Abstract

PURPOSE: Negative Pressure Wound Therapy (NPWT) has been associated with instillation (NPWTi) to provide cleaning cycles combined with vacuum therapy, avoiding constant dressings changes. NPWTi meets the treatment demands of wounds at risk infection. The aim of this study is to compare clinical results and direct costs of soft tissue traumatic wounds treatment submitted to three different coverings. METHODS: Prospective, pragmatic randomized controlled trial evaluating adult patients with traumatic wounds. 120 patients with 131 wounds were randomized to standard of care, mainly with layers of gauze (n=41), conventional NPWT (n=46), and NPWTi (n=44). Negative pressure was set at -125 mmHg in continuous mode, applied for two hours in the NPWTi group, followed by normal saline instillation with 20 minutes of dwell time. RESULTS: Sample consisted of 120 patients from 139 screened for eligibility. The mean age was 37.3 (SD14.9; min16;max86) years, primarily male (78%) with low Charlson Index (0.36;SD 1.0). Wounds were mainly degloving injuries (57%) with a mean size of 192 cm2 (min13; max1303), affecting predominantly lower extremities (85%), caused by vehicle accidents. There were no statistical differences between groups regarding baseline data. Wound time of closure (in days) was lower in the instillation group (9.2NPWTi; 11.5NPWT;14.6Layering; p=0.005), as well as the number of surgical procedures (2.9NPWTi; 3.5NPWT;6.9 Layering; p<0.001). Length of stay (in days) was slightly lower in the NPWT group (25.1NPWT;27.8NPWTi;29.1Layering; p=0.226). Costs (in $USD) were higher in the Gauze group ($5510NPWTi; $5,643NPWT;$7,162Gauze;p=0.873). CONCLUSION: Negative pressure with or without installation therapy was more effective and less costly than gauze therapy in treating complex traumatic wounds.

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call

Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.