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LETTERS TO THE EDITOR
surface, Granuflex strongly adheres to external fixator pins and to the customary adhesive wound covering. Covering the whole extremity is not necessary.
Preventing Air Leakage in Negative Atmospheric Pressure Therapy for Open Fractures Treated With External Fixators To the Editor: Negative atmospheric pressure therapy (NAPT) is a noninvasive technique for the treatment of acute and chronic wounds.1-3 NAPT consists of a sterile cell foam dressing wrapped with an adhesive covering and connected to a machine supplying a negative pressure. Blood flow to the treated area can be increased by up to 4-fold through the application of a negative pressure of 125 mm Hg.3 External fixators are frequently used in the treatment of open fractures in a variety of situations in both upper and lower extremities.4 However, external fixators make NAPT application difficult as a result of leakage from the pin sites and loosening of the adhesive covering. To prevent leakage around the pin sites, we use a commercially available hydrocolloid wound dressing material (Granuflex/DuoDERM, Convatec, Skillman, NJ), which we cut into narrow strips and wrap securely around the site where the pin penetrates the adhesive covering. The malleable structure of the dressing prevents loosening. In a previous study, cling film was used to prevent leakages in mobile parts of body by covering the whole extremity.1 The cling film, however, does not have strong adhesiveness to metals as Granuflex has. Owing to its adhesive
J Hand Surg Am.
r
_ Ilhami Oguzhan Aydogdu, MD Engin Yosma, MD Tekin S¸íms¸ek, MD Faculty of Medicine Department of Plastic, Reconstructive and Aesthetic Surgery Ondokuz Mayis University Samsun, Turkey Musa Kemal Keles¸, MD Department of Plastic, Reconstructive and Aesthetic Surgery Konya Numune Hospital Konya, Turkey http://dx.doi.org/10.1016/j.jhsa.2013.09.037 REFERENCES 1. Egemen O, Aksan T, Ozkaya O, Akan M. Letter: a cheap and simple method for prevention of air leaks in vacuum-assisted closure therapy. Int Wound J. 2011;8(4):428e429. 2. Mouës CM, Vos MC, van den Bemd GJ, Stijnen T, Hovius SE. Bacterial load in relation to vacuum-assisted closure wound therapy: a prospective randomized trial. Wound Repair Regen. 2004;12(1): 11e17. 3. Timmers MS, Le Cessie S, Banwell P, Jukema GN. The effects of varying degrees of pressure delivered by negative-pressure wound therapy on skin perfusion. Ann Plast Surg. 2005;55(6): 665e671. 4. Fragomen AT, Rozbruch SR. The mechanics of external fixation. HSS J. 2007;3(1):13e29.
Vol 38, December 2013
LETTERS TO THE EDITOR
surface, Granuflex strongly adheres to external fixator pins and to the customary adhesive wound covering. Covering the whole extremity is not necessary.
Preventing Air Leakage in Negative Atmospheric Pressure Therapy for Open Fractures Treated With External Fixators To the Editor: Negative atmospheric pressure therapy (NAPT) is a noninvasive technique for the treatment of acute and chronic wounds.1-3 NAPT consists of a sterile cell foam dressing wrapped with an adhesive covering and connected to a machine supplying a negative pressure. Blood flow to the treated area can be increased by up to 4-fold through the application of a negative pressure of 125 mm Hg.3 External fixators are frequently used in the treatment of open fractures in a variety of situations in both upper and lower extremities.4 However, external fixators make NAPT application difficult as a result of leakage from the pin sites and loosening of the adhesive covering. To prevent leakage around the pin sites, we use a commercially available hydrocolloid wound dressing material (Granuflex/DuoDERM, Convatec, Skillman, NJ), which we cut into narrow strips and wrap securely around the site where the pin penetrates the adhesive covering. The malleable structure of the dressing prevents loosening. In a previous study, cling film was used to prevent leakages in mobile parts of body by covering the whole extremity.1 The cling film, however, does not have strong adhesiveness to metals as Granuflex has. Owing to its adhesive
J Hand Surg Am.
r
_ Ilhami Oguzhan Aydogdu, MD Engin Yosma, MD Tekin S¸íms¸ek, MD Faculty of Medicine Department of Plastic, Reconstructive and Aesthetic Surgery Ondokuz Mayis University Samsun, Turkey Musa Kemal Keles¸, MD Department of Plastic, Reconstructive and Aesthetic Surgery Konya Numune Hospital Konya, Turkey http://dx.doi.org/10.1016/j.jhsa.2013.09.037 REFERENCES 1. Egemen O, Aksan T, Ozkaya O, Akan M. Letter: a cheap and simple method for prevention of air leaks in vacuum-assisted closure therapy. Int Wound J. 2011;8(4):428e429. 2. Mouës CM, Vos MC, van den Bemd GJ, Stijnen T, Hovius SE. Bacterial load in relation to vacuum-assisted closure wound therapy: a prospective randomized trial. Wound Repair Regen. 2004;12(1): 11e17. 3. Timmers MS, Le Cessie S, Banwell P, Jukema GN. The effects of varying degrees of pressure delivered by negative-pressure wound therapy on skin perfusion. Ann Plast Surg. 2005;55(6): 665e671. 4. Fragomen AT, Rozbruch SR. The mechanics of external fixation. HSS J. 2007;3(1):13e29.
Vol 38, December 2013
