Negative Pressure Wound Therapy Combined With Instillation for Sternoclavicular Joint Infection

Novel imaging methods reveal positive impact of topical negative pressure application on tissue perfusion in an in vivo skin model

“…5 In spite of huge clinical experience and clinical research mainly based on case series and clinical trials, the exact underlying mechanisms are still not fully understood. 2 , 5 , 6 , 7 , 8 , 9 , 10 The influence of TNPA on the perfusion of a wound and the flow of adjacent vessels and capillaries is part of an ongoing controversial discussion. Many experimental and clinical studies indicate an increase of blood flow across the wound and/or close to the wound margins.…”

The Effect of Negative-Pressure Wound Therapy with Instillation Compared to Current Standard Care on Wound Closure Time of Infected Wounds: A Systematic Review and Meta-Analysis

“…A study on sternoclavicular joint infections also found no difference in infection recurrences between negative-pressure wound therapy with instillation or negative-pressure wound therapy alone. 17 The study on osteomyelitis of the pelvis and lower extremities found that negative-pressure wound therapy with instillation had a recurrence rate of 10 percent, compared to 58.5 percent following conventional wound care ( p < 0.0001). 31…”

“…Meta-analysis of two randomized controlled trials 18,19 showed no significant difference in wound closure rate ( n = 240; risk ratio, 1.10; 95 percent CI, 0.97 to 1.25; I ² = 0 percent). One observational study 15 found that negative-pressure wound therapy with instillation significantly increased the number of closed wounds when compared to negative-pressure wound therapy alone (risk ratio, 1.40; 95 percent CI, 1.14 to 1.71; p = 0.001), whereas another study 17 found no significant difference. When compared to conventional wound care, two studies 14,29 found a significantly higher closure rate in favor of negative-pressure wound therapy with instillation ( n = 75; risk ratio, 1.41; 95 percent CI, 1.04 to 1.92; p = 0.03; I ² = 0 percent) (Fig.…”

“…Only two studies used higher pressures, 300 to 450 mm Hg 16 and 300 to 600 mmHg. 31 Nine studies 12,13,17–19,27–29,31 reported the frequency of dressing changes, all falling between 2 and 4 days (Table 2).…”

“…We identified three randomized controlled trials 18,19,27 and 11 observational studies, [12][13][14][15][16][17][28][29][30][31][32] comprising 1053 patients in total. All studies were published between 2008 and 2020.…”