[abstract] SYMBIOTIC USE OF EXISTING WOUND MANAGEMENT OPTIONS - WITH A TWIST.

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[abstract] SYMBIOTIC USE OF EXISTING WOUND MANAGEMENT OPTIONS - WITH A TWIST.

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Title: [abstract] SYMBIOTIC USE OF EXISTING WOUND MANAGEMENT OPTIONS - WITH A TWIST.
Author: Evans, AW; Lopez, CA; Tang, CL
Abstract: BACKGROUND: A case is described which uses pre and postoperative hyperbaric oxygen therapy (HBOT) in its traditional wound care role of microvascular rehabilitation of hypoxic tissue. Multiple surgical failures have previously occurred at the abdominal wall site and might have been attributed to shear force tension at the suture line. Accordingly, additional strategies to splint the wound site were warranted. METHODS: A 39 year-old healthy female presented with a 24cm wide and 10cm deep abdominal flap wound. Nine years previous, she received a hysterectomy, which was complicated with wound infection, sinus tract formations and dehiscence of the wound. She had undergone 32 operations over a 6year period in an attempt to surgically close the wound. All previous attempts failed and the wound remained open. Transcutaneous oximetry measurements demonstrated a perfusion defect extending over a localized portion of the previous surgically traumatized abdominal wall. Vascular rehabilitation was then achieved with HBOT as confirmed with oximetry measurements. Surgical intervention was performed to close the wound. Postoperative vacuum assisted closure (VAC) therapy was employed in an atypical manner as a brace to ensure tissue apposition and to avoid shearing forces. Concomitant postoperative HBOT was employed to ensure adequate oxygenation of healing tissues. RESULTS: The preoperative vascular rehabilitation achieved with HBOT permitted the surgical excision of chronic granulation tissue and sinus tracts with confidence of expected closure of the wound. The wound has remained closed for one year. CONCUSIONS: The sequence by which therapeutic modalities are applied based on the physiological objectives at each stage of complicated wound management may be of pivotal importance in achieving a successful result. The sequence and combination of pre and post-operative therapies which proved to be a practical solution in this case illustrates this concept and could likely be a consideration in other clinical settings.
Description: Undersea and Hyperbaric Medical Society, Inc. (http://www.uhms.org )
URI: http://archive.rubicon-foundation.org/1364
Date: 2003

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  • UHMS Meeting Abstracts
    This is a collection of the published abstracts from the Undersea and Hyperbaric Medical Society (UHMS) annual meetings.

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