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    Our research and development teams operate at a global level and generate synergies from our collective expertise and by drawing on related disciplines. We are also constantly exchanging information at an international level with independent technical institutions, key opinion leaders and multipliers in order to be able to ensure cooperation and knowledge management of the highest order. As part of this process, we also conduct extensive research, the results of which we continually present in workshops, at conferences and symposiums - either in documentation or talks given by our cooperation partners - and also publish in renowned scientific journals. This database contains a large number of these evidence-based scientific articles, most of which have been evaluated by independent assessors:

    1. Journal article

      Intrauterine negative-pressure therapy (IU-NPT) to treat peritonitis after caesarean section

    2. Journal article

      Endoscopic negative pressure therapy with open-pore film drainage and open-pore polyurethane sponge drainage for iatrogenic perforation of the esophagus

      Endoscopy 2020 52(5) 377382

      BACKGROUND

      Management of iatrogenic esophageal perforation (IEP) is challenging. Endoscopic negative pressure therapy (ENPT) is an emerging and effective tool for the treatment of gastrointestinal and anastomotic leaks. We have used ENPT as first-line therapy for IEP since 2017. The aim of this study was to present our results with this strategy in patients with IEP.

      METHODS

      Nine patients were treated with ENPT for IEP between August 2017 and August 2019. Their treatment characteristics, including duration of therapy, strategy used, and outcomes, were analyzed. Treatment included ENPT with open-pore film drainage (OFD) and open-pore polyurethane foam drainage (OPD).

      RESULTS

      Early diagnosis (< 24 hours) of IEP occurred in four patients. After a mean (standard deviation) of 19.0 (13.5) days of ENPT, 6.4 (3.4) endoscopies, and 38.1 (40.3) days of hospitalization, endoscopic treatment was effective and successful in all of the patients. Additional video-assisted thoracic surgery (VATS) was done in four patients.

      CONCLUSIONS

      ENPT is an effective new method for the management of IEP. ENPT with OFD and OPD can be combined with minimally invasive operative methods for sepsis control in IEP.

      PMID 32252093
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    3. Journal article

      Endoscopic Vacuum Therapy for Staple Line Leaks after Sleeve Gastrectomy

      Obesity surgery 2020 30(4) 13101315

      PURPOSE

      Management of staple line leaks (SLL) after sleeve gastrectomy (SG) is challenging. The aim of this study was to evaluate the effectiveness of a novel endoscopic vacuum therapy (EVT) modality in the management of sleeve leaks.

      MATERIALS AND METHODS

      Eight patients were treated with EVT for SLL. Therapy data and outcome measures including duration of therapy, therapy success, and change of treatment strategy were collected and analyzed.

      RESULTS

      During the study period, SLL occurred in 1.6% of patients who underwent SG. After 9.8 ± 8.6 days of EVT, 3.3 ± 2.2 endoscopies, and 19 ± 15.1 days of hospitalization, endoscopic treatment using EVT was successful in seven out of eight patients (87.5%).

      CONCLUSIONS

      EVT is an effective method for the management of staple line leaks after sleeve gastrectomy. The use of the intraluminal open-pore film drainage (OFD) could be considered as an advantageous modality of EVT, regarding placement and complications.

      PMID 31792702
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    4. Journal article

      Getunnelte subkutane endoskopische Unterdrucktherapie

    5. Journal article

      Compression Therapy Is Not Contraindicated in Diabetic Patients with Venous or Mixed Leg Ulcer

      Journal of clinical medicine 2020 9(11)

      The aim of this study was to investigate if compression therapy (CT) can be safely applied in diabetic patients with Venous Leg Ulcers (VLU), even when a moderate arterial impairment (defined by an Ankle-Brachial Pressure Index 0.5-0.8) occurs as in mixed leg ulcers (MLU).

      MATERIALS AND METHODS

      in one of our previous publications we compared the outcomes of two groups of patients with recalcitrant leg ulcers. Seventy-one patients were affected by mixed venous and arterial impairment and 109 by isolated venous disease. Both groups were treated by tailored inelastic CT (with compression pressure 40 mm Hg in patients with MLU and >60 mm Hg in patients with VLU) and ultrasound guided foam sclerotherapy (UGFS) of the superficial incompetent veins with the reflux directed to the ulcer bed. In the present sub analysis of the same patients we compared the healing time of 107 non-diabetic patients (NDP), 69 with VLU and 38 with MLU) with the healing time of 73 diabetic patients (DP), 40 with VLU and 33 with MLU.

      RESULTS

      Twenty-five patients were lost at follow up. The results refer to 155 patients who completed the treatment protocol. In the VLU group median healing time was 25 weeks for NDP and 28 weeks in DP (p = 0.09). In the MLU group median healing time was 27 weeks for NDP and 29 weeks for DP (p = -0.19).

      CONCLUSIONS

      when providing leg ulcer treatment by means of tailored compression regimen and foam sclerotherapy for superficial venous refluxes, diabetes has only a minor or no effect on the healing time of recalcitrant VLU or MLU.

      PMID 33227909
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    6. Journal article

      A small scale quality improvement study trialling the use of a monofilament-fibre (Debrisoft®) debridement lolly on chronic ulcers

      Wounds UK 2020 16(1)

      Objective:

      A small-scale quality improvement study to determine the clinical effectiveness and patient satisfaction of the long-handled monofilament fibre (Debrisoft®) debriding lolly on foot ulcers that were considered to be slow healing in nature.

       

      Methods:

      This was a non-comparative, small-scale quality improvement study conducted on ulcers with slough (non-fibrous) at the ulcer base. The longhandled monofilament fibre (Debrisoft®) debriding lolly was used to treat seven patients during ulcer management, following the Trust's guidance for podiatric ulcer treatment.

       

      Results:

      Improvement was noted to the majority of ulcers within the second to third week and visible changes were evident, particularly in healing times and slough reduction. Both user and patient satisfaction were high.

       

      Conclusion:

      The long-handled monofilament fibre (Debrisoft®) debriding lolly provides an easy-to-use method of debriding foot ulcers. It allows easy access to difficult areas and enables the healing mechanism to commence. Patients verbally reported positive satisfaction when the long-handled monofilament fibre (Debrisoft®) debriding lolly was used.

      Products Debrisoft Lolly
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    7. Journal article

      Sub-compression interface pressure measurements in vivo, comparing adjustable compression wraps and custom-made flat knit compression stockings

      Phlebologie 2020

      Background

      Adjustable Compression Wraps (ACW) are used as an alternative to flat-knitted compression stockings (CS) in the maintenance phase of complex decongestive therapy treating of lymphoedema.

       

      Methods

      Self-applied ACW and custom-made CS were compared using sub-compression interface pressure measurements in vivo. Measurements were recorded using manometer-based Picopress®-devices in a sample of n = 30 probands with bilateral symmetric lymphostatic lower leg oedema. Legs were randomised to CS side and ACW side. Following standardised instruction and initial pressure measurements for both systems, ACW pressure measurements were repeated after 2 and 4 hours. Static Stiffness Index and pressure gradients between measuring points B1-C were calculated.

       

      Results

      ACW showed resting pressures and SSI in therapeutic ranges and significantly higher than CS (p < 0.01; p < 0.001). ACW reached significantly higher working pressures (p < 0.001). Resting pressure sub-ACW did not show significant pressure drops after 2 and 4 hours, without re-adjusting. Average pressure gradients between ACW and CS did not differ significantly.

       

      Discussion

      The pressure values reached with ACW underline their therapeutic effects. Pressures under self-applied ACW are relatively stable, even without re-adjusting. Self-application is interpreted as effective. A thorough instruction of patients is essential.

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    8. Journal article

      Compression hosiery for venous disorders and oedema: a question of balance

      British journal of community nursing 2020 25(9) 2632

      Compression therapy for venous and lymphatic conditions may be delivered via a range of treatment modalities using many different technologies, depending on the patient's condition and needs. Clinical decision-making relies on accurate assessment of the patient, their presenting and underlying clinical condition, skill and training of the applier and the available resources. However, changes in the patient's condition or lifestyle may necessitate re-evaluation of the treatment pathway. Generally, compression bandages and Velcro wraps are used in the intensive acute phase of treatment, with self-management using compression hosiery or wraps being used for long-term maintenance to prevent recurrence. Although guidelines recommend the highest class of compression hosiery for maximum effectiveness, clinical evidence shows practical challenges associated with application and tolerance of higher pressures and stiffness. An audit of a new type of compression garment was conducted, and it showed that incorporating stiffness into circular knitted hosiery helped overcome some of these challenges with improvements in limb size, skin softening and wound size. Additionally, self-management was facilitated by the ease of donning and doffing.

      PMID 32886551
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    9. Journal article

      Die endoskopische Unterdrucktherapie zur Behandlung von ösophagealen Leckagen

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    10. Poster

      Can monofilament fibre technology help in chronic wound overgranulation? A case study

      Poster presented at Wounds UK 2019 04.11.2019 Harrogate, UK