Negative pressure wound therapy for burn patients: A meta‐analysis and systematic review

Abstract

Negative pressure wound therapy (NPWT), which has been applied in various medical specialties to accelerate wound healing, has been the object of a few investigations. We explored the effectiveness of NPWT and the possibility of its inclusion in burn management guidelines. Randomised controlled trials comparing NPWT with non‐NPWT treatments for burn wounds were extracted from PubMed. For the risk of bias analysis, all included studies were evaluated according to the Cochrane risk of bias tool and the approaches outlined in the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) Handbook. Outcomes such as graft take rate in the first week, infection rate, and overall complication rate were analysed. Six studies that included a total of 701 patients met our inclusion criteria. Qualitative analysis revealed that the NPWT group had a significantly better overall graft rate in the first week (P = 0.001) and a significantly lower infection rate (P = 0.04). No significant difference in the overall complication rate was found. Our results indicate that NPWT is a safe method for stimulating healing and lowering the infection rate of burn wounds. NPWT can be part of general burn management, and its incorporation into burn treatment guidelines is recommended.

Review of History of Basic Principles of Burn Wound Management

“…Negative pressure wound therapy (NPWT), including topical negative pressure therapy and vacuum-assisted closure, has been used in the context of open-wound management; the interface foam is applied directly to the wound bed, which is visible at the body surface [ 133 , 134 ]. NPWT has been applied to various surgical wounds since 1997 [ 135 ]. It can accelerate wound healing on both acute and chronic wounds, and it has been widely used on wounds with soft tissue defects [ 136 , 137 ].…”

The early association of water irrigation with negative pressure wound therapy does not more efficiently reduce the depth of the alkali infiltration progress into the burn

“…Our belief is that Huang C's study 8 did not show that negative pressure therapy could indeed draw out the deep‐down penetrated alkali. In fact, Huang C's application of NPWT to alkali wounds did not differ in mitigating oedema, intensifying perfusion, and advancing wound healing than did long‐term negative pressure therapy applied to thermal burn wounds or chronic wounds 20‐22 . Their results did not prove that an early application of NPWT can stop alkali from penetrating the burn's bed.…”

“…In fact, Huang C's application of NPWT to alkali wounds did not differ in mitigating oedema, intensifying perfusion, and advancing wound healing than did long‐term negative pressure therapy applied to thermal burn wounds or chronic wounds. 20 , 21 , 22 Their results did not prove that an early application of NPWT can stop alkali from penetrating the burn's bed. Therefore, an early application of water irrigation associated with NPWT does not improve the therapeutic upshot of alkali‐elicited burns.…”

Israeli Innovations in the Field of Plastic Surgery

“…The risk of infection is considered to be lower because RNPT helps in facilitating microvascular circulation, decreasing the number of dressing changes required, and providing a favorable healing environment. 42,43 Similarly, it promotes wound healing by stimulating angiogenesis, forming granulation tissue, and removing healing inhibitors. 42,44 The Vcare α system is also a novel vacuum therapy device developed by IVT Medical Ltd.…”

“…42,43 Similarly, it promotes wound healing by stimulating angiogenesis, forming granulation tissue, and removing healing inhibitors. 42,44 The Vcare α system is also a novel vacuum therapy device developed by IVT Medical Ltd. This negative pressure device can be used with TopClosure and was designed primarily to decontaminate the wound and remove excess fluid (►Fig.…”