Management of extensive cutaneous necrosis due to meningococcal septicaemia purpura fulminans with topical negative pressure (TNP) suits

Autor: A. Odutola, A. R. Kay, J. E. Rees-Lee
Rok vydání: 2011
Předmět:
Zdroj: European Journal of Plastic Surgery. 35:309-315
ISSN: 1435-0130
0930-343X
DOI: 10.1007/s00238-011-0641-7
Popis: Extensive cutaneous necrosis due to purpura fulminans presents many of the same treatment challenges as a significant burn injury. The areas of tissue loss are large, require complex and repeated dressings and create a significant reconstructive challenge. These patients are therefore often treated by burns multi-disciplinary teams (Ariivalo et al., Burns 24:272–274, 1). Topical negative pressure (TNP) therapy has a recognised role in the management of complex wounds, but its use is normally restricted to moderates sized defects. This paper describes a method of TNP dressing application to large purpura fulminans wound areas, including the buttocks and perineum, by fashioning ATNP suits. A photographically illustrated series is presented to demonstrate a TNP suit application in four consecutive paediatric cases of severe purpura fulminans, and they are representative of our practise. These cases illustrate how TNP suits provide a robust movement resistant dressing which removes exudate from the wound, splinting and reducing the wound area, promoting a graftable bed and facilitating graft take in these difficult to manage patients.
Databáze: OpenAIRE