Negative pressure wound therapy with instillation (NPWTi): Current status, recommendations and perspectives in the context of modern wound therapy.

Abstract

Introduction of negative pressure wound therapy (NPWT) revolutionized the conception of wound healing. Currently, there are an increased number of studies confirmed the high efficiency of this therapy in many clinical scenarios. Moreover, some innovations have been introduced in recent years to improve the management of complex and chronic wound.NPWT with instillation (NPWTi) combines traditional NPWT with application of topical irrigation solutions within bed of the wound. Bioburden reduction, decrease time to wound closure, promotion in granulation tissue formation, fewer operative visits have been revealed using NPWTi compared to standard NPWT.However, there are still some questioned aspect of the NPWTi and thus its superiority over standard NPWT has not been fully indicated. Moreover, based on current studies no firm conclusions have been taken concerning the type of instilled solution preferably used, range of dwell- time phase, range of negative pressure and others.The main goal of the publication is to overview and summarize the current state of art concerning NPWTi. Moreover, mechanisms of action, review of the most common used instilled solution are discussed and clinical evidence of NPWTi are described.