{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T09:10:56Z","timestamp":1782810656010,"version":"3.54.5"},"reference-count":22,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,5,24]],"date-time":"2020-05-24T00:00:00Z","timestamp":1590278400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Wound Journal"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Complex wounds with exposed critical structures such as tendon and bone are a conundrum in wound management, especially in the setting where the patient is not a suitable candidate for flap surgery. While the individual use of negative pressure wound therapy (NPWT) and oxidised regenerated cellulose (ORC)\/collagen\/silver (PROMOGRAN PRISMA) dressing has been described in the literature, there are little data on the efficacy of their combined use. In this study, we describe a novel technique of combining the use of NPWT and ORC\/collagen\/silver dressings to manage complex wound beds as an alternative management option for patients not suitable for reconstructive flap surgery. This technique was performed in a series of 37 patients with complex lower\u2010extremity wounds that were not healing with conventional NPWT alone. All patients had open wounds with exposed critical structures that were difficult to manage, such as exposed tendon, bone, deep crevices, and joint. Successful coverage of exposed critical structures was achieved in 89% of patients, and coverage was achieved within 28\u2009days of combination therapy in 82% of these patients, without any complications. The novel technique of combining ORC\/collagen\/silver dressing and NPWT provides a useful option in the armamentarium of a reconstructive surgeon dealing with difficult complex lower\u2010extremity wounds.<\/jats:p>","DOI":"10.1111\/iwj.13406","type":"journal-article","created":{"date-parts":[[2020,5,24]],"date-time":"2020-05-24T22:10:11Z","timestamp":1590358211000},"page":"1356-1365","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Combination therapy of oxidised regenerated cellulose\/collagen\/silver dressings with negative pressure wound therapy for coverage of exposed critical structures in complex lower\u2010extremity wounds"],"prefix":"10.1111","volume":"17","author":[{"given":"Mei Ling","family":"Loh","sequence":"first","affiliation":[{"name":"Department of General Surgery, Plastic, Reconstructive and Aesthetic Surgery Service Khoo Teck Puat Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin K. L.","family":"Goh","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Plastic, Reconstructive and Aesthetic Surgery Service Khoo Teck Puat Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Kong","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Plastic, Reconstructive and Aesthetic Surgery Service Khoo Teck Puat Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Varughese","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Plastic, Reconstructive and Aesthetic Surgery Service Khoo Teck Puat Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia Lin","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Podiatry Khoo Teck Puat Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2289-5266","authenticated-orcid":false,"given":"Zhiwen J.","family":"Lo","sequence":"additional","affiliation":[{"name":"Vascular Surgery Service, Department of General Surgery Tan Tock Seng Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1354-9399","authenticated-orcid":false,"given":"Chong Han","family":"Pek","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Plastic, Reconstructive and Aesthetic Surgery Service Khoo Teck Puat Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,5,24]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.12170"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.2337\/diaclin.24.2.91"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.3402\/dfa.v2i0.5893"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.3944\/AOTT.2011.2283"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1067\/j.cpsurg.2014.04.001"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1357-2725(02)00054-7"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/1534734605283001"},{"key":"e_1_2_6_9_1","unstructured":"CullenB DT BoyleC WebbY. 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