Clinical Outcomes of Negative-Pressure Wound Therapy with Instillation without Commercial Devices in the Treatment of Complex Wounds

Abstract

Background: Negative-pressure wound therapy with instillation (NPWTi) is an adjunctive treatment modality for complex and infected wounds. However, commercial devices are expensive and not readily available in many countries. The objective of this study is to introduce an NPWTi method that is applicable where commercial NPWTi devices are not available and to report the clinical outcomes of the NPWTi method for the adjunctive treatment of complex wounds.Methods: This prospective clinical experimental study included 51 patients who had wounds on which operative debridement was performed between January 2017 and March 2019. A negative-pressure wound therapy (NPWT) device was applied with an intravenous (IV) line for continuous instillation of 0.9% normal saline plus 1% povidone-iodine solution for chronic wounds. The outcomes measured were the number of operating room visits, time to final surgical procedure, number of infected wounds, time to resolution of infection, type of reconstruction operation, and occurrence of complications.Results: The average number of operations performed was 2.5±0.8, and the time to final surgical procedure was 28.4±15.4 days. The number of infected wounds was 35 (68.6%), and the time to resolution of infection was 15.0±14.6 days. All wounds were closed or covered. Though partial graft failure occurred in two cases, they healed completely by secondary healing in 2 weeks.Conclusion: A continuous-instillation NPWT system using an IV line could be an adjunctive modality in treating complex wounds at institutions where commercial NPWTi systems are not readily available.