1. Negative Pressure Wound Therapy (NPWT) : Principles and Applications A-Young Lee ( 李雅永 ) Academic support, Daewoong Pharmaceutical

2. 1995: Wound VAC ® – KCI 1947, Russia Post-op wound Wall Suction & Gauze 1952 Closed suction used prophylactically to reduce Post-op complications FoamFoam KulaVac ® -Daewoong EZ Care™ - Smith & Nephew Engenex ® (Boehringer Wound Systems) – ConvaTec Genadyne A4 – Genadyne Biotechnologies Inc. Kalypto - Kalypto Medical Medela ® - Invia MoblVac ® - Ohio Medical Prodigy™ - Premco Medical Systems, Inc. Prospera PRO-I™ & PRO-II™ Systems – Medica Renasys – Smith & Nephew Svedman™ & Sved™ Systems - Innovative Therapies Venturi™ System - Talley Group Evolution of NPWT

3. Components Foam Dressing (Three Different Sizes) Film Dressing Accessories (Suction Head, Tubing with Connectors and Clamp) Composition of KulaVAC ®

4. KulaVAC ® Bridge

5. KulaVAC ® Silver

6. KulaVAC ® Publications

8. Intermittent mode Cyclic mode

9. Patients & Methods 2012 December ~ 2013 December Institutions: Inha University Hospital, Severance Hospital, Ilsan Hospital N=61 cases (56 patients) Inclusion criteria –Age 18~65 –High-energy foot & ankle Fx 61 cases (56 patients) Calcaneus: 27 Trimalleolar: 22 Pilon: 9 Talus & distal tibia: 3 Control group (n=32) Conventional gauze dressing Test group (n=29) Dressing with Incisional NPWT

10. Demographic Data

11. Distribution of Fracture Type NPWT (N=29)Control (N=32)Total Trimalleolar 9 (31%)13 (40.6%)22 (36.1%) Pilon 5 (17.2%)4 (12.5%)9 (14.7%) Calcaneus 14 (48.3%)13 (40.6%)27 (44.3%) Talus and distal Tibia Fx. 1 (3.4%)2 (6.2%)3 (4.9%)

12. NPWT (N=29)Control (N=32)P value POD 1d5100.342 POD 3d590.468 POD 14d120.42 (Complications: maceration, erythema, skin irritation sign) Complications Associated with The Dressings

13. NPWT (N=29)Control (N=32)P value Infection030.146 Dehiscence050.035 Cosmetic evaluation7.31/106.23/100.23 Final Results at Postoperative Day 14

14. Decreases swelling more rapidly (p<0.05). Reduces wound dehiscence (p<0.05). Effects on Postop wound infection – Show reduction but not statistically significant Decreases swelling more rapidly (p<0.05). Reduces wound dehiscence (p<0.05). Effects on Postop wound infection – Show reduction but not statistically significant Effects of Incisional NPWT Effects of Incisional NPWT Helpful in reducing postoperative wound problems in high energy foot & ankle trauma. Conclusion Trial Summary

16. Daewoong Pharmaceutical Co.,Ltd. China 金正煥 (Kim Jung Hwan) Tel : 070-7417-3384 Fax : 86-10-8478-2506 Mobile : (CHI)+86-156-0046-0501, (KOR)+82-10-4171-6975 E-mail : wink0405@daewoong.co.kr/ wink0405@daewoong.co.kr/ 2558933142@qq.com Room 2208B, East Tower of Twin Towers, No.B12, JianGuoMen Wai Avenue, ChaoYang District, Beijing, China100022 北京市朝阳区建国门外大街乙十二号双子座大厦东塔 2208B KulaVAC ® Marketing Representative in China