Successful Treatment of Life-threatening Posttraumatic Wounds With Negative Pressure Wound Therapy: A Case Report.

INTRODUCTION: Debridement and control of wound drainage are critical for managing patients with extensive traumatic wounds because wound infection can result in sepsis and further complications. CASE REPORT: The authors report the case of a 19-year-old woman with an extensive crush/degloving injury to her right lower limb that was treated with negative pressure wound therapy (NPWT) with a reticulated open-cell foam dressing. The patient received 2 treatments of sharp debridement and vacuum drainage using wall suction and polyvinyl alcohol dressings. Her respiratory failure, sepsis, and septic shock continued to worsen, and she could not tolerate anesthesia. On post admission day 9, after simple debridement where only superficial necrosis tissue was debrided without anesthesia, NPWT was applied for 5 days and removed about 8500 mL of exudate the first day and 6000 mL on the second. After 5 days, her wound began to improve, granulation tissue formed, no necrotic tissues were visible, and vital signs were stable. On day 14, she underwent anesthesia, surgical debridement, and application of NPWT for an additional 5 days. Following autologous skin grafting on day 19, she was removed from the ventilator (which was started on day 3). The extensive wound was effectively closed; she recovered satisfactorily. There was no patient follow-up. CONCLUSIONS: In this case, NPWT, in continuous mode at -125 mm Hg, effectively removed exudate after simple debridement in a patient who could not tolerate anesthesia.

Correlation of polymer-like solution behaviors with electrospun fiber formation of hydroxypropyl-ß-cyclodextrin and the adsorption study on the fiber.

In this paper, the formation of hydroxypropyl-ß-cyclodextrin (HPCD) nanofibers in electrospinning and the adsorption of organic molecules on the HPCD nanofiber were studied. The properties of a polymer-like solution from the highly concentrated HPCD/N,N-dimethylformamide (DMF) solution revealed HPCD supramolecular aggregates formation. The entanglements of HPCD self-organized aggregates were one of the most important factors that significantly influenced fiber formation during cyclodextrin electrospinning. The HPCD self-organized aggregates entanglement concentration (C(e)) was investigated. Analyzing the dependence of specific viscosity (η(sp)) on concentration enabled the determination of the aggregates unentangled and entangled regimes for HPCD polymer-like solutions. The dynamic light scattering (DLS) measurements and the (1)H NMR spectra of the HPCD solutions confirmed the presence of considerable HPCD self-organized aggregates in high concentrated HPCD/DMF solutions due to the intermolecular hydrogen bonding. The scanning electron microscopy (SEM) showed the electrospinning morphology transitioned from regular beads to uniform fibers with increasing the HPCD concentration. The dependence of the fiber diameter on the zero shear rate viscosity (η(0)) was determined. The static adsorption behavior of the HPCD fibers was studied. Neutral red (NR) was used as a model organic molecule. The adsorption of NR onto HPCD fibers fitted the pseudo-second-order kinetic model. The equilibrium adsorption amount of NR was 18.41 mg g(-1), and the apparent adsorption rate constant was 9.83 × 10(-4) g mg(-1) min(-1) at 25 °C.