Comparison of Outcomes for Normal Saline and an Antiseptic Solution for Negative-Pressure Wound Therapy with Instillation

Kim, Paul J.; Attinger, Christopher E.; Oliver, Noah G.; Garwood, Caitlin S.; Evans, Karen K.; Steinberg, John S.; Lavery, Larry A.

doi:10.1097/prs.0000000000001709

Cited by 94 publications

(72 citation statements)

References 15 publications

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“…27 Kim et al conducted a prospective randomized study comparing NPWT instillation with normal saline and antiseptic solution (0,1% polyhexanide plus 0,1% betaine). 43 There was no statistical significance in any of the analyzed parameters (a number of operative visits, a length of hospital stay, a wound healing rate and a wound healing rate within 30-day follow-up) in comparison to two cohorts of patients. However, the time to final surgical procedure was statistically shorter in the normal saline group (p= 0,038).…”

Section: A Isotonic Solutionsmentioning

confidence: 78%

“…In the recent prospective randomized study, Kim et al analyzed the effect of NPWTi on wound healing using two different solutions: normal saline versus antiseptic solution (0.1% polyhexanide plus 0,1% betaine). 43 In the majority, chronic or complex wound was located within the lower extremity in both analyzed groups of treatment. There was no statistical difference between the compared groups of treatment for the number of surgeries, the length of hospital stay, wounds closed/ covered ratio and wounds ratio that remained closed within 30 days of follow up.…”

Section: Clinical Indicationsmentioning

confidence: 92%

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Negative pressure wound therapy with instillation (NPWTi): Current status, recommendations and perspectives in the context of modern wound therapy.

Bobkiewicz

Studniarek

Drews

et al. 2016

NPWTJ

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REVIEWAbstract-Introduction of negative pressure wound therapy (NPWT) revolutionized the conception of wound healing. Currently, increasing number of studies confirmed the high efficiency of this therapy in many clinical scenarios. Moreover, some innovations have been introduced in recent years to improve the management of complex and chronic wounds. NPWT with instillation (NPWTi) combines traditional NPWT with application of topical irrigation solutions within the bed of the wound. Bioburden reduction, decreases time to wound closure, promotes granulation and tissue formation. Fewer operative visits are required when using NPWTi compared to standard NPWT. However, there are still questioned aspects of the NPWTi and thus its superiority over standard NPWT has not been fully indicated. Moreover, based on current studies no firm conclusions have been taken concerning the type of instilled solution preferably used, range of dwell-time phase, range of negative pressure and others. The main goal of the publication is to overview and summarize the current state of art concerning NPWTi. Moreover, mechanisms of action, review of the most commonly used instilled solutions are discussed and clinical evidence of NPWTi are described.

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Section: A Isotonic Solutionsmentioning

confidence: 78%

Section: Clinical Indicationsmentioning

confidence: 92%

Negative pressure wound therapy with instillation (NPWTi): Current status, recommendations and perspectives in the context of modern wound therapy.

Bobkiewicz

Studniarek

Drews

et al. 2016

NPWTJ

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“…There are reports of several substances such as polyhexanide 9 , Dakin's solution 14 , silver nitrate 15 and saline 16 . In the experience reported here, we decided to use saline, which was equally effective when compared to polyhexanide in a previous controlled study in diabetic wounds 16 . This was a prospective, randomized study with 100 Patients divided into two groups of NPWTi, one with saline solution and one with polyhexanide.…”

Section: Discussionmentioning

confidence: 99%

Experiência inicial com terapia por pressão negativa por instilação em feridas complexas

Milcheski

Portocarrero

Alvarez

et al. 2017

Rev. Col. Bras. Cir.

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RESUMO Objetivo: relatar a experiência inicial com a terapia por pressão negativa por instilação em feridas complexas infectadas ou contaminadas. Métodos: a terapia por pressão negativa por instilação utilizada foi o V.A.C. Ulta com instilação Veraflo (Kinetic Concepts, Inc). O modo de operação foi contínuo com pressão sub-atmosférica ajustada em 125 mmHg por duas horas e instilação entre as pausas. O tempo de instilação foi de 20 minutos (tempo de contato do agente tópico com a ferida) e a substância instilada foi solução salina padrão a 0,9%. Após obtenção de preparo adequado da ferida, ela foi coberta com enxerto ou retalho. Resultados: foram operados dez pacientes com feridas complexas contaminadas ou infectadas. O número médio de trocas da TPNi foi 1,4, o número médio total de cirurgias foi de 2,4, o intervalo até a cobertura da ferida foi de 6,3 dias e o intervalo até a alta foi de 11,4 dias. Conclusão: a comparação da terapia por pressão negativa por instilação com dois estudos prévios (controle histórico) evidenciou um tempo de internação menor, favorecendo a TPNi. Este estudo teve um caráter inicial, fazendo-se necessário conduzir um trabalho randomizado e controlado para confirmar a eficácia desta terapia e verificar a sua custo-efetividade.

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“…Allowing an instilled solution to dwell in the wound bed helps to cleanse the wound and the NPWT cycle helps remove solubilized contaminants, devitalized tissue, and slough [16]. Hypochlorite-based solutions [17,18] and 0.9% normal saline [19][20][21] as topical instillation solutions have shown positive clinical outcomes.…”

Section: Introductionmentioning

confidence: 99%

“…A growing body of literature supports the use of NPWT with instillation and dwell time (NPWTi-d) with positive clinical outcomes and potential cost savings being reported [19][20][21][22][23]. Additionally, several published reviews and recommendations exist for the use of NPWTi-d in acute and chronic wounds [15,16,24].…”

Section: Introductionmentioning

confidence: 99%

Initial Experience Using a Novel Reticulated Open Cell Foam Dressing with Through Holes during Negative Pressure Wound Therapy with Instillation for Management of Pressure Ulcers

Fernández¹,

Ellman²,

Jackson³

2017

J Trauma Treat

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Several published reviews and recommendations exist for the use of negative pressure wound therapy (NPWT) with instillation and a dwell time (NPWTi-d) in acute and chronic wounds. Specific dressings for use with NPWTi-d have also been developed, including a reticulated open cell foam dressing with through holes (ROCF-CC) that assists in removing thick wound exudate and infectious materials. ROCF-CC is especially helpful for wound cleansing when debridement is not possible or appropriate in patients.We report our initial experiences in using NPWTi-d with ROCF-CC in patients with pressure ulcers. An algorithmic approach was used to determine appropriate treatment to reach the goals of therapy (i.e., wound bed preparation, granulation tissue formation, and removal of infectious materials). Previous therapies included honey and gauze soaked in Dakin's solution. All patients received antibiotics and debridement when possible.Five patients (3 females and 2 males) received NPWTi-d with ROCF-CC (instillation of saline or a hypochlorous solution with a dwell time of 10 minutes, followed by 2-3 hours of -125 mmHg NPWT). Patient comorbidities included obesity, diabetes mellitus, hypertension, and peripheral artery disease. Mean age of patients was 65.2 years (range: 50-82 years). After an average of 6 days of therapy (range 2-9 days), all wounds treated with NPWTi-d with ROCF-CC showed rapid granulation tissue formation.We also noted improved removal of devitalized tissue and subsequent granulation tissue formation in patients receiving hypochlorous solution compared to patients receiving saline during NPWTi-d with ROCF-CC. All patients were eventually transferred to a skilled nursing facility. In our clinical practice, NPWTi-d with ROCF-CC provided effective and rapid removal of the thick exudate and infectious materials and promoted excellent development of underlying granulation tissue.

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Comparison of Outcomes for Normal Saline and an Antiseptic Solution for Negative-Pressure Wound Therapy with Instillation

Abstract: Therapeutic, II.

Cited by 94 publications

References 15 publications

Negative pressure wound therapy with instillation (NPWTi): Current status, recommendations and perspectives in the context of modern wound therapy.

Negative pressure wound therapy with instillation (NPWTi): Current status, recommendations and perspectives in the context of modern wound therapy.

Experiência inicial com terapia por pressão negativa por instilação em feridas complexas

Initial Experience Using a Novel Reticulated Open Cell Foam Dressing with Through Holes during Negative Pressure Wound Therapy with Instillation for Management of Pressure Ulcers

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