Research progress on negative pressure wound therapy with instillation in the treatment of orthopaedic wounds

Abstract

Negative pressure wound therapy with instillation (NPWTi) has the dual function of negative pressure sealing drainage and irrigation, which overcomes the disadvantages of NPWT, such as tube obstruction, inability to apply topical medicine, and poor anti-infection ability. NPWTi has been researched extensively and widely used in various types of wounds, and certain effects have been achieved. A series of parameters for NPWTi have not been unified at present, including the flushing fluid option, flushing mode, and treatment period. This paper reviews the research progress of these parameters for NPWTi and their application in the treatment of orthopaedic wounds.instillation, negative pressure wound therapy, orthopaedic wounds, treatment parameters Key Messages• NPWTi has the dual function of negative pressure sealing drainage and irrigation • setting of treatment parameters for NPWTi has not been unified yet: further research studies are required • although there are multiple choices of instillation solutions, normal saline is recommended as the first choice; the recommended setting is the intermittent instillation mode and À125 to 150 mmHg, the duration time depends on the type of wound • NPWTi has been widely used in all kinds of wounds in orthopaedics, such as acute or chronic infected wounds, osteomyelitis, soft tissue injuries, and surgical wound management

RETRACTED: Effects of negative‐pressure wound therapy in the prevention of surgical‐site wound infection after vascular surgery: A meta‐analysis

“…This method also prevents external bacteria from causing cross-infection, serving an anti-infection role and expediting wound healing. 42,43 The results of this study indicate that the incidence of wound infection and complications in the NPWT group is significantly lower than that in the control group. Although the rates of superficial and deep wound infections are lower in the NPWT group, the differences are not statistically significant.…”

“…Connected through drainage tubing and a negative‐pressure device, the suction strength can be adjusted to continuously draw out necrotic tissue, blood, exudate, bacteria, and other substances from the wound. This method also prevents external bacteria from causing cross‐infection, serving an anti‐infection role and expediting wound healing 42,43 . The results of this study indicate that the incidence of wound infection and complications in the NPWT group is significantly lower than that in the control group.…”

Effectiveness of negative pressure wound therapy: Minimum five-year follow-up and review of the literature

“…However, the study raises aspects such as wound healing and improvement in quality of life or reduction in pain that cannot be measured financially. A new technique such as NPWT with continuous wound irrigation is also looking for a place in the treatment palette according to the article by Wu et al [17] One of the limitations of the study is that, due to impracticality, it was often difficult to place and vacuum the grafts onto the tendons. In addition, the small number of cases did not allow us to draw conclusions about wound healing due to wound fluid cultures.…”

Comparative analysis of the efficacy of drip drainage surgery and bone cement placement surgery in the treatment of haematogenous osteomyelitis of the extremities

“…After debridement, a 3L nutrient bag is selected for antibiotic uid (concentration of 2.6 g/L) irrigation and ushing; usually, 1 in-tube is placed proximal to the limb and 2 out-tubes are placed distal to the limb [24] (Fig. 2, A); and nally, the wound is closed with sutures, and the duration of the drip is usually about 7 days.…”

“…Drip drainage surgery has an inaccurate antibiotic ush, extravasation of the ush uid, catheter clogging requiring early extubation, and sometimes it is di cult to meet the therapeutic needs [27]. However, it reduces soft tissue damage and intraoperative exposure, promotes necrotic tissue lysis or drainage, and removes necrosis and exudate before and after surgical debridement or when surgical debridement is not possible [24].…”