15. Hoekstra MJ et al. A histological comparison of acute inflmamatory responses with a hydrofibre or tulle gauze dressing. J Wound Care. 2002
  • 16. HFM-2015-017. Data on file. 2015. ConvaTec Inc.

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