“Low cost, modified negative pressure wound therapy in infected orthopaedic wounds: can it be as effective as its costly counterparts?”

Abstract

BackgroundInfected wounds pose a great financial burden on our healthcare system. Negative pressure wound therapy (NPWT) has brought a paradigm shift in the management of these wounds. However, availability and high cost of a conventional NPWT system remains a challenge. We carried out this study to assess whether we can replicate functioning of the conventional NPWT system using resources which are easily available in most hospitals and determine the clinical efficacy and cost effectiveness of the same. Material and methodsA prospective study was conducted in the orthopaedic department at our tertiary care institute from January 2018 to December 2019. Fifty six patients with contaminated or infected orthopaedic wounds were included in the study. Wound dressings were carried out by modified negative pressure therapy and their results were studied. ResultsThe study group consisted of 41 males and 15 females. Duration of stay in hospital ranged from 6 to 37 days, with average duration of 14.05 days. Wound closure was achieved by secondary suturing in 18 (32.2%) of the cases and split thickness skin grafting in 38 (67.8%) of the cases. Wound assessment done using the revised Photographic wound assessment tool revealed an average of 60% reduction in scores, post procedure. The average cost of the dressing could be considerably reduced during the study by the use of available material. ConclusionThrough our study we describe a simple and effective method of application of negative pressure dressings which may be beneficial in low resource settings. Our method is easily reproducible and does not require expertise for its application, at the same time it is cost effective and efficient in wound care.