Negative-Pressure Wound Therapy in Acute Traumatic and Surgical Wounds in Orthopaedics.

Abstract

Management of soft-tissue injuries that either are or are not accompanied by open fractures has proven to be challenging. The first clinical reports of negative-pressure wound therapy (NPWT) were published in 19931. NPWT has been widely adopted and indications have expanded to include high-risk closed incisions, skin grafts, and flap coverage. Several review articles2-5 exist on NPWT in the orthopaedic literature. This article includes historically relevant clinical and basic-science studies in addition to more current literature obtained from a PubMed search (with use of the terms “negative pressure wound therapy” and “vacuum-assisted closure”) of papers published from 2009 through 2013. More than 1300 studies (including a number of Level-I to Level-IV-evidence clinical studies related to acute orthopaedic traumatic and surgical wounds) were identified as being published during that time period. The primary components of NPWT systems are reticulated open-pore foam or gauze, a semi-occlusive drape, and a suction device with a fluid reservoir. Several manufacturers supply commercially available systems …