Factors associated with positive outcomes in 131 patients treated with gauze-based negative pressure wound therapy

Abstract

Negative Pressure Wound Therapy (NPWT) is commonly used in many surgical specialties to improve wound management and healing outcomes. This study reports the ability of gauze-based NPWT to address several treatment goals commonly defined at the onset of therapy. A prospective, multi-center, non-comparative clinical investigation was carried out using gauze-based NPWT in chronic and acute wounds. 131 patients including traumatic, post-surgical and chronic wounds were assessed. Weekly percentage reductions in wound area, depth and volume were 8.3%, 15.8% and 20.5% respectively (p < 0.001). A reduction in exudate level was observed from baseline to treatment discontinuation (p < 0.001). An increase (p = 0.007) in red granulation tissue and a decrease (p < 0.001) in non-viable tissue was observed. Baseline wound characteristics associated with slower rates of progress included chronic wound aetiologies, longer wound duration prior to NPWT and presence of diabetes as a co-morbidity. Important indicators of wounds which had improved sufficiently and no longer required NPWT included reduction in volume and exudate levels. Gauze-based NPWT can be used to address many of the treatment goals commonly defined at the onset of therapy including reduction in wound volume, management of exudate and infection status, and improvement in wound bed quality.

Effects of Negative Pressure Wound Therapy on Healing of Free Full‐Thickness Skin Grafts in Dogs

“…The accelerated appearance of granulation tissue we observed was striking, and is consistent with what has been documented in open wounds treated with NPWT, both experimentally, and in most, but not all clinical studies in the medical literature . Rapid fibroplasia is also reported in the veterinary literature, with granulation tissue appearing several days earlier in open wounds treated with NPWT, compared to standard‐of‐care dressings .…”

“…In the past decade, negative pressure wound therapy (NPWT) has become an increasingly popular adjunct in human medicine, used in a variety of wound healing and surgical applications . NWPT (also termed vacuum‐assisted closure, topical negative pressure) involves the application of a regulated, sub‐atmospheric pressure through a porous dressing placed over a wound bed that has been sealed from its atmospheric environment (Figure ) .…”

Non‐invasive assessment of negative pressure wound therapy using high frequency diagnostic ultrasound: oedema reduction and new tissue accumulation

“…The wound and its associated filling are then covered with an adhesive drape to form an airtight seal over the wound. Earlier debate as to what the optimum pressure value is and whether the wound packing substance needs to be made from a specific material, has given way to consensus that a range of materials and pressures are likely to be needed to meet the full range of clinical needs (4–6). There appears to be no single mechanism of action which can explain the effect NPWT has on wounds.…”

Negative pressure wound therapy

“…98 Dunn et al validated factors associated with positive and negative outcomes in patients treated with gauzebased NPWT; these outcomes were similar to those noted with foam dressings. 99 Gauze-and foam-based NPWT products appear to produce similar proportions of closed split-thickness skin graft (STSG) wounds according to Fraccalvieri et al; however, the wounds closed with a foambased (-125 mmHg) system applied on average at 25.9 days as compared to a gauze-based (-80 mmHg) system applied on average at 24.7 days were less pliable with a thicker scar beneath the graft. 100 Dunn et al noted a 96% overall STSG take, increase in granulation tissue to 90% median wound area, and a decrease in non-viable tissue (20%-0%) for wounds treated with gauze-based NPWT (-80 mmHg) for 12 days pre-treatment and 5 days post-treatment.…”