Topical negative-pressure wound therapy: emerging devices and techniques

Limb salvage procedure in immunocompromised patients with therapy‐resistant leg ulcers—The value of ultra‐radical debridement and instillation negative‐pressure wound therapy

“…Wound size, location, and severity as well as the general health condition determines the choice of the reconstructive surgery procedure for each individual patient. Surgical debridement and NPWT are well‐established tools for wound bed preparation prior to definite wound closure 22,44 . NPWT has been successfully applied to various complex non‐healing wounds.…”

“…NPWT has been successfully applied to various complex non‐healing wounds. NPWT showed to reduce the complexity of the required surgical procedure 22,45 . Surgical debridement is a fast and effective way of removing necrotic or infectious tissue in order to restore the wound bed 44,46 .…”

“…Computer‐controlled topical NPWT showed to reduce bacteria levels along with granulation tissue formation, wound size reduction, improvement of local blood circulation, and various improvements at cellular and molecular levels 22,55‐58 . This led to its application to various different wound types over the course of the last few decades 22,59 . Bacterial colonisation impairs leg ulcer healing ultimately leading to its chronification 60 .…”

“…Negative‐pressure wound therapy (NPWT), an invention of the late 20th century, has nowadays been broadly used as temporary wound coverage acting as a successful tool for wound bed preparation of many different wound types. This includes but is not limited to acute, chronic, infectious, and burn wounds 22,23 . The additional application of intermittent fluid instillation such as normal saline, polyhexanide, povidone‐iodine, or octenidine dihydrochloride to the wound bed for a pre‐defined time period (dwell time) can have a sufficient micro‐debridement effect especially to infectious or contaminated wounds 24‐26 .…”

“…This includes but is not limited to acute, chronic, infectious, and burn wounds. 22,23 The additional application of intermittent fluid instillation such as normal saline, polyhexanide, povidone-iodine, or octenidine dihydrochloride to the wound bed for a pre-defined time period (dwell time) can have a sufficient micro-debridement effect especially to infectious or contaminated wounds. [24][25][26] Irrigation of the wound bed and the removal of debris and pathogenic bacteria showed to reduce the microbial film at the wound surface.…”