Negative Pressure Wound Therapy System Research Articles

Negative-pressure wound therapy in combination with bronchial occlusion to treat bronchopleural fistula: a case report

BackgroundBronchopleural fistula, which usually accompanies bronchial fistula and empyema, is a severe complication of lung cancer surgery. Negative-pressure wound therapy can enhance drainage and reduce the empyema cavity, potentially leading to early recovery. This therapy is not currently indicated for bronchopleural fistulas because of the risk of insufficient respiration due to air loss from the fistula.Case presentationA 73-year-old man, who was malnourished because of peritoneal dialysis, was referred to our hospital for the treatment of lung cancer. Right lower lobectomy with mediastinal lymph node dissection was performed via posterolateral thoracotomy, and the bronchial stump was covered with the intercostal muscle flap. His postoperative course was uneventful and he was discharged. However, he was readmitted to our hospital because of respiratory failure and diagnosed as having bronchopleural fistula on the basis of the bronchoscopic finding of a 10-mm hole at the membranous portion of the inlet of the remnant lower lobe bronchus. Thus, thoracotomy debridement and open window thoracostomy were immediately performed. After achieving infection control, bronchial occlusion was performed using fibrin glue and a polyglycolic acid sheet was inserted through a fenestrated wound. Bronchial fistula closure was observed on bronchoscopy; therefore, a negative-pressure wound therapy system was applied to close the fenestrated wound. The collapsed lung was re-expanded and the granulation tissue around the wound increased; therefore, thoracic cavity size decreased and thoracoplasty using the latissimus dorsi was performed.ConclusionsThis bronchopleural fistula was treated successfully after a right lower lobectomy using an extra-pleural bronchial occlusion and negative-pressure wound therapy.

Moist Wound Healing with Commonly Available Dressings.

Significance: A moist wound environment has several benefits that result in faster and better quality of healing. It facilitates autolytic debridement, reduces pain, reduces scarring, activates collagen synthesis, facilitates and promotes keratinocyte migration over the wound surface, and supports the presence and function of nutrients, growth factors, and other soluble mediators in the wound microenvironment. Recent Advances: Wound dressings can be utilized to create, maintain, and control a moist environment for healing. Moist wound dressings can be divided into films, foams, hydrocolloids, hydrogels, and alginates. We are also including negative pressure wound therapy systems in the moist dressings. Critical Issues: An optimal wound dressing should provide a moist environment and have an optimal water vapor transmission rate (WVTR) and absorptive capacity. It should also protect the wound against trauma and contamination and be easy to apply, painless to remove, and esthetically acceptable or even pleasing. Future Directions: Interventions, particularly dressing changes, by medical caregivers are labor intensive and expensive and there should be a continuous effort to reduce their number per week. Smart dressings with integrated microsensors and delivery capabilities that would allow wireless real-time monitoring and treatment of the wound would be very advantageous. This way the state of the wound as well as the wear time of the dressing could be assessed without dressing removal or visit to the wound care center. In addition, an ability to adjust the WVTRs to the exudate level of the wound (or having a large absorptive capacity without changing the WVTR) would be useful. This feature would guarantee an optimal level of hydration of the wound surface throughout the treatment.

The modulation of the burn wound environment by negative pressure wound therapy: Insights from the proteome

Negative pressure wound therapy has been used to promote wound healing in a variety of settings, including as an adjunct to silver-impregnated dressings in the acute management of paediatric burns. Fluid aspirated by the negative pressure wound therapy system represents a potentially insightful research matrix for understanding the burn wound microenvironment and the intervention's biochemical mechanisms of action. The aim of this study was to characterize the proteome of wound fluid collected using negative pressure wound therapy from children with small-area thermal burns. Samples were obtained as part of a randomized controlled trial investigating the clinical efficacy of adjunctive negative pressure wound therapy. They were compared with blister fluid specimens from paediatric burn patients matched according to demographic and injury characteristics. Protein identification and quantification were performed via liquid chromatography tandem mass spectrometry and sequential window acquisition of all theoretical mass spectra data-independent acquisition. Proteins and biological pathways that were unique to or enriched in negative pressure wound therapy fluid samples were evaluated using principal components, partial least squares-discriminant, and gene ontology enrichment analyses. Eight viable samples of negative pressure wound therapy fluid were collected and analyzed with eight matched blister fluid samples. A total of 502 proteins were quantitatively profiled in the negative pressure wound therapy fluid, of which 444 (88.4%) were shared with blister fluid. Several proteins exhibited significant abundance differences between fluid types, with negative pressure wound therapy fluid showing a higher abundance of matrix metalloproteinase-9, arginase-1, low affinity immunoglobulin gamma Fc region receptor III-A, filamin-A, alpha-2-macroglobulin, and hemoglobin subunit alpha. The results lend support to the hypothesis that negative pressure wound therapy augments wound healing through the modulation of factors involved in the inflammatory response, granulation tissue synthesis, and extracellular matrix maintenance. Data are available via ProteomeXchange with identifier PXD023168.

Recent strategic approach in postburn extremity scars and contractures

This study aims to present the outcomes from current alternative treatment modalities combined with the conventional techniques used in the treatment of burn contractures. Twenty-nine patients were included in the study. Patients were divided into three groups according to the severity of contractures: 1- mild, 2- moderate, and 3- severe. Skin defects that occurred following the incision and scar contracture release were closed with a collagen-elastin acellular dermal matrix (ADM). The split-thickness skin graft was evenly placed on the ADM and fixed with absorbable sutures. The grafts were closed with NPWT (negative pressure wound therapy system) dressings. In platelet-rich plasma (PRP) mild cases as well as moderate and severe PRP cases, stem cell and fat injection were applied. PRP injection was applied to the scar base before the contracture; fat injection and stem cells were applied at the 3rd and 6th months. Preoperative and postoperative range of motion (ROM), Patient and Observer Scars Evaluation Scale (POSAS), and histopathological scores were evaluated. There was a statistically significant decrease in postoperative POSAS scores (p < .05) and a significant increase in the ROM score (p < .05). Histopathological examination revealed an increased postoperative collagen accumulation and organization, increased vascularization, decreased scar tissue thickness and increased subcutaneous tissue thickness. There was no difference in treatment outcomes between the groups. Based on the current findings, we conclude that ADM, stem cell-rich fat grafting, and PRP therapies combined with conventional methods could satisfactorily improve functional outcomes in the repair of burn contractures.

Comparison of Healthcare Costs Associated With Patients Receiving Traditional Negative Pressure Wound Therapies in the Post-Acute Setting.

ObjectiveA retrospective national insurance claims database analysis evaluated total and wound-related costs for acute and chronic wound patients treated with negative pressure wound therapy (NPWT), comparing a product specific NPWT (NPWT-K) to other NPWT systems (NPWT-O).MethodsPatients with one or more NPWT claims between January 2016 and September 2018 in an outpatient setting with continuous medical and pharmacy benefits for six months before the initial (index) NPWT claims and 12 months post index were assessed. The cohorts were propensity score matched based on age, gender, comorbidities, and payer type. Each cohort included 3,368 patients after matching. Costs were evaluated at 30 days, three months, and 12 months after initial NPWT placement. Hospital admission rates, emergency room (ER) visits, and NPWT device switching were evaluated at 30 days. Differences were analyzed by t-test and chi-square test.ResultsAt 30 days, wound-related costs were $8,583 and $11,334, and total cost to treat was $17,809 and $24,405 for NPWT-K and NPWT-O, respectively (p < 0.0001). NPWT-O patients had higher NPWT, wound-related, and total costs across all time periods, as well as a longer average length of therapy (p = .0039). There was no statistical difference in 30-day hospital admissions (p = 0.089); although 30-day ER visits were higher for NPWT-K (4.9% vs. 3.3%, p = 0.0007). A higher degree of switching from NPWT-O to NPWT-K occurred at 30 days (NPWT-O 2.5% vs. 0.4%, p < 0.0001).ConclusionsThis comparative effectiveness analysis indicates differences remain across NPWT suppliers in wound-related and total cost to treat for patients who receive durable NPWT in the outpatient setting.

Using a bio-scanner and 3D printing to create an innovative custom made approach for the management of complex entero-atmospheric fistulas

Enteroatmospheric fistulae are challenging clinical conditions that require surgical expertise and that can result in chronic debilitating conditions placing the patient in a vicious cycle characterized by non healing wounds and malnutrition. They are a complex entity that presents great variability depending on the number, shape, and size of the fistulous orifices, their debit, and the dimensions of the wound. This means that, at present, there is no device that adapts to the anatomical characteristics of each patient and manages to control the spillage of intestinal effluvium from the wound. The aim of this study is to describe the manufacturing technique and to assess the preliminary results of a custom device designed through bioscanner imaging and manufactured using 3D printing for use with negative pressure wound therapy (NPWT) in the management of enteroatmospheric fistula. A proof of concept is given, and the design of the device is presented for the first time. After obtaining images of each fistula with a bioscanner, a personalised device was designed for each patient by 3D printing shape of a prism and a hollow base, taking into account the dimensions of the fistulous area in order to perform a floating ostomy to isolate the wound from the debit enteric. The polycaprolactone (PCL) device was placed including inside the fistulous surface and surrounding it with the NPWT system in order to accelerate wound healing.

Use of Negative Pressure Wound Therapy Systems after Radical Vulvectomy for Advanced Vulvar Cancer

A retrospective cohort study was performed to evaluate the efficacy of negative pressure wound therapy in improving vulvectomy healing. Women who underwent radical vulvectomy with complete inguinofemoral lymphadenectomy for advanced vulvar cancer were divided into two groups according to immediate postoperative care: patients treated with negative pressure wound therapy using the device applied on the site of the wound (including vulva and inguinal region), and patients receiving conventional care. 18 patients were included in the study. 7 (38.9%) women were treated with negative pressure wound therapy immediately after the surgery and were included in the intervention group, and 11 (61.1%) patients were included in the control group. Women who received negative pressure wound therapy had significantly lower length of stay in the hospital (14.2 ± 4.7 versus 17.1 ± 6.1 days, mean difference −6.90 days, 95% confidence interval −11.91 to −1.89), and significantly lower length for wound healing (−31.90 days, 95% confidence interval −43.48 to −20.32). In conclusion, the utilization of the negative wound pressure therapy may contribute to reduce hospitalization after radical vulvectomy for vulvar cancer. Large and well-designed randomized trials with cost effectiveness analyses are needed to confirm these findings.

Negative pressure therapy for stoma closure sites-a nonrandomised case control study.

The PICO (Smith & Nephew, UK) dressing is a single use negative pressure wound therapy (NPWT) system that is designed to be used for up to 7 days for closed wounds. We aimed to assess its use for stoma closure wounds. We conducted a retrospective analysis of stoma reversal wounds from April 2018 to June 2019. The wound was partially closed with an absorbable subcutaneous suture in a purse-string fashion. A 15 cm × 15 cm PICO dressing was applied directly over this wound. A control group who had received partial purse string closure with packing over the same time period was identified. Patients were contacted and information collected using a questionnaire. The primary outcome measure was the number of visits for dressing changes in the community. Further information was collected about length of stay, time to resolution of pain and return to work. On average, the patients with PICO dressings attended the community nurses 1.9 times. The patients in the PICO group stated it took 1-2 weeks to return to full work/daily activities. The control group averaged attending the community nurse 11.9 times, and 33% had not returned to work/daily activities in 1-2 weeks. Those who had a PICO dressing required fewer visits to the community nurse and the majority were able to return to work or resume usual activities within 1 to 2 weeks. This pilot study suggests that negative pressure dressings may be a useful aid for stoma closure site wounds.

Closed-incision negative-pressure wound management in surgery—literature review and recommendations

Summary Background Wound healing deficits and subsequent surgical site infections are potential complications after surgical procedures, resulting in increased morbidity and treatment costs. Closed-incision negative-pressure wound therapy (ciNPWT) systems seem to reduce postoperative wound complications by sealing the wound and reducing tensile forces. Materials and methods We conducted a collaborative English literature review in the PubMed database including publications from 2009 to 2020 on ciNPWT use in five surgical subspecialities (orthopaedics and trauma, general surgery, plastic surgery, cardiac surgery and vascular surgery). With literature reviews, case reports and expert opinions excluded, the remaining 59 studies were critically summarized and evaluated with regard to their level of evidence. Results Of nine studies analysed in orthopaedics and trauma, positive results of ciNPWT were reported in 55.6%. In 11 of 13 (84.6%), 13 of 15 (86.7%) and 10 of 10 (100%) of studies analysed in plastic, vascular and general surgery, respectively, a positive effect of ciNPWT was observed. On the contrary, only 4 of 12 studies from cardiac surgery discovered positive effects of ciNPWT (33.3%). Conclusion ciNPWT is a promising treatment modality to improve postoperative wound healing, notably when facing increased tensile forces. To optimise ciNPWT benefits, indications for its use should be based on patient- and procedure-related risk factors.

Management of Grade IV Pressure Ulcers With a Novel Negative Pressure Device in Traumatic Paraplegia Subjects.

IntroductionPressure ulcers (PUs) are a major health problem for bedridden patients or persons with reduced mobility; individuals with spinal cord injury (SCI) are more prone to developing pressure ulcers. The purpose of this study was to determine the efficacy of a novel negative pressure wound therapy (NPWT) system for the treatment of Grade IV PUs.MethodsA total of 34 SCI patients with Grade IV PUs were divided into two groups: 17 cases were managed by our bellows-powered negative pressure device (NPD) and 17 received wet-to-moist gauze dressing as standard wound care.ResultsWound healing outcome measures were recorded every week (at seven days) and compared at weeks 3, 6, and 9. There were no significant changes in the length and width of PUs between the groups till week 3. Significantly reduced length and width of NPD-treated PUs were found at week 6 (p=0.04) that further reduced at week 9 (p=0.001) as compared to standard wound care. Similarly, significant reduction in the depth of PUs was found in the NPD-treated group at week 9 (p<0.05). Exudate levels were significantly (p=0.001) lower in the NPD-treated group as compared to the standard wound care group from week 3 (2.96±0.21 vs 2.62±0.49); this difference continued through week 9 (1.35±0.75 vs 0.14±0.35). Disappearance of slough and formation of healthy granulation tissue was significantly higher in the NPD-treated PUs after week 6 (p=0.001).ConclusionNPWT may be the future of wound healing. As an alternative to the existing electrically powered NPWT systems, our NPD is safe, easy to apply, and efficacious in treating the PUs.

“Low cost, modified negative pressure wound therapy in infected orthopaedic wounds: can it be as effective as its costly counterparts?”

BackgroundInfected wounds pose a great financial burden on our healthcare system. Negative pressure wound therapy (NPWT) has brought a paradigm shift in the management of these wounds. However, availability and high cost of a conventional NPWT system remains a challenge. We carried out this study to assess whether we can replicate functioning of the conventional NPWT system using resources which are easily available in most hospitals and determine the clinical efficacy and cost effectiveness of the same. Material and methodsA prospective study was conducted in the orthopaedic department at our tertiary care institute from January 2018 to December 2019. Fifty six patients with contaminated or infected orthopaedic wounds were included in the study. Wound dressings were carried out by modified negative pressure therapy and their results were studied. ResultsThe study group consisted of 41 males and 15 females. Duration of stay in hospital ranged from 6 to 37 days, with average duration of 14.05 days. Wound closure was achieved by secondary suturing in 18 (32.2%) of the cases and split thickness skin grafting in 38 (67.8%) of the cases. Wound assessment done using the revised Photographic wound assessment tool revealed an average of 60% reduction in scores, post procedure. The average cost of the dressing could be considerably reduced during the study by the use of available material. ConclusionThrough our study we describe a simple and effective method of application of negative pressure dressings which may be beneficial in low resource settings. Our method is easily reproducible and does not require expertise for its application, at the same time it is cost effective and efficient in wound care.

Improved Perioperative Seroma and Complication Rates Following the Application of a 2-Layer Negative Pressure Wound Therapy System After Inguinal Lymphadenectomy for Metastatic Cutaneous Melanoma

BackgroundPerioperative complications following inguinal lymphadenectomy, including seroma formation, are frequent. We have employed a 2-layer negative pressure wound therapy (2-LNPWT) as a method to reduce seroma rate and perioperative complications. We present the outcome of our initial experience with 2-LNPWT and compare the outcomes of its use with traditional closed suction drains (CSDs).Materials and methodsA non-randomised retrospective case–control series was analysed. Surgeons performing inguinal lymphadenectomy for metastatic cutaneous melanoma utilised either the 2-LNPWT therapy or traditional CSDs according to their practice preference.ResultsThe study included 111 patients. The cohorts were well matched for gender, disease burden, body mass index and comorbidities. The 2-LNPWT technique was associated with significantly better postoperative outcomes than CSD, in terms of incidence of seroma formation (26.9% vs 49.4%; p < 0.03), period of drainage (15 days vs 20 days; p = 0.005) and return to theatre rate (0% vs 15.3%; p = 0.03). The overall seroma rate was 44.1%. The only significant association with seroma initiation was the type of drainage system used (2-LNPWT 31.2% vs CSD 58.3%; p < 0.03; OR 3.0). The method of drainage did not alter the course of an established seroma. There was no significant difference in overall or disease-specific survival detected between the 2 groups.ConclusionThis retrospective non-randomised case control study has demonstrated the safe use of a novel application of negative pressure wound therapy that significantly reduced the incidence of seroma formation and postoperative complication rate for inguinal lymphadenectomy for melanoma.

A Survey of Cardiac Surgery Infections With PICO Negative Pressure Therapy in High-Risk Patients

Surgical site complications represent major concerns in many surgical specialties and lead to an increased length of hospital stay and the need for additional treatments and care. This investigation aimed to report survey data from the introduction of the PICO negative pressure wound therapy system (Smith & Nephew, Hull, United Kingdom) in a single hospital in France regarding cardiac surgical procedures through standard median sternotomy. The patients in this study were at high risk of developing surgical site infections. PICO was used immediately postoperatively on the closed incision sites in all patients undergoing cardiac surgical procedures. Data were compared with a retrospective cohort of patients in whom PICO had not been used postoperatively. In total, 233 anonymized patient records were reviewed, 142 of which used the PICO device and 91 of which did not. PICO was shown to provide both clinical and economic benefits over standard care across a range of different cardiac surgical patients. The rates of complications, including deep surgical wound infections and mediastinitis, were reduced. As noted, PICO had advantages over standard care in these patients, and complication rates decreased. This study demonstrated cost savings and an increase in available surgical and hospital capacity related to PICO use.

The impact of negative pressure wound therapy for closed surgical incisions on surgical site infection: A systematic review and meta-analysis

BackgroundSurgical site infections cause substantial morbidity and mortality. Negative pressure wound therapy may reduce the risk of surgical site infections, but current evidence is unclear. The objective of this study was to examine whether negative pressure wound therapy reduces the risk of surgical site infections and other wound complications when compared with conventional dressings in all patients with primarily closed surgical wounds. MethodsA comprehensive systematic review of randomized controlled trials was conducted. Trials that compared a negative pressure wound therapy system to any non-negative pressure wound therapy dressing in surgical wound(s) intended to heal by primary intention were eligible. Surgical site infection was the primary outcome, and secondary outcomes included wound dehiscence, pain, seroma, healing time, length of stay, device-related complications, cost-effectiveness, and quality of life. Selection, extraction, and risk of bias steps were done in duplicate, and data were synthesized using random effects meta-analyses. A priori sensitivity and subgroup analyses of the primary outcome were completed. The Grading of Recommendations, Assessment, Development, and Evaluations framework was used to appraise the quality of the evidence. ResultsForty-four randomized controlled trials with N = 5,693 patients were included. Patients treated with negative pressure wound therapy experienced nearly a 40% reduction in the risk of surgical site infections relative to those with conventional dressings, which was statistically significant: pooled risk ratio 0.61, 95% confidence interval 0.49–0.74, I2 = 26%. The effect remained consistent across surgical specialties and brands of negative pressure wound therapy devices. A statistically significant reduction in wound dehiscence and seroma incidence was also observed. ConclusionThere is moderate certainty that negative pressure wound therapy applied to closed surgical incisions reduces the risk of surgical site infections across all surgical procedures.

Clinical Outcomes of Negative-Pressure Wound Therapy with Instillation without Commercial Devices in the Treatment of Complex Wounds

Background: Negative-pressure wound therapy with instillation (NPWTi) is an adjunctive treatment modality for complex and infected wounds. However, commercial devices are expensive and not readily available in many countries. The objective of this study is to introduce an NPWTi method that is applicable where commercial NPWTi devices are not available and to report the clinical outcomes of the NPWTi method for the adjunctive treatment of complex wounds.Methods: This prospective clinical experimental study included 51 patients who had wounds on which operative debridement was performed between January 2017 and March 2019. A negative-pressure wound therapy (NPWT) device was applied with an intravenous (IV) line for continuous instillation of 0.9% normal saline plus 1% povidone-iodine solution for chronic wounds. The outcomes measured were the number of operating room visits, time to final surgical procedure, number of infected wounds, time to resolution of infection, type of reconstruction operation, and occurrence of complications.Results: The average number of operations performed was 2.5±0.8, and the time to final surgical procedure was 28.4±15.4 days. The number of infected wounds was 35 (68.6%), and the time to resolution of infection was 15.0±14.6 days. All wounds were closed or covered. Though partial graft failure occurred in two cases, they healed completely by secondary healing in 2 weeks.Conclusion: A continuous-instillation NPWT system using an IV line could be an adjunctive modality in treating complex wounds at institutions where commercial NPWTi systems are not readily available.

Development of empirical model and controller for negative pressure wound therapy system

Negative pressure wound therapy process usually helps to heal the diabetic open wound much better by applying smooth vacuum process. This therapy gives the positive effects based on the stimulation of formation of granulation tissue, blood flow, angiogenesis, cell proliferation, accelerated secondary wound closure and removal of bacteria from the wound. Generally maintaining the negative pressure in the system is a challenging task which desires the patient to feel more relaxed during the period of healing. In this work attaining and authenticating of a mathematical model of a negative pressure wound therapy system is presented. The established model is based on the vacuum system along with the pump and other elements. The objective of the model is to perform with the design and analysis of a proportional integral derivative control algorithm. It has been validated that this algorithm, is suitable in controlling the vacuum pressure in the chamber, which is based on the simulation on MATLAB Simulink.

Development of empirical model and controller for negative pressure wound therapy system

Negative pressure wound therapy process usually helps to heal the diabetic open wound much better by applying smooth vacuum process. This therapy gives the positive effects based on the stimulation of formation of granulation tissue, blood flow, angiogenesis, cell proliferation, accelerated secondary wound closure and removal of bacteria from the wound. Generally maintaining the negative pressure in the system is a challenging task which desires the patient to feel more relaxed during the period of healing. In this work attaining and authenticating of a mathematical model of a negative pressure wound therapy system is presented. The established model is based on the vacuum system along with the pump and other elements. The objective of the model is to perform with the design and analysis of a proportional integral derivative control algorithm. It has been validated that this algorithm, is suitable in controlling the vacuum pressure in the chamber, which is based on the simulation on MATLAB Simulink.

Indigenous negative pressure wound treatment: Easy, effective and affordable

The purpose of this study was to evaluate the use of negative pressure wound therapy in traumatic injuries, post operative wound dehiscence and pressure sores. Negative-pressure wound therapy (NPWT) is believed to accelerate wound healing by increasing blood flow, promoting angiogenesis, suction removal of matrix metalloproteinases. In our study we have used cost effective material as an alternative to the more expensive commercial NPWT in the management of complex wounds. Material and Methods: This study is a prospective evaluation of NPWT in 70 patients with traumatic injuries, post operative wound dehiscence and pressure sores. In our study we have used low cost indigenous NPWT set for wound therapy. Dressing was changed for every 4 days till the desired granulations tissue is formed for skin cover.Results: Of the 70 patients treated with indigenous NPWT, 42 (60 %) patients achieved direct closure and 28 patients (40%) required split thickness skin grafting. Conclusion: Our study showed low cost indigenous NPWT system producing comparable results at meagre cost to commercially available NPWT. NPWT has now become an established method of wound management. Low cost Indigenous NPWT can be revolutionary in wound management urban as well as in rural areas of our country.

Negative Pressure Wound Therapy (NPWT) in Breast Surgery

Background: The use of Negative Pressure Wound Dressing has been found to promote the wound healing process, therefore, reducing the risk of surgical site complications. The use of this technique amongst breast cancer patients, who have often encountered a distressing journey, may prove beneficial in making the post-operative process less eventful. Many of these patients have a limited time window to start adjuvant treatment. The use of a negative pressure device is recommended in both prophylactic and therapeutic scenarios. NPWT may also be used in patients who have undergone cosmetic breast surgery. We have evaluated the use of NPWT in breast surgery with an updated and systematic review of the available literature.&#x0D; Methods: The authors systematically searched the PubMed, Science Direct, and Wiley Online databases using the phrases “Negative Pressure Wound Therapy in Breast surgery” and “Vacuum-Assisted Closure in Breast Wound” and all publications, including relevant data were considered eligible for inclusion in the review.&#x0D; Results: We have found reports of 7 studies, 3 retrospective, 2 prospective, one randomized trial, and one case series. The complication rate in the NPWT group versus conventional dressing group has been reported in 5 papers. A statistically significant effect in favor of NPWT was documented in three trials.&#x0D; Conclusion: The current evidence supports the notion that NPWT systems are beneficial in enhancing the healing of complicated breast wounds. However, larger studies exploring the effectiveness of this technique would be of interest to breast surgeons.

LEA 5. Use of Disposable Negative Pressure Wound Therapy on Split-Thickness Skin Graft Recipient Sites for Peripheral Artery Disease Foot Wounds—Two Case Reports

Negative pressure wound therapy (NPWT) is a popular and effective adjunct treatment for a great variety of wounds including split-thickness skin graft (STSG). Studies have concluded that NPWT improves STSG uptake. Recent technologic advancements have led to the advent of a new generation of NPWTs. These are the disposable, ultraportable, and mechanically operated NPWTs designed to treat smaller wounds with low to moderate exudates. We report here a novel use of the disposable NPWT (SNAP Therapy System; KCI, San Antonio, Tex) for STSG recipient sites in two patients with peripheral artery disease foot wounds. In both patients, there was 100% STSG uptake. The lightweight disposable NPWT system made for a more cost-effective and comfortable experience for patients. Disposable NPWT may be a feasible alternative to conventional NPWT to aid with STSG uptake for peripheral artery disease foot wound recipient sites.