Patients presenting with radiation burns secondary to Ca

1. Parkcrest Plastic Surgery, Inc. St. Louis, MO S. Gregg Couper, PA-C, CWS, FCCWS, MPAS; Zach Graefser, MA Background Results Clinical Observations Pt. A Pt. B Pt. C • The new, lower pressure NPWT system unique dressing achieved complete wound closure with essentially no complications or further deterioration of the wound or peri-wound tissue. • 100% granulation tissue and wound volume reduction of >80% was also achieved within 4 – 5 weeks. • Importantly, the composition of the new skin was less fibrotic, more supple, and showed improved vascularity, resulting in a more stable scar. • The graph below quantifies the percentage reduction in wound area and volume for Pt. A. • Despite the compromised, friable skin condition, the healing process with this NPWT system was typical of that observed with other wounds; rapid granulation tissue formation (volume reduction) followed by reduction in area. Treatment of Radiation Burns Using a Novel Negative Pressure Wound Therapy System* with Minimal Adherence Bio-DomeTM Dressing Technology 5.0 x 3.0 x 1.0 cm 4.0 x 2.8 x 0.8 cm Healed 3-23-07 4-4-07 9-13-07 Representative Data- Reduction in Wound Area and Volume Purpose Healed 20.0 x 7.0 x 2.0 cm 18.0 x 6.5 x 2.0 cm 8-27-07 6-8-07 6-15-07 Patients presenting with radiation burns secondary to Ca treatment pose a significant challenge to the successful management of their wounds. Radiation therapy is known to cause skin atrophy, erythema, moist or dry desquamation, compromised vascularity leading to ulceration, pain, burning, and itching1. Treating such wounds with negative pressure wound therapy (NPWT), due to the typical levels of pressure (125mm Hg) and the type / design of intra-wound dressings, may cause further complications due to the friable nature of the effected tissue. Determine the effectiveness of novel, negative pressure wound therapy with Bio-DomeTM Dressing Technology* in managing radiation burns and minimizing the complications associated with NPWT systems and dressings. Three patients receiving radiation therapy for cancer were treated with a new NPWT System* that employs a relatively low level of negative pressure (75 mmHg) and a uniquely designed, minimal adherence polyester dressing. Radiation burns of the anterior chest wall, lateral chest wall and following mastectomy were represented in the study. Data were collected at each dressing change to quantify wound size, exudate amount, non-viable tissue and granulation tissue. As needed, the new NPWT system was used in conjunction with sharp debridement and biological xenografts. Subjects 6.0 x 5.0 x 1.0 cm 6.0 x 4.3 x 0.8 cm 6.0 x 3.9 x 0.4 cm 12-6-07 3-23-08 1-11-08 Conclusions/Relevance Methods • The new NPWT system for radiation burn patients significantly reduced the known complications. • The system allowed the simultaneous application of biological xenografts, thereby enabling dual therapies where needed. 1White R A, Miki R A, Kazmeier P, Anglen J O, “Vacuum assisted closure complicated by erosion and hemorrhage of the anterior tibial artery”, J Orthop. Trauma (2005);19:pp56-59. *Novel Negative Wound Pressure Therapy: EngenexTM Advanced Negative Pressure Wound Therapy System