title: Growth factors, silver dressings and negative pressure wound therapy in the management of hard-to-heal postoperative wounds in obstetrics and gynecology: a review.
abstract: OBJECTIVE
  The last two decades witnessed the development of numerous innovative regimens for the management of patients with abnormally healing and infected wounds. Growth factors, negative pressure wound therapy (NPWT) and antiseptic dressings containing silver are examples of methods with best documented efficacy, being widely used in the treatment of acute and chronic post-traumatic wounds, burns and ulcers of various etiology. As far as obstetrics and gynecology are concerned, prevention and treatment of infected, hard-to-heal postoperative wounds is of crucial importance. This article reviews the available literature to discuss the possibilities for use, efficacy and cost-effectiveness of growth factors, NPWT and silver dressings in the treatment of difficult-to-heal postsurgical wounds in obstetrics and gynecology.
  
  
  METHODS
  An extensive search of the English and Polish literature via PubMed and EMBASE databases was undertaken for articles published between January 1960 and April 30, 2014 to identify articles that described and assessed use, efficacy and cost-effectiveness of growth factors, silver dressings and NPWT in patients with hard-to-heal postoperative wounds following obstetric or gynecological surgery.
  
  
  CONCLUSIONS
  Literature review regarding the use of growth factors, NPWT and silver dressings suggests that these methods may play an important role in the management of wounds after invasive obstetric and gynecological procedures. Obese patients, patients after vulvectomy or prior radiation therapy may benefit most, however, due to non-numerous randomized reports, prospective studies on the use of above-mentioned methods in the treatment of postsurgical wounds following obstetric and gynecological interventions are required.
authors: Department of Obstetrics, Gynecology and Oncology, II Faculty of Medicine, Mazovian Bródno Hospital, Medical University of Warsaw, Warsaw, Poland, stanirowski@gmail.com.
authors: Paweł Jan
authors: PJ
authors: Stanirowski
authors: Anna
authors: A
authors: Wnuk
authors: Krzysztof
authors: K
authors: Cendrowski
authors: Włodzimierz
authors: W
authors: Sawicki
mesh_terms: D001458:Bandages; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins; D054843:Negative-Pressure Wound Therapy / Q000379:methods; D013513:Obstetric Surgical Procedures; D011183:Postoperative Complications; D011184:Postoperative Period; D018030:Silver Compounds / Q000627:therapeutic use*; D016896:Treatment Outcome; D014945:Wound Healing; D014946:Wound Infection / Q000628:therapy*
chemical_list: D036341:Intercellular Signaling Peptides and Proteins; D018030:Silver Compounds