By Kryger Z.B., Sisco M.
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About the Authors
Dr. Da Cheng Hao is an affiliate Professor and precept investigator on the institution of atmosphere and Chemical Engineering, established on the Biotechnology Institute, Dalian Jiaotong college, Dalian, P. R China. he's a visitor Prof. of Institute of Medicinal Plant improvement (IMPLAD), chinese language Academy of clinical Sciences (CAMS), Beijing, P. R China.
Dr. Xiao Jie Gu is a Lecturer on the university of setting and Chemical Engineering, dependent on the Biotechnology Institute, Dalian Jiaotong collage, Dalian, P. R China.
Professor Pei Gen Xiao is an Academician of chinese language Academy of Engineering and the top of Key Laboratory of Bioactive elements and assets usage of chinese language natural drugs, Ministry of schooling, established at IMPLAD, CAMS, Beijing, P. R China.
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Extra info for Practical Plastic Surgery
Nevertheless, these results have yet to be confirmed in randomized control trials. Practical Plastic Surgery, edited by Zol B. Kryger and Mark Sisco. ©2007 Landes Bioscience. 1. Indications and contraindications for use of NPWT Indication Chronic open wounds Diabetic ulcer Pressure sore Traumatic wounds Extirpative defects Spinal and orthopedic wounds Sternotomy defects Open abdomen Burns Skin graft bolster Notes Debridement must be performed prior to application of NPWT Brachytherapy and external-beam irradiation can be performed through the dressing Dressing can be placed directly over hardware after debridement has been performed Excellent for the temporary management of bowel edema and gross peritoneal contamination May be applied over allograft of skin substitute NPWT improves graft take by limiting shear forces and evacuating fluid collections Contraindications Malignancy in the wound Untreated underlying osteomyelitis Nonenteric or unexplored fistulas Undebrided necrotic tissue Untreated active soft tissue infection Exposed internal organs Exposed blood vessels or vascular prosthetic grafts Coagulopathic patients (relative) Technique Application of NPWT can be performed by anyone with the appropriate training, provided that the wound is hospitable.
Foams are not recommended for dry wounds. Foams protect wounds well (although do not reduce force on pressure ulcers), facilitate autolytic debridement, and minimize granulation tissue. As with other dressings, at least one inch of surrounding skin should be covered, and foams can be left on the wound surface for up to seven days. Examples of foams are LyofoamTM and AllevynTM. Alginates Alginates are composed of naturally occurring mannuronic or glucuronic acid polymers from brown seaweed. They come available as pastes, granules, powders, pads or ropes which soften, gel and conform to the wound, thereby functioning to absorb, exudate and fill dead space.
One should wait at least 7-10 minutes for the vasoconstrictive effects of the epinephrine to take effect. Suggested Reading 1. Ahlstrom KK, Frodel JL. Local anesthetics for facial plastic procedures. Otolaryng Clin N Am 2002; 35(1):29. 2. Baker IIIrd JD, Blackmon Jr BB. Local anesthesia. Clin Plast Surg 1985; 12(1):25. 3. Klein JA. Tumescent technique for regional anesthesia permits lidocaine doses of 35 mg/kg for liposuction. J Dermatol Surg Oncol 1990; 16(3):248. 4. Zilinsky I, Bar-Meir E, Zaslansky R et al.