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Aims: To date, there is no distinct principle determining whether to use irrigation under negative-pressure wound therapy (NPWT). We developed a new economical device to manage difficult wounds, employing 1 of 2 techniques depending on the wound condition. Methods: This case series study was conducted in 12 patients with difficult wound, from 2017 to 2018. Four patients were treated with Type A bidirectional irrigation system (wound irrigation), while 8 patients were treated with Type B bidirectional irrigation system (wound irrigation combined with NPWT). Results: In the Type A device group, inflammatory profiles in case I, case IV, and case VIII were not monitored due to the stability of their wound. The mean recovery period was 3.75 weeks (2-8 weeks), with decreases in 100% healing rate. In the Type B device group, we noted an average of 71% reduction in inflammatory profiles. All patients' infections were resolved or were healing, and 7 patients recovered satisfactorily. The recovery period ranged from 4 to 17 weeks, with a median value of 7 weeks. Conclusion: Bidirectional irrigation system decreases secondary infections and complications, and increases the healing rate in patients with difficult wound. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 75 year old man presented to an emergency department due to dysphagia and shortness of breath. Topics mentioned include the computed tomography performed to him, the hypoxia with persistent cough he suffered, and his post-obstructive pulmonary oedema (POPE) associated with upper airway obstruction.