title: The Bagautdinov dressing method: negative pressure wound therapy in a patient with an allergy to acrylate adhesive.
abstract: Current embodiments of negative pressure wound therapy (NPWT) create a hermetically sealed chamber at the surface of the body using polyurethane foam connected to a vacuum pump, which is then covered by a flexible adhesive drape. Commercially available NPWT systems routinely use flexible polyethylene films that have a sticky side, coated with the same acrylate adhesives used in other medical devices such as ECG leads and grounding pads. Severe reactions to the acrylate adhesives in these other devices, although uncommon, have been reported. We describe the case of a 63-year-old woman with an intractable leg ulcer resulting from external-beam radiotherapy (XRT). Treatment with a standard commercial NPWT system induced severe inflammation of the skin in direct contact with drape adhesive. We successfully administered prolonged, outpatient NPWT to the patient using an alternative method (first described by Bagautdinov in 1986), using plain polyethylene film and petrolatum. The necessary hermetic seal is achieved by smearing the skin with petrolatum before applying the polyethylene film and activating the vacuum pump. The Bagautdinov method is a practical solution to the problem of adapting NPWT to patients with contact sensitivity or skin tears related to the adhesive compounds in the flexible drapes. Its use of a circumferential elastic wrap to maintain constant pressure on the seal probably limits the Bagautdinov technique to the extremities.
authors.affiliation: Aesthetic and Plastic Surgery Institute, University of California, Irvine, CA, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Daar
authors.affiliation: Aesthetic and Plastic Surgery Institute, University of California, Irvine, CA, USA.|Rehabilitative Services, Burn & Wound Clinic, University of California, Irvine, CA, USA.|Department of Surgery, Long Beach Veterans Affairs Health Care System, Long Beach, CA, USA.|Department of Surgery, University of California, Irvine, CA, USA.
authors.forename: Garrett A
authors.initials: GA
authors.lastname: Wirth
authors.affiliation: Aesthetic and Plastic Surgery Institute, University of California, Irvine, CA, USA.
authors.forename: Gregory Rd
authors.initials: GR
authors.lastname: Evans
authors.affiliation: Rehabilitative Services, Burn & Wound Clinic, University of California, Irvine, CA, USA.
authors.forename: Melissa
authors.initials: M
authors.lastname: Carmean
authors.affiliation: Department of Surgery, Long Beach Veterans Affairs Health Care System, Long Beach, CA, USA.|Department of Surgery, University of California, Irvine, CA, USA.
authors.forename: Ian L
authors.initials: IL
authors.lastname: Gordon
mesh_terms: D000179:Acrylates / Q000009:adverse effects*; D000269:Adhesives / Q000009:adverse effects*; D001458:Bandages / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006967:Hypersensitivity; D007249:Inflammation / Q000209:etiology* / Q000628:therapy; D007871:Leg Ulcer / Q000628:therapy; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy / Q000379:methods*; D010577:Petrolatum / Q000627:therapeutic use*; D016896:Treatment Outcome; D014945:Wound Healing
chemical_list: D000179:Acrylates; D000269:Adhesives; D010577:Petrolatum
keywords: Adhesive allergy; Bagautdinov dressing; Negative pressure wound therapy