Tratamiento de defectos de cobertura en los miembros con el sistema de presión negativa en pacientes con cultivo positivo

background: negative pressure to treat wounds was advocated by fleischmann. the system (based on suction to fill a cavity with granulation tissue), removes fluids, improves circulation and stimulates granulation tissue proliferation. methods: thirty-one patients with coverage defects were treated between october 2004 and october 2009, with 10 months average follow up. two of them were lost to follow up and four had negative cultures; the latter were used as a control group. results: the n.p.s. (negative pressure system) produced a layer of granulation tissue on bone, tendons, or implants that allowed for primary closure, and coverage with skin grafts or local flaps, even in patients with positive cultures. the longest time the system was used were 22 days, and five were the most changes that had to be made to the system in the same patient. conclusions: the n.p.s. removes debris, including inflammatory mediators. improving the local environment enhances healing compared to traditional methods. this allows for wound closure with simple methods, avoiding microvascular flaps. in infected wound patients, it would favor the administration of antibiotics to the wound. no significant differences were noted in treatment duration in patients with either positive or negative cultures.