Treatment of Radiation Burns Using a Novel Negative Pressure Wound Therapy System* with Minimal Adherence Bio-DomeTM Dressing Technology

• 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.

S. Gregg Couper, PA-C, CWS, FCCWS, MPAS; Zach Graefser, MA

• 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.

Pt. A

Pt. B

Pt. C

*Novel Negative Wound Pressure Therapy: EngenexTM Advanced Negative Pressure Wound Therapy System1White 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.

3-23-07

8-27-076-15-076-8-07

9-13-074-4-07

5.0 x 3.0 x 1.0 cm 4.0 x 2.8 x 0.8 cm Healed

12-6-07 3-23-081-11-08

20.0 x 7.0 x 2.0 cm 18.0 x 6.5 x 2.0 cm Healed

6.0 x 5.0 x 1.0 cm 6.0 x 4.3 x 0.8 cm

• 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.

6.0 x 3.9 x 0.4 cm

Parkcrest Plastic Surgery, Inc.St. Louis, MO

Purpose

Background

Subjects

Methods

Results Clinical Observations

Conclusions/Relevance

Representative Data- Reduction in Wound Area and Volume