Reducing Risks Associated With Negative-Pressure Wound Therapy: Strategies for Clinical Practice

Abstract

Negative-pressure wound therapy represents a relatively new strategy for wound management. Significant, life-threatening complications (bleeding, infection, and retained dressing material) have been associated with negative-pressure wound therapy. As a result, the Food and Drug Administration published several warnings to negative-pressure wound therapy users and recommended that clinicians ordering, managing, and/or monitoring negative-pressure wound therapy be aware of the potential complications and be prepared to take prompt action to reduce patients' risk for harm. This article reviews and organizes published consensus, expert opinion, research, and manufacturer guidelines about patient safety during negative-pressure wound therapy relevant to nurses practicing in acute and critical care settings, including in advanced practice roles.

Retained Negative Pressure Wound Therapy Foams as a Cause of Infection Persistence

“…Minor complications mostly involve device malfunctions, loss of pressure, and leakage or damage to periwound skin caused by the trac pad. 37,38 Major complications include toxic shock syndrome, 39 bleeding complications, 40 arterial erosion and hemorrhage, 41 empyema, 42 uncon-trolled sepsis, 43 and major bleeding complications due to cardiac rupture. 44 Based on these reports, the United States Food and Drug Administration (FDA) has identified bleeding, infection, and retained dressing material as three potentially lifethreatening complications of NPWT.…”

“…44 Based on these reports, the United States Food and Drug Administration (FDA) has identified bleeding, infection, and retained dressing material as three potentially lifethreatening complications of NPWT. 38…”

“…29 -A count of the inserted foams should be made at each procedure (similar to the standard practice for swabs, needles, and instruments). 27,34,38 -Attempts should be made to use the largest single piece of foam in the wound bed. Whenever possible, the use of more than one piece of foam should be avoided.…”

“…Whenever possible, the use of more than one piece of foam should be avoided. 38 -If foams have to be trimmed for any reason, this should occur in a manner that does not promote fragmentation upon removal. The trimming itself should take place away from the wound and the patient to reduce the risk of fragments in the wound.…”

Lesão por pressão em pacientes acamados com idade avançada e os cuidados de enfermagem: Uma revisão integrativa da literatura

“…Outra questão muito importante a ser realizada é a capacitação profissional e educação contínua dos profissionais, segundo o autor Pachá et al (2018), a capacitação profissional é também uma forma de cuidado, tanto na prevenção quando no tratamento. Desse modo 2 artigos abordaram acerca da importância da prevenção de lesão por pressão através da educação continuada (Campo et al, 2019;Mattox, 2017).…”