A systematic review of topical negative pressure therapy for acute and chronic wounds

Ubbink, Dirk T.; Westerbos, S. J.; Nelson, E Andrea; Vermeulen, Hester

doi:10.1002/bjs.6238

Cited by 204 publications

(111 citation statements)

References 26 publications

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“…When testing differences between means we used a Shapiro-Wilk test for the normality of the two distributions followed by an independent t-test or Mann-Whitney U test as appropriate. A Chi-square test 8 or Fisher's exact test was used for proportions. The differences in mean costs and outcomes between the two arms were used to estimate the ICER.…”

Section: Economic Analysismentioning

confidence: 99%

“…There have been a number of reviews of NPWT [4][5][6][7][8] , with some favouring NPWT over standard dressings [5,6] and others failing to find convincing evidence of benefit [4,7,8].…”

Section: Introductionmentioning

confidence: 99%

“…The majority of these focus either primarily or entirely on studies of NPWT in the treatment setting [5][6][7][8], although a Cochrane review of NPWT for prophylactic postoperative use concluded that the evidence for effectiveness was unclear [4].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Cost-effectiveness analysis alongside a pilot study of prophylactic negative pressure wound therapy

Heard

Chaboyer

Anderson

et al. 2017

Journal of Tissue Viability

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Section: Economic Analysismentioning

confidence: 99%

“…There have been a number of reviews of NPWT [4][5][6][7][8] , with some favouring NPWT over standard dressings [5,6] and others failing to find convincing evidence of benefit [4,7,8].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Cost-effectiveness analysis alongside a pilot study of prophylactic negative pressure wound therapy

Heard

Chaboyer

Anderson

et al. 2017

Journal of Tissue Viability

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“…On the whole, current study data do not allow for conclusions on a significant advantage of a certain wound dressing in the healing rate of diabetic or venous ulcers [15,76,78,79,81,87,88]. …”

Section: Moisture Balancementioning

confidence: 88%

Evidence‐based topical management of chronic wounds according to the T.I.M.E. principle

Klein

Schreml

Dolderer

et al. 2013

J Deutsche Derma Gesell

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SummaryThe number of patients suffering from chronic wound healing disorders in Germany alone is estimated to be 2.5-4 million. Therapy related expenses reach 5-8 billion Euros annually. This number is partially caused by costly dressing changes due to non-standardized approaches and the application of non-evidence-based topical wound therapies. The purpose of this paper is to elucidate a straightforward principle for the management of chronic wounds, and to review the available evidence for the particular therapy options. The T.I.M.E.-principle (Tissue management, Inflammation and infection control, Moisture balance, Epithelial [edge] advancement) was chosen as a systematic strategy for wound bed preparation. Literature was retrieved from the PubMed and Cochrane Library databases and subjected to selective analysis.Topical wound management should be carried out according to a standardized principle and should further be synchronized to the phases of wound healing. Despite the broad implementation of these products in clinical practice, often no benefit exists in the rate of healing, when evaluated in meta-analyses or systematic reviews. This insufficient evidence is additionally limited by varying study designs. In case of non-superiority, the results suggest to prefer relatively inexpensive wound dressings over expensive alternatives. Arbitrary endpoints to prove the effectiveness of wound dressings, contribute to the random use of such therapies. Defining rational endpoints for future studies as well as the deployment of structured therapy strategies will be essential for the economical and evidence-based management of chronic wounds.

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“…With regard to the case described above, it is probable that conventional dressings would have been unlikely to have successfully maintained an environment conducive to healing, considering the presence of a purulent fistula in contact with the prosthetic arterial graft and the large areas of dehiscence. Systematic reviews 8,9 and a randomized study 10 show the effectiveness of negative pressure dressings in a range of situations, in terms both of the proportion of wounds healed and the speed with which they close, and they are particularly effective for diabetic feet, [11][12][13] skin grafts 14 and infections after surgery. 15,16 However, there is still a lack of good quality randomized studies free from conflicts of interest that would allow the method to be evaluated more thoroughly.…”

Section: Discussionmentioning

confidence: 99%

Uso de curativo a vácuo como terapia adjuvante na cicatrização de sítio cirúrgico infectado

et al. 2017

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Infections at the sites of surgery involving synthetic prostheses are challenging to treat. We present a case of a patient with multiple comorbidities who had undergone an aortobifemoral bypass 6 years previously and then re-intervention at the femoral anastomoses for restenosis 5 years previously. The patient presented with acute left inguinal pain and swelling and was diagnosed with a ruptured femoral pseudoaneurysm and hemodynamic instability. A repair was conducted by interposition of a silver-coated Dacron graft in the emergency room, and a large abdominal incisional hernia was repaired with synthetic mesh during the same intervention. After surgery, the patient remained intubated in intensive care for a long period. Meanwhile, she presented dehiscence of sutures and a left inguinal purulent fistula that was in contact with the vascular prosthesis. Conservative treatment was chosen, with debridement of wounds and vacuum therapy. The patient improved and the wounds healed. This could be an important tool in similar cases.Keywords: treatment; healing; abdominal injury closure techniques; infection; vascular prosthesis. ResumoInfecções de sítios cirúrgicos com envolvimento de próteses sintéticas constituem grande desafio para tratamento. Apresentamos o caso de uma paciente com múltiplas comorbidades, histórico de enxerto aortobifemoral há 6 anos e reabordagem das anastomoses femorais por reestenoses há 5 anos. Apresentou dor inguinal esquerda e abaulamento súbitos com diagnóstico de pseudoaneurisma femoral roto e instabilidade hemodinâmica. Foi submetida a correção emergencial com interposição de prótese de dácron recoberta por prata e correção de grande hérnia incisional abdominal com tela sintética ao mesmo tempo. No pós-operatório, manteve-se por longo período sob terapia intensiva com dificuldade de extubação. Nesse ínterim, apresentou deiscência das suturas e fístula purulenta inguinal esquerda em contato com a prótese vascular. Optou-se pelo tratamento conservador, com desbridamento das feridas e aplicação de curativo a vácuo. A paciente evoluiu com melhora e cicatrização das feridas. Essa pode se constituir em ferramenta importante em casos similares.Palavras-chave: terapêutica; cicatrização; técnicas de fechamento de ferimentos abdominais; infecção; prótese vascular.

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A systematic review of topical negative pressure therapy for acute and chronic wounds

Abstract: There is little evidence to support the use of TNP in the treatment of wounds.

Cited by 204 publications

References 26 publications

Cost-effectiveness analysis alongside a pilot study of prophylactic negative pressure wound therapy

Cost-effectiveness analysis alongside a pilot study of prophylactic negative pressure wound therapy

Evidence‐based topical management of chronic wounds according to the T.I.M.E. principle

Uso de curativo a vácuo como terapia adjuvante na cicatrização de sítio cirúrgico infectado

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