Abstract
Background: Mankind has always suffered wounds throughout time due to trauma, disease, and lifestyles. Many wounds are non-healing and have continued to be challenging. However, utilizing advanced wound care treatments, such as negative pressure wound treatment with instillation and dwell time (NPWTi-d), has proven beneficial.NPWTi-d is indicated in a variety of wounds, such as trauma, surgical, acute, pressure injuries, diabetic foot ulcers, and venous leg ulcers. Bacteria and bioburden interrupts wound healing by increasing the metabolic needs, ingesting, and robbing the necessary nutrients and oxygen.Instillation therapy is the technique of intermittently washing out a wound with a liquid solution. The mechanism of action is instilling fluid into the wound bed, soaking for a determined time, loosening and cleaning of exudate, contaminants, and/or infection, removing fluid via negative pressure, thus promoting tissue growth.Case study: The patient was diagnosed with a large lymphedema mass on the right upper thigh. Surgical removal of the lymphedema mass was indicated due to interference with quality of life. After a failed flap and surgical debridement, NPWTi-d with normal saline was implemented.Results: The patient had excellent results, with obvious forming of red, beefy granulation, epithelization tissue development, and a cleaner, healthier wound bed. Settings for the NPWTi-d was 18 minutes dwell time, every 2.5 hours with a constant pressure of 125 mm/hg pressure.Conclusion: The NPWTi-d demonstrated to be an instrumental treatment in supporting and stimulating healing. Early application of the treatment with normal saline as the instillation fluid prepared the previously failed wound for quicker healing.
Highlights
Bacteria promotes an inflammatory environment, secreting harmful cytokines, which constricts blood flow, inhibits cell migration for tissue growth, and prevents wound healing/closure [1]
Instillation therapy is the technique of intermittently washing out a wound with a liquid solution
Bacteria and bioburden interrupts wound healing by increasing the metabolic needs, ingesting and robbing the necessary nutrients and oxygen needed for tissue repair and growth [1]
Summary
Bacteria promotes an inflammatory environment, secreting harmful cytokines, which constricts blood flow, inhibits cell migration for tissue growth, and prevents wound healing/closure [1]. The mechanism of action is to intermittently and automatically instill the fluid into the wound beds, soak for a determined time to loosen and clean the tissue of exudates, contaminants, and/or infection, which is removed via negative pressure into the collection canister. This treatment is called negative pressure wound therapy with instillation and dwell time (NPWTi-d). The mechanism of action is instilling fluid into the wound bed, soaking for a determined time, loosening and cleaning of exudate, contaminants, and/or infection, removing fluid via negative pressure, promoting tissue growth
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