Как выбрать вариант NPWT на практике (губки или повязки, показания к их использованию в зависимости от цели лечения, выбор аппарата)

NPT is part of the daily management of complex wounds with delayed healing. It is essential in 2018 to understand the mechanisms of action of the various machines available on the wound market in France. In order to put the right indication for a defined clinical problem to know the difference between fixed and heavy techniques, imposing immobilization of the patient due to the need for a permanent connection and the simpler, ambulatory techniques that combine effective negative pressure while allowing a better quality of life. The recent contribution of the instillation has completed the offer by opening the possibility of instilling in the wound variable liquids in their composition and their effect. The recent introduction of a new foam also suggests the possibility of cleaning the wound with a tool hitherto reserved for the promotion of granulation tissue.Терапия отрицательным давлением (NPWT – negative pressure wound therapy) является частью протокола лечения сложных ран при их замедленном заживлении. На сегодняшний день необходимо понимать механизмы действия различных аппаратов для NPWT, которые представлены на рынке. Рекомендации, применимые к конкретным клиническим ситуациям, приведены с учетом разницы между стационарными методами, требующими обездвиживания пациента из-за необходимости постоянного подключения к устройству, создающему отрицательное давление, и более простыми, амбулаторными методами, которые позволяют проводить эффективную NPWT, обеспечивая при этом лучшее качество жизни. Недавнее появление на рынке аппаратов, с помощью которых можно осуществлять ирригационно-инстилляционную терапию, дополнило метод, открыв возможность закапывать в рану жидкости, разные по своему составу и эффекту. Губки последнего поколения в совокупности с NPWT позволяют еще и очищать поверхность раны (ранее они использовались только для стимуляции роста грануляционной ткани)

Erythropoietin Improves the Survival of Fat Tissue after Its Transplantation in Nude Mice

Background: Autologous transplanted fat has a high resorption rate, providing a clinical challenge for the means to reduce it. Erythropoietin (EPO) has non-hematopoietic targets, and we hypothesized that EPO may improve long-term fat graft survival because it has both pro-angiogenic and anti-apoptotic properties. We aimed to determine the effect of EPO on the survival of human fat tissue after its transplantation in nude mice. Methodology/Principal Findings: Human fat tissue was injected subcutaneously into immunologically-compromised nude mice, and the grafts were then treated with either 20 IU or 100 IU EPO. At the end of the 15-week study period, the extent of angiogenesis, apoptosis, and histology were assessed in the fat grafts. The results were compared to vascular endothelial growth factor (VEGF)-treated and phosphate-buffered saline (PBS)-treated fat grafts. The weight and volume of the EPOtreated grafts were higher than those of the PBS-treated grafts, whose weights and volumes were not different from those of the VEGF-treated grafts. EPO treatment also increased the expression of angiogenic factors and microvascular density, and reduced inflammation and apoptosis in a dose-dependent manner in the fat grafts. Conclusions/Significance: Our data suggest that stimulation of angiogenesis by a cluster of angiogenic factors and decreased fat cell apoptosis account for potential mechanisms that underlie the improved long-term survival of fa

How to choose the NPWT option in practice (sponges or dressings, indications for their use depending on the purpose of treatment, device selection)

NPT is part of the daily management of complex wounds with delayed healing. It is essential in 2018 to understand the mechanisms of action of the various machines available on the wound market in France. In order to put the right indication for a defined clinical problem to know the difference between fixed and heavy techniques, imposing immobilization of the patient due to the need for a permanent connection and the simpler, ambulatory techniques that combine effective negative pressure while allowing a better quality of life. The recent contribution of the instillation has completed the offer by opening the possibility of instilling in the wound variable liquids in their composition and their effect. The recent introduction of a new foam also suggests the possibility of cleaning the wound with a tool hitherto reserved for the promotion of granulation tissue.</jats:p