Abstract
to report the initial experience with Negative-Pressure Wound Therapy with instillation in infected or contaminated complex wounds. the negative-pressure wound therapy with instillation used was V.A.C. Ulta with Veraflo instillation (Kinetic Concepts, Inc). The mode of operation was continuous with negative pressure set at 125 mmHg for two hours and instillation between the pauses. The instillation time was 20 minutes (contact time of the topical agent with the wound) and the instilled substance was 0.9% normal saline. After adequate preparation of the wound, it was covered with graft or flap. ten patients with complex or contaminated wounds were operated on. The mean number of NPWTi changes was 1.4, the mean number of surgeries was 2.4, the interval until complete wound coverage was 6.3 days, and the interval up to the time of discharge was 11.4 days. the comparison of the negative-pressure wound therapy with instillation with two previous studies (historical control) evidenced a shorter hospitalization time, favoring TPNi. This study had an initial character, making it necessary to conduct a randomized and controlled trial to confirm the efficacy of this therapy and verify its cost-effectiveness.
Highlights
Negative pressure therapy (NPT) has been used successfully for decades on a global level
A variation of this therapy has been introduced, the combination of the negative pressure with instillation (NPWTi) of topical agents, which is being introduced in our environment[2,3]
The only change in conduct was the replacement of traditional NPT by NPT with instillation (NPWTi)
Summary
Negative pressure therapy (NPT) has been used successfully for decades on a global level. It has simplified and shortened the treatment of complex wounds, constituting a valuable tool in the preparation of the wound bed until its final closure[1]. We use it in our service since 2001. A variation of this therapy has been introduced, the combination of the negative pressure with instillation (NPWTi) of topical agents, which is being introduced in our environment[2,3]. NPT properties are multiple, such as stimulation of wound granulation, reduction of edema, reduction of excess fluid and wound debris, and reduction of bacterial contamination in the wound[4]
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