Topical negative pressure therapy: current concepts and practice.

Research into topical negative pressure therapy (TNPT) started in 1989 with Dr Louis Argenta and Prof Michael Morykwas of Wake Forest University School of Medicine in North Carolina, USA. In 1997, Morykwas and Argenta concluded that TNPT both enhanced granulation tissue formation and helped bacterial clearance, through the actions of negative pressure Armstrong and Lavery confirmed this in 2005, concluding that TNPT therapy was promoting the development of granulation tissue. Numerous other studies have proved that TNPT is beneficial for a myriad of other wounds including: sternotomy wounds, extensive de-gloving injuries, various soft tissue injuries prior to surgical closure, skin grafting, pressure sores, leg ulcers, sacral pressure ulcers, acute traumatic soft tissue defects, and soft tissue defects following rigid stabilisation of lower extremity fractures. This review aims to summarise the clinical and scientific concepts of TNPT and its future applications.

Excluded gastric mucosa presenting as a polypoid tumor in the duodenal stump after B II resection.

We present endoscopic findings of a polypoid tumor in the duodenal stump after Billroth II partial gastric resection in a 61-year-old male. Histologic examination of the tumor revealed gastric mucosa of antral type. Accordingly, Congo red dyeing test failed to show acid secretion. The excluded antral mucosa did not gain any clinical significance in this patient since there was no history of peptic ulcer relapse within the 25 years after gastric operation.