Application Of Negative Pressure Wound Therapy Research Articles

Negative pressure wound therapy in surgical practice: an Institutional experience from a tertiary centre of North India.

<b>Introduction:</b> Negative pressure wound therapy (NPWT) has been suggested as a gold standard for managing complex wounds and to reduce the time of healing and overall morbidity and mortality of the patient. </br></br> <b>Aim:</b> We have done a retrospective study to observe the outcome in patients managed with negative pressure wound therapy for varied etiologies. </br></br> <b> Methods:</b> Patients with complicated wounds including lower limb wounds post-debridement, upper limb wounds post-debridement, postoperative abdominal wound dehiscence, abdominal and chest abscess wounds post-debridement and amputation stumps, managed with negative pressure wound therapy were studied on the basis of wound outcome, total hospital stay, days of NPWT application and pressure and mode of NPWT. </br></br> <b>Results:</b> A total of 42 patients with complicated wounds were included in the study. Mean hospital stay was 16.2 days and mean NPWT application time was 8.29 days with NPWT being applied on average for 3.91 days post-procedure like debridement or amputation or after wound dehiscence in which debridement was not done. As many as 41.5% of wounds were closed with suturing, 48.8% healed by secondary intention and 9.8% were covered with split-thickness skin grafts. A significant observation was made for lower pressure being used for abdominal wound dehiscence (75 mmHg) compared to other wounds on limbs (mean 98.33 mmHg) (P < 0.001). Re-debridement after the 1st cycle of NPWT was needed in 40% of wounds managed with intermittent mode compared to 6.2% in continuous mode (P = 0.028). </br></br> <b>Conclusion:</b> NPWT can reduce and manage wound complications with improvement in the quality of life of patients when used at an appropriate time with knowledge of its mechanism and functionality.

P34. CONTINUOUS NEGATIVE PRESSURE WOUND THERAPY REGULATES HEALING AND FIBROSIS IN MURINE EXCISIONAL WOUNDS

PURPOSE: Hypertrophic scarring is a fibroproliferative disorder that can occur post-operatively resulting in significant functional and esthetic morbidity. Mechanical forces are known to modify the wound microenvironment and influence cellular behavior and organization. The potential effects of micromechanical force application through Negative Pressure Wound Therapy (NPWT) on skin scarring have not yet been explored in vivo. Here we investigate the application of continuous NPWT in a murine excisional wound model. METHODS: 20 obese and diabetic (db/db) mice received a 1×1 cm2 full thickness excisional dorsal skin wound and were separated into two groups, treated either with occlusive covering (Control, n=10), or NPWT (continuous, -125 mmHg, 7 days; NPWT, n=10). The wounds were photographed on days 0, 7, and 10, and the animals sacrificed and tissue harvested on day 10 for histological and molecular analysis. RESULTS: Although use of NPWT was shown to significantly increase Yes-associated protein (YAP), Engrailed-1 (En1) was significantly decreased. Use of NPWT significantly increased fibronectin deposition and improved collagen deposition and organization. Western blotting showed significantly increased RhoA and YAP and decreased Caspase-3 in the NPWT group. CONCLUSION: Taken together, our findings indicate that the mechanotransduction forces exerted by NPWT uncouple YAP, a mechanical signaling protein, from En1. Fibroblasts of an En1 lineage are known to mediate fibrotic processes that lead to scarring, while increased expression of caspase-3 has been linked to keloid formation. Therefore, through its actions on fibroblast proliferation and apoptosis, NPWT may play a significant role in final scar appearance.

Clinical Uses of NPWT with Irrigation of Normal Saline in Diabetic Foot Ulcer: Outcome Assessed by DEPA Score.

Introduction:Diabetic foot ulcer (DFU) is a common complication of uncontrolled diabetes. Negative pressure wound therapy (NPWT) with irrigation of normal saline is one of the methods for wound care and dressing techniques in DFU. Wound assessment is another aspect of DFU management for deciding whether the wound is prepared or not for coverage. The present study uses DEPA score as a wound assessment tool in DFU.Materials and Methods:This case series include 11 patients with DFU who were treated using NPWT with simultaneous irrigation of normal saline.Results:All 11 patients were male and age more than 60. Most patients have duration of diabetes for less than 10 years. Staphylococcus aureus (n = 5, 45.4%) was most common bacterial flora. Most patients in series presented with DEPA score more than 7 and after application of NPWT instillation therapy significant improvement seen with score in most of the patient with DEPA score below 6. Mean time for NPWT (irrigation) application was 15 days. Mean time of wound preparation was 18.7 days. Final surgical procedures executed in all patients, split skin grafting performed in 7 patients. 4 patients had wound coverage by reverse sural flap (2), medial plantar flap (1) and local flap coverage (1).Conclusion:NPWT with normal saline irrigation is an effective method of wound preparation in DFU. DEPA score is an important tool for assessment of wound preparation which gives exact information for timing of wound coverage once diabetic foot wound is prepared.

Negative-pressure wound therapy after stoma reversal in colorectal surgery: a randomized controlled trial.

BackgroundStoma-reversal surgery is associated with high postoperative morbidity, including wound complications and surgical-site infections (SSIs). This study aims to assess whether the application of negative-pressure wound therapy (NPWT) can improve wound healing compared with conventional wound dressing.MethodsThis was a single-centre, superiority, open-label, parallel, individually randomized controlled trial. Patients undergoing stoma reversal were randomized (1 : 1) to receive NPWT or conventional wound dressing. The primary endpoint of the study was the rate of wound complications and SSIs after stoma closure. The secondary endpoints were postoperative wound pain, rate of wound healing after 30 days from stoma closure, and wound aesthetic satisfaction.ResultsBetween June 2019 and January 2021, 50 patients were allocated to the NPWT group (all received NPWT, 49 were analysed); 50 patients were allocated to the conventional wound dressing group (48 received the treatment, 45 were analysed). No significant difference was found in wound-complication rate (10 per cent NPWT versus 16 per cent controls; odds ratio 0.61 (95 per cent c.i. 0.18 to 2.10), P = 0.542) and incisional SSI rate (8 per cent NPWT versus 7 per cent controls; odds ratio 1.24 (95 per cent c.i. 0.26 to 5.99), P = 1.000). The NPWT group showed less pain, higher aesthetic satisfaction (P < 0.0001), and a higher proportion of wound healing (92 versus 78 per cent; P = 0.081) compared with the control group.ConclusionNPWT does not reduce the incidence of SSI after stoma-reversal surgery compared with conventional wound dressing. However, NPWT improved the healing of uninfected wounds, reduced wound pain and led to better aesthetic outcomes.Registration number: NCT037812016 (clinicaltrials.gov).

Change in granulation tissue coverage and bacteriological load using Low Cost Negative Pressure Wound Therapy in acute musculoskeletal wounds

BackgroundLow cost Negative Pressure Wound Therapy (NPWT) dressings have been considered as an alternative to traditional daily dressings. There is scanty literature evaluating the change in the percentage area of wound covered by granulation tissue following application of low-cost NPWT. The change in the bacteriological flora following application of low-cost NPWT devices has also not been evaluated. MethodsPatients above the age of 18 years with acute musculoskeletal injuries of <3 weeks duration which underwent a surgical debridement and required subsequent wound coverage were included in the study. Area of the wound and the area covered by the granulation tissue as well as the bacteriological count were measured before and after application of NPWT. A low cost NPWT using wall mounted vacuum device was put on the patient giving a constant negative pressure of 125 mm of Hg for 2 days. The findings before and after application of NPWT were compared and analyzed using Wilcoxin Signed-rank test. Results21 patients with mean age of 35.52±15.075 were included. The pre-NPWT granulation tissue area ranged from 122 mm2 to 8483 mm2 with a mean of 1648.38 mm2 (SD = 1933.866). The post-NPWT granulation tissue area ranged from 234 mm2 to 7847 mm2 with a mean of 2364.48 mm2 (SD = 1857.716). The mean increase in granulation tissue was 716.1 mm2.The pre-NPWT wound area ranged from 422 mm2 to 10847 mm2 with a mean of 4009.62 mm2 (SD = 3026.209). The post-NPWT wound area ranged from 326 mm2 to 9143 mm2 with a mean of 3410.33 mm2 (SD = 2636.206). The mean reduction in wound size was 599.29 mm2.The pre-NPWT bacteriological count ranged from 3000/ml to 130000000/ml with a mean of 12616761.90/ml (SD = 29664589.37). The post-NPWT bacteriological count ranged from 1000/ml to 380000000/ml with a mean of 26401523.81/ml. The mean increase in bacteriological count was 13784761.91/ml. ConclusionThere was a statistically significant decrease in wound size (p = 0.001) and statistically significant increase in percentage area of granulation tissue coverage (p = 0.000) following low cost NPWT application. However there was no statistically significant increase in bacteriological clearance in these patients.

Immediate application of negative pressure wound therapy following lower extremity flap reconstruction in sixteen patients

Negative pressure wound therapy (NPWT) is usually applied in wound management and soft-tissue salvage after the development of complications. However, immediate postoperative application of NPWT over the flap coverage is seldom reported. We evaluate the effectiveness of immediate postoperative application of NPWT following fasciocutaneous or muscle flap coverage for lower leg reconstruction. A retrospective review of patients who underwent either fasciocutaneous or muscle flap coverage of lower leg soft-tissue defects applied with NPWT immediately after surgery was conducted in a level I trauma center. Sixteen patients, with an average age of 51.2 years, were included in the study. Nine patients had trauma-related soft-tissue loss, six had subsequent soft-tissue defects after debridement, and one had burn injury. Two patients had been treated with free anterolateral thigh flaps, 11 with pedicle flaps, and three with muscle flaps. All flaps survived except for those in two patients with venous congestion on postoperative day 1, which needed further debridement and skin grafting. Therefore, the use of immediate incisional NPWT is an alternative for wound care following flap coverage. The U-shaped design allows easy flap observation and temperature check. Furthermore, this method eliminates any concerns of vascular pedicle compression under negative pressure.

Negative pressure wound therapy following excision of pilonidal sinus disease: A retrospective review.

There is no agreed definitive surgical treatment for pilonidal sinus disease (PSD) with several techniques in use with varying success. Negative pressure wound therapy (NPWT) is used to accelerate wound healing but literature in the context of PSD remains sparse. The aim of this study was to evaluate outcomes in patients with PSD treated by a standardised technique of complete surgical excision followed by the application of NPWT. A retrospective observational cohort study of all patients with PSD managed by complete surgical excision followed by application of NPWT was performed over a five year period. The primary endpoints were PSD recurrence and failed wound healing. Sixty-one patients underwent treatment during the study period. There was 100% compliance with NPWT. All patients' wounds healed successfully, with the median time to healing being 28days. One patient (1.6%) developed recurrent PSD and required further surgery. Two patients (3.3%) developed postoperative wound infections. Five patients, who had been managed previously by other operative approaches and subsequently developed recurrence, were successfully managed by this technique. Most patients (52.4%) were managed as a day case procedure. Surgery for PSD should have low recurrence rates, prompt wound healing, minimal complications, short inpatient lengths of stay and be tolerated by the patient. Our results demonstrate that our technique meets these criteria. To our knowledge, this study contains the largest number of patients with PSD managed by excision and NPWT in the literature.

Negative-pressure wound therapy – advantages and disadvantages

The applications of negative-pressure wound therapy (NPWT) have achieved remarkable diversification. Initially used in the therapy of soft tissue wounds related to open fractures, this technique led to the understanding of the complex mechanisms underlying it. This paper aims to analyze the evolutionary scenarios of a group of patients with heterogeneous lesions under negative pressure aspiration treatment. We aimed to identify and analyze various associated pathologies that have the potential to negatively influence the healing process under negative pressure treatment and implicitly analyze the particularities of representative cases for the group whose evolution under treatment proved to be unfavorable. Retrospective, observational study, type series of cases focused on a group of 17 hospitalized patients, who received treatment by negative aspiration, between 2015-2019 in the Surgery Department of the University Emergency Hospital Bucharest. Regarding the obtained results, diabetes mellitus, obliterating arteriopathy, and anemia had a prevalent distribution in the group with unfavorable evolution. The glycemic value can predict 17% of the evolutionary scenario of a patient (favorable/unfavorable) being necessary an integrative therapeutic conduct. Concluding, although an extremely promising therapeutic option, NPWT can prove to be disappointing given its impact in the background of suboptimally managed comorbidities.

Use of Negative Pressure Wound Therapy in the Treatment of Limb Wounds: A Case Series of 42 Horses

Traumatic limb injuries are common in horses. Negative pressure wound therapy (NPWT) has been proven to promote wound healing in human medicine. It has also been described for the treatment of wounds in horses. In this retrospective study, clinical records of 42 (n = 42) animals were assessed. Categories of wounds, duration of NPWT application, frequency of resetting the NPWT device, technical complications, and tolerance to the procedure were recorded. 42 wounds were classified as bony (n = 15; 36 %), articular (n = 14; 33 %), tenosynovial (n = 9; 21%), muscular (n = 2; 5%) and cutaneous (n = 2; 5 %). NPWT was used to help (1) first intention healing by preoperative (n = 3; 7 %) or postoperative (n = 7; 17%) application, (2) second intention healing (n = 31; 74%), and (3) delayed primary closure (n = 1; 2%). Duration of NPWT application ranged from 2 to 36 days (mean 11.5), with the system staying in place for periods ranging from 1 to 7 days (mean 4.5). In 69% (n = 29) of the cases, healing was considered satisfactory at discharge. 26 % (n = 11) of horses were discharged whilst ideally NPWT should have been continued. 2 animals (n = 2; 5%) were euthanized after surgery due to unrelenting pain. The procedure was well tolerated except in 1 horse who showed signs of discomfort at the first application. This study demonstrated that NPWT with long periods of application can be used successfully to manage various types of limb wounds.

Adjustable, Skin-Stretching External Fixation Device and Negative Pressure Wound Therapy Application for Infected Full-Thickness Skin Defects: A Case Series Study.

Skin defects-especially infected, massive full-thickness defects-can be challenging to manage. Traditionally, defects are repaired using free flaps or musculocutaneous flaps.Many side effects and complications are associated with flaps, however, such as infection, pain, donor site pain, and poor cosmesis. This case series evaluates the use of an adjustable, skin-stretching external fixation device and negative pressure wound therapy (NPWT) to repair soft tissue defects. In this retrospective series, 7 patients with skin defects were treated with an adjustable, skin-stretching external fixation device and NPWT between January 2014 and December 2017. All patients were followed until complete healing was achieved. Each patient's age, sex, defect size, mechanism of injury, healing time, results, and complications were recorded. The average patient age was 37.43 years ± 10.47 SD (range, 26-55 years). The average skin defect area was 14.5 cm2 ± 5.26 * 23.25 ± 9.01 cm2 (range, 7-15 cm2 * 10-30 cm2), and average healing time was 3.29 months ± 1.60 (range, 1-6 months). All defects healed, and 2 patients developed ulcers. This series showed the adjustable, skin-stretching external fixation device and NPWT to be a simple, safe, and effective means of managing skin defects, with minimal complications.

Oncologic feasibility for negative pressure wound therapy application in surgical wounds: A meta-analysis.

Negative pressure wound therapy (NPWT) decreases postoperative complications of various surgeries. However, the use of NPWT for oncological surgical wounds remains controversial. To evaluate the association of NPWT with oncologic recurrence in surgical wounds without residual malignancy, we analysed studies that compared NPWT with conventional non‐pressure dressings for cancer surgical wounds without residual tumour by August 12, 2020. We compared tumour recurrence rates and postoperative complications between the two procedures. The six studies included 118 patients who received NPWT, and 149 patients who received conventional non‐pressure wound care. The overall quality of the included studies was high based on the Newcastle–Ottawa scale score of 7.5. Tumour recurrence after NPWT was not significantly different compared with conventional non‐negative pressure wound care (9.3% versus 11.4%, P = 0.40). There was no significant heterogeneity between the studies (I2 = 3%). Although NTWT was associated with a lower complication rate compared with the control group, the result was non‐significant (P = 0.15). Application of NPWT in oncologic resection wounds without residual malignancy revealed no difference in local recurrence and may reduce the risk of postoperative complications compared with conventional non‐negative pressure dressings. NPWT can be considered an alternative method for reconstruction in challenging cases.

Use of negative pressure wound therapy as a bolster over skin grafts in patients with severe burn injuries at a tertiary care burn centre in India

BackgroundManagement of deep burn requires aggressive debridement of non-viable burnt tissue and closure with skin grafts or flaps but challenge is to manage wound exudates and patient discomfort and to avoid shear force and pain cause by frequent dressing changes. This observational case series assessed outcomes of negative pressure wound therapy (NPWT) use as a bolster in pilot surgery (primary surgery) over skin grafts in patients with severe burns in a burn center in Indore, India in term of wound healing, pain, caregivers and nurses workload. MethodsPatients with extensive burns (≥30% total body surface area [TBSA]) were admitted to the burn unit between January and December 2020. Acute burn victims (burns present <24 h from burn injury) and patients over the age of 18 were included in this study. All patients received primary standard burn care including debridement of non-viable tissue, wound closure with homograft or autografts, and application of NPWT as a bolster in first sitting (Pilot surgery). NPWT dressings were changed every three to four days. Skin graft healing was monitored during dressing changes. Patient reported pain was recorded using the 10-point Likert pain scale. ResultsThirteen patients with an average TBSA of 42.6% (range 30–63%) underwent treatment. A total of 8 patients suffered from flame burns, 4 from electrical burns, and 1 from scald burns. The average length of hospital stay was 18.1 ± 6.2 days with wound closure in 9.1 ± 4.3 days. An average of 3.5 ± 1.3 dressing changes occurred. All patients were discharged without requiring re-grafting. No complications were observed, except small non-healing burn wounds in four patients that required further standard wound care to reach complete re-epithelisation. The overall patient reported pain was 3.4 ± 1.2. ConclusionsUse of NPWT as a bolster in patients with severe burns resulted in decreased wound healing time, pain score, workload of nursing staff and caregivers and early rehabilitation of survivor.

799 Negative Pressure Wound Therapy Following Excision of Pilonidal Sinus Disease: A Retrospective Review

Abstract Background Pilonidal sinus disease (PSD) is a common condition that can have a detrimental impact on patient quality of life. Definitive surgical management for PSD is challenging and remains a contentious issue. Primary closure is associated with a high recurrence rate, while healing by secondary intention comes with slow healing and burdensome wound care. Negative pressure wound therapy (NPWT) is widely used to accelerate healing. Aim To evaluate outcomes in patients with PSD treated by a standardised technique of complete surgical excision followed by the application of NPWT. Method A retrospective observational cohort study of all patients with PSD managed by complete surgical excision followed by application of NPWT was performed over a 5-year period. Results 41 patients underwent excision of PSD with application of NPWT during the observation period. All patients’ wounds healed successfully with NPWT. Only one patient (2.4%) developed recurrent PSD and required further surgery. Discussion The ideal surgery for PSD should have a low recurrence rate. Our results demonstrate that our technique of complete surgical excision followed by application of NPWT meets all these criteria. To our knowledge, this study contains the largest number of patients with PSD managed by excision and NPWT in the literature.

Clinical application of negative-pressure wound therapy in uncomplicated cardiac pacemaker pocket infection

Objective: To investigate the feasibility of negative-pressure wound therapy (NPWT) in the treatment of uncomplicated cardiac pacemaker pocket infection. Methods: From January 2013 to March 2020, 35 patients with uncomplicated cardiac pacemaker pocket infection were admitted to the Department of Cardiology of Peking University First Hospital, including 21 males and 14 females, aged 27 to 84 years. The retrospective cohort study was conducted. After a complete debridement followed by continuous NPWT (with negative pressure of -16.67 kPa), the pulse-generator was inserted into the new pocket between the musculus pectoralis major and pectoralis minor. Pressure drainage tube was put into the old pocket space. NPWT with the same mode was used again for 5 to 7 days after the wound was closed. The removed pocket tissue of patients was observed with hematoxylin-eosin staining. The wound healing on 10 to 12 days after the operation of pacemaker replacement was observed, and the recurrence of infection was observed during 6 to 42 months follow-up after operation. Results: The fibrous sac wall was observed in pocket tissue of the patients, and the tissue was partially covered with stratified epithelium, with many chronic inflammatory cells infiltration. Multinucleated giant cell reaction was observed in the tissue of some patients. Ten to twelve days after the operation of pacemaker replacement, 35 patients had good wound healing, and sutures were removed. After 6 to 42 months follow-up after operation, 31 patients were cured with no recurrence of infection and the wounds were well-healed; 4 patients who had recurrent infection received whole system of pacemaker removal after the operation. Conclusions: On the premise of complete debridement, NPWT is an alternative treatment for patients with uncomplicated cardiac pacemaker pocket infection.

Negative-Pressure Wound Therapy for a Replanted Finger with Complicated Wound

Negative-pressure wound therapy (NPWT) is widely used for open wounds in various anatomical sites. Extensive research has been carried out on the application of NPWT; exposed blood vessels in the periwound area are a known contraindication to NPWT. In this study, we report a case where a replanted finger with not only exposed vessels but also uncontrolled infection was treated with NPWT. A 60-year-old man visited our emergency department with incomplete amputation of his left index and middle fingers. After replantation of his two fingers, necrosis of the middle finger with severe methicillin-resistant &lt;i&gt;Staphylococcus aureus&lt;/i&gt; infection complicated managing the wound. After 3 weeks of maintaining conventional wound dressings, we performed NPWT for successful granulation tissue formation and infection control. After the treatment, the wound was completely covered by a split-thickness skin graft. We thus suggest that NPWT can be an effective reconstructive method, including for intractable wounds with exposed pedicle and severe infection after replantation.

Negative pressure wound therapy does not diminish efficacy of topical antibiotic powder in a preclinical contaminated wound model.

AimsHigh-energy injuries can result in multiple complications, the most prevalent being infection. Vancomycin powder has been used with increasing frequency in orthopaedic trauma given its success in reducing infection following spine surgery. Additionally, large, traumatic injuries require wound coverage and management by dressings such as negative pressure wound therapy (NPWT). NPWT has been shown to decrease the ability of antibiotic cement beads to reduce infection, but its effect on antibiotic powder is not known. The goal of this study was to determine if NPWT reduces the efficacy of topically applied antibiotic powder.MethodsComplex musculoskeletal wounds were created in goats and inoculated with a strain of Staphylococcus aureus modified to emit light. Six hours after contaminating the wounds, imaging, irrigation, and debridement and treatment application were performed. Animals received either vancomycin powder with a wound pouch dressing or vancomycin powder with NPWT.ResultsThere were no differences in eradication of bacteria when vancomycin powder was used in combination with NPWT (4.5% of baseline) compared to vancomycin powder with a wound pouch dressing (1.7% of baseline) (p = 0.986), even though approximately 50% of the vancomycin was recovered in the NPWT exudate canister.ConclusionThe antimicrobial efficacy of the vancomycin powder was not diminished by the application of NPWT. These topical and locally applied therapies are potentially effective tools that can provide quick, simple treatments to prevent infection while providing coverage. By reducing the occurrence of infection, the recovery is shortened, leading to an overall improvement in quality of life.Cite this article: Bone Joint Res 2021;10(2):149–155.

Negative pressure wound therapy for skin necrosis prevention after snakebite in the emergency department: A retrospective cohort study.

This retrospective cohort study aimed to compare the effectiveness of conventional treatment and ultra-early application of negative pressure wound therapy (NPWT) in patients with snakebites.Patients who visited the emergency department within 24 hours after a snakebite were assigned to the non- NPWT or NPWT group. Swelling resolution time and rates of necrosis, infection, and operations were compared between the 2 groups. The Stony Brook Scar Evaluation Scale was used to measure short- and long-term wound healing results.Among the included 61 patients, the swelling resolution time was significantly shorter in the NPWT group than in non- NPWT group (P = .010). The NPWT group showed lower necrosis (4.3% versus 36.8%; P = .003) and infection (13.2% and 4.3%; P = .258) rates than the non- NPWT group. The median Stony Brook Scar Evaluation Scale scores were higher in the NPWT group than in the non- NPWT group (P< .001).These findings suggest that ultra-early application of NPWT reduces edema, promotes wound healing, and prevents necrosis in patients with snakebites.

Clinical experience of the use of Integra in combination with negative pressure wound therapy: an alternative method for the management of wounds with exposed bone or tendon

The use of Integra has attracted great interest in the treatment of wounds with exposed bone or tendon, which may lead to associated morbidities. However, the use of Integra alone results in poor wound outcomes. We conducted a randomized clinical study to evaluate the combined effects of Integra and negative pressure wound therapy (NPWT). Thirty-six patients with wounds with exposed bone or tendons were treated with Integra alone and with a combination of Integra and NPWT (n = 18 respectively). Negative pressure (125 mm Hg) was applied intermittently till Integra was revascularized. The take rate of Integra and time taken from Integra coverage to skin transplantation was recorded for each case. The average take rate of Integra in the conventional treatment group (Integra with partial packing compression dressings) was lower than that for the new treatment group (Integra with NPWT) (p < 0.001, 95% CI: 6.44–0.20). The mean time period from Integra coverage to skin transplantation was longer for the conventional treatment group than for the new treatment group (p < 0.001, 95% CI: −13.18 to −11.24). The application of NPWT could potentially increase the take rate of Integra and shorten the duration of hospital stay. The use of Integra with NPWT could be a treatment option for wounds with exposed bone or tendon.

Consensus on the application of negative pressure wound therapy of diabetic foot wounds.

Because China is becoming an aging society, the incidence of diabetes and diabetic foot have been increasing. Diabetic foot has become one of the main health-related killers due to its high disability and mortality rates. Negative pressure wound therapy (NPWT) is one of the most effective techniques for the treatment of diabetic foot wounds and great progress, both in terms of research and its clinical application, has been made in the last 20 years of its development. However, due to the complex pathogenesis and management of diabetic foot, irregular application of NPWT often leads to complications, such as infection, bleeding and necrosis, that seriously affect its treatment outcomes. In 2020, under the leadership of Burns, Trauma and Tissue Repair Committee of the Cross-Straits Medicine Exchange Association, the writing group for ‘Consensus on the application of negative pressure wound therapy of diabetic foot wounds’ was established with the participation of scholars from the specialized areas of burns, endocrinology, vascular surgery, orthopedics and wound repair. Drawing on evidence-based practice suggested by the latest clinical research, this consensus proposes the best clinical practice guidelines for the application and prognostic evaluation of NPWT for diabetic foot. The consensus aims to support the formation of standardized treatment schemes that clinicians can refer to when treating cases of diabetic foot.

Financial Disclosure Appendix for "Soft-Tissue Wound Management: Current Applications of Negative-Pressure Wound Therapy With Instillation".

Financial Disclosure Appendix for "Soft-Tissue Wound Management: Current Applications of Negative-Pressure Wound Therapy With Instillation".