Extensive cutaneous necrosis due to purpura fulminans presents many of the same treatment challenges as a significant burn injury. The areas of tissue loss are large, require complex and repeated dressings and create a significant reconstructive challenge. These patients are therefore often treated by burns multi-disciplinary teams (Ariivalo et al., Burns 24:272–274, 1 ). Topical negative pressure (TNP) therapy has a recognised role in the management of complex wounds, but its use is normally restricted to moderates sized defects. This paper describes a method of TNP dressing application to large purpura fulminans wound areas, including the buttocks and perineum, by fashioning ATNP suits. A photographically illustrated series is presented to demonstrate a TNP suit application in four consecutive paediatric cases of severe purpura fulminans, and they are representative of our practise. These cases illustrate how TNP suits provide a robust movement resistant dressing which removes exudate from the wound, splinting and reducing the wound area, promoting a graftable bed and facilitating graft take in these difficult to manage patients.
European Journal of Plastic Surgery – Springer Journals
Published: Apr 1, 2012
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