title: Using a Contradictory Approach to Treat a Wound Induced by Hematoma in a Patient With Antiphospholipid Antibody Syndrome Using Negative Pressure Wound Therapy: Lessons Learnt.
abstract: A 48-year-old woman with antiphospholipid syndrome (APS) had multiple skin necrosis caused by massive bleeding and hematoma collection at the right lower leg, left thigh, and abdomen. During the first month, we did surgical debridement every 2 to 3 days with meticulous coagulation and applied negative pressure wound therapy (NPWT). Then as the base showed initial granulation, we changed the NPWT every 4 days. NPWT was used with lower pressure and cyclic mode (-40 to -75 mm Hg) to minimize trauma and to reduce the possibility of bleeding from the wounds. After 2 months of NPWT treatment, all the wounds eventually healed with secondary intension despite the patient's condition with diabetes, hemodialysis, anticoagulant use, and corticosteroid therapy. This report supports the idea that if accompanied by conservative debridement with meticulous bleeding control, application of NPWT in low pressures and close monitoring of the patient, NPWT is possible to use even in wounds of patients with risk for bleeding.
authors.affiliation: Seoul Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Min Young
authors.initials: MY
authors.lastname: Jang
authors.affiliation: Seoul Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Joon Pio
authors.initials: JP
authors.lastname: Hong
authors.affiliation: "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: Anca
authors.initials: A
authors.lastname: Bordianu
authors.affiliation: Seoul Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea hyunsuk.suh@amc.seoul.kr.
authors.forename: Hyun Suk
authors.initials: HS
authors.lastname: Suh
mesh_terms: D016736:Antiphospholipid Syndrome / Q000150:complications*; D003646:Debridement / Q000379:methods; D005260:Female; D006406:Hematoma / Q000150:complications*; D006801:Humans; D007871:Leg Ulcer / Q000209:etiology / Q000628:therapy*; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy / Q000379:methods*; D014945:Wound Healing
keywords: antiphospholipid antibody syndrome; bleeding; hematoma; negative pressure wound therapy (NPWT); wound