CaseStudy - BIOXA Therapeutics, sro

CaseStudy
Genadyne A4 and foam to treat a
postoperative debridment flank abscess
Michael S. DO, The Wound Healing Center Indianapolis, IN
Cynthia Peebles RN D.O.N., Becky Beck RN Heartland at Prestwick NH Avon, IN
Patient is a 67 year old morbidly obese female who developed a flank abscess requiring aggressive debridement.
Postoperatively, therapy was commenced using the Genadyne A4 pump and foam at 80mmHg. Using this therapy,
rapid improvements were noted. Despite dramatic decreases eases in allwound dimensions, the patients overall
condition worsened with progressive malnutrition and immobility. Approximately two week after the last picture, she
succumbed to her multiple co-morbidities The wound had decreased from 19x5x7 cm to 15x3x4 cm.
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Genadyne Biotechnologies
65 Watermill Lane | Great Neck | NY 11021 | U.S.A
Tel.: +1-516-487-8787 Fax: +1-516-487-7878
E-mail: [email protected] | www.genadyne.com
dec
CaseStudy
Sacral pressure ulcer
This is a 63 year old female suffering from sacral pressure ulcer.
Comorbidities: Malnutrition, Diabetes, PAD,PVD, Hypertension, Albumin 3.0
The wound received sharp debridement and then was placed on the Genadyne A4 NPWT system using AMD gauze
dressing and flat drain. Drainage was shown to be serosanguinous in nature and produced approximately 50 cc per
day. The dressings were changed every 72 hours and the patient had no complaints of pain. The wound developed
a nice bed of granulation tissue to the point NPWT was discontinued and the wound was covered with a traditional
dressing protecting the new epithelium.
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Genadyne Biotechnologies
65 Watermill Lane | Great Neck | NY 11021 | U.S.A
Tel.: +1-516-487-8787 Fax: +1-516-487-7878
E-mail: [email protected] | www.genadyne.com
dec
CaseStudy
Diabetic foot
Comorbities: Uncontrolled Diabetes, Hypertension, CHF, CAD, PAD, PVD and 2 ppd smoker x20 years
67 year old male presented with diabetic foot ulcer that had originated proximal to the 2nd,3rd,and 4th metatarsal
heads. The wound had been present for six months and traditional wound care had been attempted with hydrocolloids, Calcium alginates, and hydrogel to no avail.
The wound bed presented 20% thick yellow slough which was debrided via curette, and the Genadyne A4 NPWT
pump was applied using AMD gauze and a flat drain at -75mmhg. Offloading was instructed to the patient and dressings were changed every 72 hours. The wound produced approximately 15 cc of serosanguinous drainage per day.
The wound never produced any further slough and granulated quickly. There was no pain reported by the patient.
Ambulation was restored and a full recovery was obtained.
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Genadyne Biotechnologies
65 Watermill Lane | Great Neck | NY 11021 | U.S.A
Tel.: +1-516-487-8787 Fax: +1-516-487-7878
E-mail: [email protected] | www.genadyne.com
dec
CaseStudy
Diabetic foot ulcer
71 year old male presents with Wagner grade 3 diabetic foot ulcer to the plantar and lateral aspects of foot. Pt received TMA 3
years prior. Comorbitities: Diabetes, PVD, PAD, Wheelchair and bed bound, dehydration, Albumin 3.5 Prior Treatment: moist
to dry dressings, alginates and hydrogels to no avail
The patient received sharp debridement for removal of slough and redefinition of wound edges. He was then placed
on the Genadyne A4 NPWT system at a pressure of -70 mmhg using AMD gauze and a flat drain. The dressings were
changed after the initial 48 hours and presented serosanguinous drainage at 30 cc’s per day. Minimal slough was found
at dressing change and the dressings changes were then ordered to be completed every 72 hours. The patient complained of minimal pain at dressing change and application. The wound remained unremarkable for infection and granulation started to appear after the third dressing change. Granulation continued to occur to the point where NPWT
was discontinued and traditional wound dressings were applied using hydrogel. A complete recovery was obtained.
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Genadyne Biotechnologies
65 Watermill Lane | Great Neck | NY 11021 | U.S.A
Tel.: +1-516-487-8787 Fax: +1-516-487-7878
E-mail: [email protected] | www.genadyne.com
dec
CaseStudy
Scral pressure ulcer
73 year old female presented with sacral pressure ulcer. The wound was covered in slough and eschar was present. Prior
treatment included moist to dry dressings, Calcium alginates and acticoat silver dressings to no avail. Comorbitities: Immobility, CAD, CVA, PVD, Hypertension
The wound received sharp debridement where slough and eschar were removed and the wound edges defined. The
patient was then placed on the Genadyne A4 NPWT system at -90 mmhg and a AMD gauze dressing with flat drain
was applied. The wound produced 25-50 cc of sanguinous drainage for first 48 hours. At first dressing change the
wound was pink, and no signs of slough or infection were present. The dressing continued to be changed every 48
hours. The drainage was serous in nature and wound continued to granulate nicely. Therapy was discontinued and a
surgical flap was placed, with full closure obtained.
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Genadyne Biotechnologies
65 Watermill Lane | Great Neck | NY 11021 | U.S.A
Tel.: +1-516-487-8787 Fax: +1-516-487-7878
E-mail: [email protected] | www.genadyne.com
dec
CaseStudy
XLR8 and foam to treat a postoperative
metatarsal amputation defect
Michael S. DO, The Wound Healing Center Indianapolis, IN / Miller Gerry Hash DPM, Bloomington, IN
Patient is a 48 year old male who underwent amputation of the 5th metatarsal due to progression of a diabetic foot
ulcer with osteomyelitis. Expert surgical intervention resulted in a large lateral foot tissue defect.
Therapy was commenced using the Genadyne XLR8 pump and XLR8 foam at 80mmHg. Using this therapy, rapid
improvements were noted with an excellent progress.
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Genadyne Biotechnologies
65 Watermill Lane | Great Neck | NY 11021 | U.S.A
Tel.: +1-516-487-8787 Fax: +1-516-487-7878
E-mail: [email protected] | www.genadyne.com
CaseStudy
XLR8 and foam foam to treat a to treat
a Large, Sternal Wound Dehiscence
Michael S. DO, The Wound Healing Center Indianapolis, IN / Miller Cynthia Peebles RN D.O.N., Becky Beck RN Avon, IN
Patient is a 76 yo female who underwent coronary bypass grafting X 4. Shortly after surgery, she began having drainage from the wound through three separate defects (Picture 1). Her Surgeon and Infectious Disease physicians elected
to not open or debride the wound and commenced Negative Pressure Wound Therapy by placing the KCI black foam
on her skin covering the three skin defects. She was transferred to the nursing care facility where she was evaluated.
Debridement encompassing the involved skin and the wound base and sides was performed (Picture 2). Therapy
was commenced using the Genadyne XLR8 pump and XLR8 foam at 80mmHg (Picture 3). Using this therapy, rapid
improvements were noted with an excellent final appearance noted.
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Genadyne Biotechnologies
65 Watermill Lane | Great Neck | NY 11021 | U.S.A
Tel.: +1-516-487-8787 Fax: +1-516-487-7878
E-mail: [email protected] | www.genadyne.com
june
CaseStudy
Surgical Dehiscense 3 month open
dehiscense s/p Lumbar Laminectomy
Comorbitities: Severe Malnutrition, CAD, Small Bowel Resection. Wound dimensions: 4x2x2 with 7 cm tunneling distally
and 6.5 cm tunneling superiorly and 3 cm undermining laterally. Prior Care: Moist to dry dressings, calcium alginates, silver
hydrogel to no avail. Laboratory: Albumin 1.9 Poor eating habits. No enteral or TPN administered.
This 79 year old Caucasian male was admitted to the hospital for a small bowel resection. Upon arrival and assessment,
his prior lumbar laminectomy incision site was found to be dehisced. He had no care-­givers in the home and was
found to be dehydrated as well as malnourished. Traditional wound care was applied at time of admission to no avail.
Albeit the patients albumin was below therapeutic values, and protein supplements were added to his p.o. diet, his
appetite remained substandard and surgery was consulted for possible peg tube placement. The surgeons declined to
do surgery due to his hemodynamic instability and his combativeness.
The decision was made to start NPWT via Genadyne XLR8 at -100 mmHg and a foam dressing with JP drain as conduit.
Initial wound assessment showed 70% thick, sticky yellow slough in the wound bed but the wound edges remained
unremarkable. The wound was cleaned with normal saline and gauze and the NPWT dressing was applied.
Initial dressing change was performed at 48 hours revealing a decrease in slough to 20%, the wound was pink in
appearance and approximately 50 cc’s of serosanguinous drainage was in the collection canister. A new dressing was
applied with orders to change in another 48 hours.
The second dressing change occurred in 48 hours with no slough remaining in the wound bed, tissue was pink and
beginning to granulate. The undermining decreased 2 mm and the tunneling decreased 0.5 cm in depth. Again, with
less than adequate albumin level the wound was progressing. The dressing was reapplied and continued at -100
mmHg. Unfortunately, the patient succumbed to an anterior wall myocardial infarction one day later.
Conclusion: Considering the low albumin, and the co-morbitites, the wound was debrided, and started to heal both
with the tunneling and undermining involved by the use of NPWT and the Genadyne XLR8 Negative Pressure Wound
Therapy System.
jan
feb
march
april
may
june
july
aug
sept
start treatment
oct
nov
end treatment
Genadyne Biotechnologies
65 Watermill Lane | Great Neck | NY 11021 | U.S.A
Tel.: +1-516-487-8787 Fax: +1-516-487-7878
E-mail: [email protected] | www.genadyne.com
dec
CaseStudies
CASE SERIES OF APPLICATION OF GENADYNE NPWT SYSTEM IN DIFERENT CHRONIC
WOUND IN THE LONG TERM CARE SETTINGS
Sergei Kochlatyi, MD, NMD, WCC, CWS, FCCWS, FAPWCA
Introduction:
Wound management became very important part of the rehabilitation process in the long term care facilities as well as
home care. New modality on Negative Pressure Wound Therapy (NPWT) offers new edge to approach to chronic and acute
wounds, providing improved healing rates, better patient and caregiver satisfaction and reduced cost for wound care. There
are two mainstream NPWT systems applications – one utilizes foam and another moist gauze to be applied onto the wound
base. Each of them has certain advantages and drawbacks. We present series of clinical cases utilizing Genadyne NPWT
system with moist gauze application for wound management.
Case 1
Patient RB. is 95 y.o. female with PMH significant fro anemia, colon cancer, mastectomy, CHF, HTN, underwent colon
resection which was complicated by wound infection and dehiscence. NPWT was utilized on the wound at negative
constant 80mmHg. Wound size on initial presentation was 135 cm2. After 8 weeks of the NPWT wound size decreased
to 19 cm2 and patient was discharged home.
Case 2
Patient ZA is 89 y.o female with PMH significant for HTN, dementia, depression, underwent ventral hernia repair
which was complicated by wound infection and dehiscence. NPWT was utilized on the wound at negative constant
80mmHg. Wound size on initial presentation was 18 cm2 and after four weeks of NPWT was healed completely.
Case 3
Patient AR is 86 y.o. female with PMH significant for spinal stenosis, osteoporosis, HTN. Presented to the nursing home
with chronic Stage IV pressure ulcer over sacral area. Size of the wound was 20 cm2. Due to chronicity of the wound it
was initially treated with Calcium Alginate dressing with minimal response for two weeks and then NPWT was started
to stimulate wound. After four weeks of NPWT at negative constant 80mmHg wound size decreased to 1,6 cm2 and
wound developed epibole and further progress was halted and NPWT was discontinued.
Case 4
Patient OH is 99 y.o. female with PMH significant for dementia, breast cancer, HTN, CAD, hypothyroidism, joints contractures. Presented to the nursing home with chronic Stage IV pressure ulcer over sacral area. Size of the wound was
9 cm2 with undermining of 1cm. Due to chronicity of the wound it was initially treated with Hydrogel impregnated
gauze dressing with minimal response for one week and then NPWT was started to stimulate wound. After nine weeks
of NPWT at negative constant 80mmHg wound size decreased to 1,2 cm2 and wound developed epibole and further
progress was halted and NPWT was discontinued.
Case 5
Patient RV is 70 y.o. male with PMH significant for paraparesis, HTN, prostate cancer, bowel resection. Presented to the
nursing home with chronic Stage IV pressure ulcer over sacral area. Size of the wound was 12.0 cm2 with tunneling of
6.5 cm. NPWT was started to stimulate wound. After seven weeks of NPWT at negative constant 80mmHg wound size
decreased to 2,0 cm2 and tunneling decreased to 4,5 cm.
Case 6
Patient CJ is 73 y.o. female with PMH significant for CHF, DM, peripheral neuropathy, PVD, depression. Patient underwent left leg femoral-popleteal artery bypass and left foot TMA for gangrene. Surgery was complicated by wound
infection and dehiscence. On admission to the long-term care facility patient had three surgical wounds: left medial
thigh wound size was 18.0 cm2, left medial leg wound was 14.0 cm2 and left foot wound was 65.5 cm2. NPWT was
utilized on the wound at negative constant 80mmHg. After six weeks of NPWT left medial thigh wound and left medial
leg wound healed completely left foot wound size decreased to 19.3 cm2.
Case 7
Patient MC is 80 y.o. female with PMH significant for PVD, DM, HTN, breast cancer, CVA, COPD, anemia, CRF, CABG.
Patient underwent left foot TMA for gangrene. Surgery was complicated by wound infection and dehiscence. Left foot
TMA wound size was 26.4 cm2. NPWT was utilized on the wound at negative constant 80mmHg. After four weeks of
the NPWT wound size decreased to 28.0 cm2 and NPWT was discontinued due to failure to provide further benefit and
significant peri-wound skin maceration due to difficulty maintaining dressing seal and excessive exudates.
Conclusions:
Genadyne NPWT systems has been proven to be effective in different types of chronic and acute wounds management in long-term care settings. Success of NPWT is largely dependent on several factors, including patient’s general
medical condition, anatomy of the wound, proficiency of the medical staff on application of the NPWT dressings
Genadyne Biotechnologies
65 Watermill Lane | Great Neck | NY 11021 | U.S.A
Tel.: +1-516-487-8787 Fax: +1-516-487-7878
E-mail: [email protected] | www.genadyne.com