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Vacuum-Assisted Therapy for Combined Volar-Dorsal Soft-Tissue Defects of the Hand: A Case Report.
David S Klein1, John M Yingling, Priya Patel
1David S. Klein, DO, is Orthopedic Surgeon, Department of Orthopedic Surgery, Morristown Medical Center, Tri-County Orthopedics, Cedar Knolls, New Jersey. In the Department of Orthopedic Surgery, Jersey City Medical Center-RWJBarnabas Health, John M. Yingling, DO, is Orthopedic Surgeon; Priya Patel, MD, is Research Fellow, Hand Surgery; and John T. Capo, MD, is Orthopedic Surgeon, Division of Hand Surgery. The authors have disclosed no financial relationships related to this article. Submitted January 5, 2021; accepted in revised form March 1, 2021; published online ahead of print August 19, 2021.
A novel "Hand Vac" technique uses a self-fabricated sponge glove for negative-pressure wound therapy on complex hand injuries. This method effectively treats deep infections and soft-tissue defects, potentially preventing amputation.
Area of Science:
- Plastic Surgery
- Wound Care
- Biomedical Engineering
Background:
- Negative-pressure wound therapy (NPWT) application to hands is challenging due to complex anatomy.
- Severe hand infections and soft-tissue defects require innovative treatment strategies.
Observation:
- A case report details managing a diabetic patient's deep hand infection with extensive volar and dorsal soft-tissue defects.
- A reproducible, self-fabricated sponge glove was created for NPWT, termed "Hand Vac."
- The glove was applied to the hand, sealed, and connected to a single suction port.
Findings:
- The "Hand Vac" technique successfully treated the severe hand infection and soft-tissue defects.
- The patient avoided hand amputation, with wounds showing progressive granulation and healing.
- The technique facilitated eventual wound closure with split-thickness skin grafts.
Implications:
- The "Hand Vac" offers a simplified, effective NPWT approach for complex hand wounds.
- This technique is easily reproducible and adaptable for managing extensive volar and dorsal hand defects.
- It presents a viable alternative for limb salvage in severe hand trauma and infection cases.
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