PMC5828939_01
Initial necrotic wounds of the right lower extremity prior to the first operative debridement with evidence of full-thickness lesions caused by the granulomatosis polyangiitis (GPA) (formerly known as Wegener's granulomatosis).
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F1
All the wounds converted to full-thickness necrotic lesions for which he repeatedly underwent debridement (Figures 1 through 4).
Initial necrotic wounds of the bilateral lower extremities and abdomen prior to the first operative debridement caused by the granulomatosis polyangiitis (GPA) (formerly known as Wegener's granulomatosis).
eplasty18e12_fig2.jpg
PMC5828939_01_eplasty18e12_fig2.jpg
F2
All the wounds converted to full-thickness necrotic lesions for which he repeatedly underwent debridement (Figures 1 through 4).
Open wounds to the bilateral lower extremities and abdomen after the first operative debridement for the necrotic full-thickness lesions.
eplasty18e12_fig3.jpg
PMC5828939_01_eplasty18e12_fig3.jpg
F3
All the wounds converted to full-thickness necrotic lesions for which he repeatedly underwent debridement (Figures 1 through 4).
Open wounds to the bilateral lower extremities after the first operative debridement for the necrotic full-thickness lesions.
eplasty18e12_fig4.jpg
PMC5828939_01_eplasty18e12_fig4.jpg
F4
All the wounds converted to full-thickness necrotic lesions for which he repeatedly underwent debridement (Figures 1 through 4).
VAC Veraflo tracking device (inferior dual lumen) over the Abthera system (blue sponge) device placed for intra-abdominal instillation of Vashe solution. The VAC dressing (silver sponge) on the right upper and lower quadrant immediately adjacent under negative pressure wound therapy is a single lumen device.
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PMC5828939_01_eplasty18e12_fig5.jpg
F5
It was decided to combine a VAC Vera-Flo for irrigation (KCI, a company of Acelity) therapy with the ABNWPT (Figure 5).
The VAC Veraflo suction device display showing the settings for instillation as well as negative pressure wound therapy. Fill Asist is turned "OFF" and the Start Phase reads "Instill". The Instill Volume (mL) reads 500 for the amount to be instilled into the abdomen and the "Soak Time (minutes)" is set at "15 minutes." VAC Therapy Time (hours) is reading set at "3." The Target Pressure (mmHg) reads "125" and Intensity is read at "Medium." The side canister is currently a 500 mL container but was increased to the larger capacity container of 1000 ml.
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F6
Initially, 500 mL NS was instilled for 30 minutes (Figure 6); all subsequent cycles utilized HOCl solution through the VAC Vera-Flo device into the abdomen, 500 mL over 30 minutes, and removed every 3 hours with the VAC Vera-Flo device.