The Use of NPWT-i Technology in Complex Surgical Wounds

Abstract

Advanced wound management of complex surgical wounds remains a significant challenge as more patients are being hospitalized with infected wounds. Reducing recurrent infections and promoting granulation tissue formation is essential to overall wound healing. Wounds with acute infection and critical colonization require advanced multimodal approaches including systemic antibiotics, surgical debridement, and primary wound care. The goal in surgical wound management is to optimize clinical outcomes such as time to wound closure and functional recovery. A review of current literature suggests that negative pressure wound therapy with instillation (NPWT-i) is a viable adjunct therapy in the management of infected wounds especially in patients with medical comorbidities. The aim of this case series is to highlight the ability of NPWT-i as adjunct to prepare the wound bed for closure on infected surgical wounds that would normally require multiple operations to obtain source control.

Negative pressure wound therapy with instillation: International consensus guidelines update

“…Some panel members did not recommend use in cases of patients with hidradenitis suppurativa or calciphylaxis, but other panel members reported successful use of NPWTi‐d in the presence of both of these conditions, similar to a small case series described in the literature …”

Does negative pressure wound therapy with saline instillation improve wound healing compared to conventional negative pressure wound therapy? - A randomized controlled trial in patients with extremity ulcers

“…It also has the advantage of being universally available and physiological. Various case series have shown successful outcomes with saline with regards to improved granulation tissue [ 15 , [19] , [20] , [21] ], mean duration of therapy, proportion of wounds closed and time to final surgical procedure [ 5 , 11 , [22] , [23] , [24] ]. There is lack of controlled clinical evidence in the literature demonstrating superiority of any of the above listed instilled topical antiseptics compared with saline as instillation solution [ 11 ] and in a recently published randomized study, addition of 0.1% polyhexanide-betaine solution for irrigation of wounds in diabetic foot infection patients showed no added benefit in terms of clinical outcomes [ 13 ].…”

¿Es posible la terapia de presión negativa en hospitalización a domicilio?: caso clínico

“…La presión ejercida sobre el lecho puede ser continua o intermitente, con valores que oscilan entre los 50 y los 125 mmHg 3,4 . La TPN es utilizada ampliamente en heridas complejas de diferentes etiologías: úlceras por presión, heridas quirúrgicas, quemaduras, heridas traumáticas y heridas infectadas [5][6][7][8][9][10][11] . La WUWHS sugiere que la TPN es el "gold standard" en tratamiento de dehiscencias en heridas esternales y heridas abdominales abiertas 1 .…”