negative pressure wound therapy
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Indications
- pressure ulcer (stage III or IV) not responding to conventional therapy[1]
- severe traumatic wounds
- diabetic foot infections
- wounds complicated by invasive infection or extensive biofilm
Contraindications
- simple wounds or wounds in patients without comorbidities
- of no benefit for patients with severe open fracture of the lower limb[4]
Clinical significance
- reduces frequency of dressing changes
- may decrease cost of nursing time
- may decrease cost of supplies
- may improve patient's quality of life[1]
Procedure
- consists of nonadherent, reticulated foam* placed placed into the wound bed & covered with an occlusive transparent film
- an evacuation tube is connected to the film & negative pressure is applied with an adjustable vacuum pump[1]
- dressing is changed every 48 hours
* some systems use gauze packing
Mechanism of action
- stimulates formation of granulation tissue & wound retraction
- reduces edema at the wound site
- pulls fluid from the wound
- improves blood flow to the wound
More general terms
References
- ↑ 1.0 1.1 1.2 1.3 Geriatric Review Syllabus, 9th edition (GRS9) Medinal-Walpole A, Pacala JT, Porter JF (eds) American Geriatrics Society, 2016
Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022 - ↑ Gupta S, Ichioka S. Optimal use of negative pressure wound therapy in treating pressure ulcers. Int Wound J. 2012 Aug;9 Suppl 1:8-16. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22727135
- ↑ Kim PJ, Attinger CE, Olawoye O et al Negative Pressure Wound Therapy With Instillation: Review of Evidence and Recommendations. Wounds. 2015 Dec;27(12):S2-S19. PMID: https://www.ncbi.nlm.nih.gov/pubmed/26966814 Free Article
- ↑ 4.0 4.1 Costa ML, Achten J, Bruce J et al Effect of Negative Pressure Wound Therapy vs Standard Wound Management on 12-Month Disability Among Adults With Severe Open Fracture of the Lower Limb: The WOLLF Randomized Clinical Trial. JAMA. 2018; 319(22):2280-2288 PMID: https://www.ncbi.nlm.nih.gov/pubmed/29896626 https://jamanetwork.com/journals/jama/fullarticle/2684606
- ↑ Apelqvist J, Willy C, Fagerdahl AM et al. EWMA document: negative pressure wound therapy. J Wound Care. 2017;26(Sup 3):S1-S152 PMID: https://www.ncbi.nlm.nih.gov/pubmed/28345371 https://www.magonlinelibrary.com/doi/abs/10.12968/jowc.2017.26.Sup3.S1
- ↑ Dumville JC, Webster J, Evans D et al. Negative pressure wound therapy for treating pressure ulcers. Cochrane Database Syst Rev. 2015 May 20;20(5):CD011334 PMID: https://www.ncbi.nlm.nih.gov/pubmed/25992684 https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD011334.pub2/full