Abstract: Silver is now commonly used in wound dressings and other topical formulations to assist in the management of infected wounds and those at risk of infection. While providing potent broad-spectrum antimicrobial activity, these dressings should not compromise the activity of cells that are involved in the wound healing process. Therefore, the purpose of this study was to evaluate the effect of 7 proprietary silver-containing dressings (AQUACEL® Ag [nonwoven A], Acticoat® Absorbent [nonwoven B], SILVERCEL® [nonwoven C], Contreet® Foam [foam A], PolyMem® Silver [foam B], Urgotul® S.Ag [gauze], and SilvaSorb® [hydrogel]) on fibroblast behavior (ie, viability and contraction) within a collagen gel matrix. Rates of fibroblast contraction were measured at 24-hour intervals over 96 hours, followed by quantitative evaluation of cell viability using the trypan blue exclusion assay. The results showed that there were differences in fibroblast behavior, and in particular, 3 dressings (nonw

Abstract: The high-powered parallel waterjet is a new surgical debridement tool that precisely removes tissue using a high-energy water beam. In this retrospective study, 20 patients with chronic wounds who were operatively debrided with the high-powered parallel waterjet were compared with 14 chronic wound patients debrided with conventional instruments. The hydrosurgery patients required a mean of 1.14 surgeries to obtain a prepared wound bed compared to 2.0 surgeries for conventional patients. This improvement in patient outcomes resulted in approximate savings of $2,800 for the hospital, per patient, when using the waterjet. The introduction of this new surgical technology has changed the paradigm for surgical debridement of chronic wounds.

Abstract: Lipomembranous panniculitis is an uncommon process wherein chronic inflammatory destruction of the fat produces a woody, painful hardening of the skin, especially of the legs. Ulceration may occur. Treatment has often been prolonged and variable in success. The authors herein report a highly successful means of managing the process—excision of the subcutaneous mass using a carbon dioxide laser, producing a pocket-like defect (marsupialization) and healing by secondary intention.

Abstract: An obese patient presented with a Candida albicans ventriculitis and peritonitis after a ventriculo-peritoneal drain became infected. The open abdomen (laparostomy) was treated with a topical negative pressure (TNP) abdominal dressing system. The patient was first treated with an ileocecal resection, which was later complicated by an abdominal compartment syndrome for which a laparostomy was needed. With the TNP abdominal dressing system alone, the abdominal fascia showed extreme retraction. In the literature, several authors propose the combination of sutures with the TNP system in order to approximate wound edges. The herein described combination of the TNP abdominal dressing system with a progressive Bogotá bag closure is based on the same principles. Despite aggressive surgical and medical therapy, the patient eventually died of a systemic Pseudomonas infection. The TNP abdominal dressing system alone may not be powerful enough to prevent retraction of the fascia. Combina