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Besondere Indikationen der Vakuumversiegelungstherapie in der Dermatochirurgie

Special indications for negative pressure wound therapy in dermatologic surgery

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Zusammenfassung

In den letzten Jahren hat die Vakuumversiegelung von akuten und chronischen Wunden in der Dermatochirurgie immer mehr Anhänger gefunden. Gerade bei nicht heilenden diabetischen, chronisch venösen oder auch arteriellen Ulzerationen im Fuß- und Unterschenkelbereich ist diese Technik ein fester Bestandteil der Behandlungsoptionen. Aber auch in der Versorgung von großen Exzisionswunden, beispielsweise nach der Entfernung großer Tumoren, wird die Vakuumtherapie vorzugsweise zur Induktion von Granulationsgewebe und Verkleinerung des Wunddefekts vor Spalt- oder Vollhauttransplantation oder lokaler Lappenplastik verwendet. Neben diesen allseits bekannten Anwendungsmöglichkeiten kann die Vakuumversiegelung auch für „neue“ oder seltenere Anwendungen gute Dienste leisten, von denen einige in diesem Übersichtsbeitrag dargestellt werden sollen.

Abstract

In recent years negative pressure wound therapy (NPWT) has gained more and more supporters in dermatologic surgery. NPWT has become one of the standard therapeutic options, especially for non-healing diabetic, venous and arterial ulcers of the legs. When managing large wounds after tumor surgery, NPWT is frequently used to induce granulation tissue and reduce wound size before the wound is closed with split- or full-thickness skin grafts or local flaps. In addition to these well-established uses, NPWT can be also employed for a variety of “new” or rare indications, some of which are presented in this review.

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Literatur

  1. Arslan E, Ozturk OG, Aksoy A et al (2011) Vacuum-assisted closure therapy leads to an increase in plasma fibronectin level. Int Wound J 8:224–228

    Article  PubMed  Google Scholar 

  2. Blackburn JH, Boemi L, Hall WW et al (1998) Negative-pressure dressings as a bolster for skin grafts. Ann Plast Surg 40:453–457

    Article  PubMed  Google Scholar 

  3. Blume PA, Key JJ, Thakor P et al (2010) Retrospective evaluation of clinical outcomes in subjects with split-thickness skin graft: comparing V.A.C.® therapy and conventional therapy in foot and ankle reconstructive surgeries. Int Wound J 7:480–487

    Article  PubMed  Google Scholar 

  4. Chen E, Friedman HI (2011) Management of regional hidradenitis suppurativa with vacuum-assisted closure and split thickness skin grafts. Ann Plast Surg 67:397–401

    Article  PubMed  CAS  Google Scholar 

  5. Chin MS, Ogawa R, Lancerotto L et al (2010) In vivo acceleration of skin growth using a servo-controlled stretching device. Tissue Eng Part C Methods 16:397–405

    Article  PubMed  Google Scholar 

  6. Gabriel A, Thimmappa B, Rubano C et al (2012) Evaluation of an ultra-lightweight, single-patient-use negative pressure wound therapy system over dermal regeneration template and skin grafts. Int Wound J 9(Suppl 1):32–39

    Article  PubMed  Google Scholar 

  7. Genecov DG, Schneider AM, Morykwas MJ et al (1998) A controlled subatmospheric pressure dressing increases the rate of skin graft donor site reepithelialization. Ann Plast Surg 40:219–225

    Article  PubMed  CAS  Google Scholar 

  8. Greene AK, Puder M, Roy R et al (2006) Microdeformational wound therapy – effects on angiogenesis and matrix metalloproteinases in chronic wounds of 3 debilitated patients. Ann Plast Surg 56:418–422

    Article  PubMed  CAS  Google Scholar 

  9. Gumus N (2012) Negative pressure dressing combined with a traditional approach for the treatment of skull burn. Niger J Clin Pract 15:494–497

    Article  PubMed  CAS  Google Scholar 

  10. Holle G, Riedel K, Gregory H von et al (2007) Vacuum-assisted closure therapy. Current status and basic research. Unfallchirurg 110:490–504

    Article  PubMed  CAS  Google Scholar 

  11. Hsu CC, Chow SE, Chen CP et al (2013) Negative pressure accelerated monolayer keratinocyte healing involves Cdc42 mediated cell podia formation. J Dermatol Sci 70(3):196–203

    Article  PubMed  CAS  Google Scholar 

  12. Kairinos N, Solomons M, Hudson DA (2010) The paradox of negative pressure wound therapy – in vitro studies. J Plast Reconstr Aesthet Surg 63:174–179

    Article  PubMed  Google Scholar 

  13. Kilpadi DV, Cunningham MR (2011) Evaluation of closed incision management with negative pressure wound therapy (CIM): hematoma/seroma and involvement of the lymphatic system. Wound Repair Regen 19:588–596

    Article  PubMed  Google Scholar 

  14. Llanos S, Danilla S, Barraza C et al (2006) Effectiveness of negative pressure closure in the integration of split thickness skin grafts – a randomized, double-masked, controlled trial. Ann Surg 244:700–705

    Article  PubMed  Google Scholar 

  15. Lu F, Ogawa R, Nguyen DT et al (2011) Microdeformation of three-dimensional cultured fibroblasts induces gene expression and morphological changes. Ann Plast Surg 66:296–300

    Article  PubMed  CAS  Google Scholar 

  16. Meissner M, Kaufmann R (2011) Surgical wounds of the scalp. Hautarzt 62:354–361

    Article  PubMed  CAS  Google Scholar 

  17. Morykwas MJ, Argenta LC, SheltonBrown EI et al (1997) Vacuum-assisted closure: a new method for wound control and treatment: animal studies and basic foundation. Ann Plast Surg 38:553–562

    Article  PubMed  CAS  Google Scholar 

  18. Moues CM, Toorenenbergen AW van, Heule F et al (2008) The role of topical negative pressure in wound repair: expression of biochemical markers in wound fluid during wound healing. Wound Repair Regen 16:488–494

    Article  PubMed  Google Scholar 

  19. Muensterer OJ, Keijzer R (2011) A simple vacuum dressing reduces the wound infection rate of single-incision pediatric endosurgical appendectomy. JSLS 15:147–150

    Article  PubMed  Google Scholar 

  20. Nuutila K, Siltanen A, Peura M et al (2013) Gene expression profiling of negative-pressure-treated skin graft donor site wounds. Burns 39:687–693

    Article  PubMed  Google Scholar 

  21. Pachowsky M, Gusinde J, Klein A et al (2012) Negative pressure wound therapy to prevent seromas and treat surgical incisions after total hip arthroplasty. Int Orthop 36:719–722

    Article  PubMed  Google Scholar 

  22. Palm HG, Hauer T, Simon C et al (2011) Vacuum-assisted closure of head and neck wounds. HNO 59:819–830

    Article  PubMed  Google Scholar 

  23. Reddix RN Jr, Tyler HK, Kulp B et al (2009) Incisional vacuum-assisted wound closure in morbidly obese patients undergoing acetabular fracture surgery. Am J Orthop (Belle Mead NJ) 38:446–449

    Google Scholar 

  24. Stannard JP, Gabriel A, Lehner B (2012) Use of negative pressure wound therapy over clean, closed surgical incisions. Int Wound J 9(Suppl 1):32–39

    Article  PubMed  Google Scholar 

  25. Stechmiller JK, Kilpadi DV, Childress B et al (2006) Effect of vacuum-assisted closure therapy on the expression of cytokines and proteases in wound fluid of adults with pressure ulcers. Wound Repair Regen 14:371–374

    Article  PubMed  Google Scholar 

  26. Timmers MS, Le Cessie S, Banwell P et al (2005) The effects of varying degrees of pressure delivered by negative-pressure wound therapy on skin perfusion. Ann Plast Surg 55:665–671

    Article  PubMed  CAS  Google Scholar 

  27. Wackenfors A, Sjogren J, Gustafsson R et al (2004) Effects of vacuum-assisted closure therapy on inguinal wound edge microvascular blood flow. Wound Repair Regen 12:600–606

    Article  PubMed  Google Scholar 

  28. Wilkes RP, Kilpad DV, Zhao Y et al (2012) Closed incision management with negative pressure wound therapy (CIM): biomechanics. Surg Innov 19:67–75

    Article  PubMed  Google Scholar 

  29. Willy C, Thun-Hohenstein H von, Lubken F von et al (2006) Experimental principles of the VAC®-therapy – pressure values in superficial soft tissue and the applied foam. Zentralbl Chir 131:S50–S61

    Article  PubMed  Google Scholar 

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Interessenkonflikt

E.M. Valesky, R. Kaufmann und M. Meissner geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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  1. Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Frankfurt am Main, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland

    E.M. Valesky, R. Kaufmann & M. Meissner

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  1. E.M. Valesky
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  2. R. Kaufmann
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  3. M. Meissner
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Correspondence to E.M. Valesky.

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Valesky, E., Kaufmann, R. & Meissner, M. Besondere Indikationen der Vakuumversiegelungstherapie in der Dermatochirurgie. Hautarzt 64, 585–591 (2013). https://doi.org/10.1007/s00105-013-2545-x

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  • DOI: https://doi.org/10.1007/s00105-013-2545-x

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