Prevention and therapy of acute and chronic wounds using NPWT devices during the COVID-19 pandemic, recommendation from The NPWT Working Group

Bartosz Mańkowski,Tomasz Banasiewicz,Zsolt Szentkereszty,Rolf Becker,Mike Laukoetter,Martin Hutan,Zielinski Maciej,Marco Fraccalvieri,Lenka Veverkov,John Murphy,Marcin Malka,Adam Bobkiewicz,Csaba Toth,Sudheer Karlakki,Wojciech Francuzik

doi:10.18487/npwtj.v7i2.58

Abstract

Recent SARS-CoV-2 pandemic leading to a rapidly increasing number of hospitalizations enforced reevaluation of wound management strategies. The optimal treatment strategy for patients with chronic wounds and those recovering from emergency and urgent oncological surgery should aim to minimize the number of hospital admissions, as well as the number of surgical procedures and decrease the length of stay to disburden the hospital staff and to minimize viral infection risk. One of the potential solutions that could help to achieve these goals may be the extensive and early use of NPWT devices in the prevention of wound healing complications. Single-use NPWT devices are helpful in outpatient wound treatment and SSI prevention (ciNPWT) allowing to minimize in-person visits to the health care center while still providing the best possible wound-care. Stationary NPWT should be used in deep SSI and perioperative wound healing disorders as soon as possible. Patient’s education and telemedical support with visual wound healing monitoring and video conversations have the potential to minimize the number of unnecessary in-person visits in patients with wounds and therefore substantially increase the level of care.

Highlights

T HE epidemiological situation in the world caused by the SARS-CoV-2 virus leads to a rapidly increasing number of hospitalizations
4) optimal wound healing should be provided to patients with a higher risk of developing SSI by using an effective wound dressing suitable for discharge — single-use Negative Pressure Wound Therapy (NPWT) combined with patient education on wound dressing self-removal and, in selected cases, in wound dressing changes
In order to reduce the risk of viral transmission, early treatment of wound healing complications, and reducing the risk of SSI using NPWT is advisable, especially during the SARS-CoV-2 pandemic

Summary

Introduction

T HE epidemiological situation in the world caused by the SARS-CoV-2 virus leads to a rapidly increasing number of hospitalizations. The relative liberal use of ciNPWT, may well be advantageous for patients who are discharged as an inpatient earlier than normal to free up capacity for acute COVID beds may continue to receive good quality healthcare at home.[11] This strategy may be highly important in a group of patients undergoing urgent surgery or those with wounds classified as contaminated. Dowset et al provided data on the clinical and economic benefit of sNPWT in patients with chronic wounds allowing to free up medical staff.[18] Similar benefits have been shown in the closed incision groups .[7, 19] The same principles will apply to acute and surgical wounds during the COVID19 pandemic This is especially important as there is evidence that the effectiveness of sNPWT is similar in inpatient and outpatient setting.[20]. The main problems associated with the wound healing process are listed below

Problem

Conclusion