Negative Pressure Wound Therapy Research Articles

Temporal Regulation of Early-Stage Cytokine Expression in Diabetic Wound Healing Under Negative Pressure Wound Therapy

Temporal Regulation of Early-Stage Cytokine Expression in Diabetic Wound Healing Under Negative Pressure Wound Therapy

Noninferiority of Copper Dressings Than Negative Pressure Wound Therapy in Healing Diabetic Wounds: A Randomized Clinical Trial.

Objective: To evaluate if treatment of diabetic wounds by copper oxide impregnated dressings (COD) is noninferior to negative pressure wound therapy (NPWT). Approach: Following the CONSORT guidelines, patients with diabetes mellitus (type 1 or type 2) and noninfected wounds eligible for treatment with NPWT were randomized into two groups. One group received NPWT followed by standard wound care dressings, whereas the other was treated exclusively with COD. The primary outcome was wound size reduction, measured blindly using a 3D wound-imaging system. Secondary outcomes included patient and caregiver convenience (assessed via visual analog scores), cost, and additional wound parameters. Results: COD showed statistically significant noninferiority to NPWT in wound size reduction throughout the study (p < 0.01). The percentage of wounds that closed was 47.83% (11/23) and 34.78% (8/23) in the COD and NPWT arms, respectively (p > 0.05). The average time to wound closure, adjusted to potential confounders, such as gender, age, body mass index, diabetes, and smokers, was similar in both arms (p > 0.05). COD were found to be more convenient than NPWT for both patients (p < 0.001) and caregivers (p = 0.003), with a significantly shorter application time (p < 0.001). The COD cost was 14% of NPWT cost ($470 compared with $3,360). Innovation: COD may be considered as the first line of treatment for diabetic foot wounds when NPWT seems indicated. Conclusions: Using copper dressings as a first line of treatment of diabetic wounds, when NPWT is indicated, is expected to reduce health costs, improve convenience, and increase compliance without compromising the final outcome.

Reducing Infections and Improving Healing in Complex Wounds: A Systematic Review and Meta-Analysis.

Background and Objectives: Wound management in complex and traumatic injuries remains a significant clinical challenge, with a high risk of surgical site infections (SSIs) and associated complications. This systematic review and meta-analysis aim to evaluate the effectiveness of diverse interventions, including Negative Pressure Wound Therapy (NPWT), advanced dressings, irrigation techniques, antibiotic regimens, and innovative therapies, in improving wound healing outcomes and reducing infection rates. Materials and Methods: An exhaustive literature search focused on the use of NPWT, dressings, and antibiotics in the care of chronic wounds was conducted following PRISMA guidelines in the PubMed, Scopus, Web of Science, and CINAHL databases. Eligible studies included randomized controlled trials and prospective cohorts assessing interventions for wound care in trauma, surgical, and chronic wound settings. The risk of bias was assessed using the ROB2 tool. Subgroup analyses were performed to evaluate the relative risk (RR) of infections based on the intervention type. Results: The analysis included 17 studies spanning diverse geographical and clinical settings. NPWT demonstrated significant benefits in reducing infection rates compared to control groups (RR: 0.590, 95% CI: 0.458-0.760, and p < 0.001). Although advanced dressings demonstrated clinically relevant benefits as reported across the included studies, the meta-analysis did not reveal statistically significant differences (RR: 0.516, 95% CI: 0.242-1.100, and p = 0.087). Antibiotic therapies significantly reduced infections when administered within 24 h of injury, while low-pressure irrigation techniques effectively minimized bacterial contamination without causing tissue damage. Growth factors and honey-based treatments exhibited promising results in accelerating wound healing and reducing infection risks in chronic wounds. Conclusions: NPWT emerges as a highly effective intervention for infection prevention and wound healing, supported by robust evidence. Advanced dressings and innovative therapies show potential but require further research for conclusive evidence. These findings underscore the importance of tailoring wound care strategies to the clinical context and patient needs. Future research should focus on long-term outcomes and cost-effectiveness analyses to enhance the integration of these therapies into clinical practice.

Postoperative Infection After Esophageal Injury in Anterior Cervical Spine Surgery: A Comprehensive Review of Diagnosis, Management, and Outcomes.

Postoperative infection following anterior cervical spine surgery, particularly when complicated by esophageal injury, is a rare but serious condition associated with significant morbidity and mortality. This review elucidates the complex interplay between postoperative infection and esophageal injury. We systematically analyzed studies from 2000 to 2025 using PubMed, Scopus, and Web of Science, focusing on infection, esophageal injury, surgical outcomes, and management strategies, with emphasis on recent advances in diagnostics, surgical techniques, and postoperative care. Our findings highlight the multifactorial nature of these complications and the critical role of early recognition, accurate diagnosis, and timely management. Imaging modalities such as CT, MRI, and contrast esophagography, along with flexible esophagoscopy, are indispensable in assessing injury and infection extent. Effective management requires a multidisciplinary approach integrating broad-spectrum antibiotics, surgical debridement, vascularized flap reinforcement, negative pressure wound therapy, and antibiotic-loaded cement beads. Meticulous postoperative care with prolonged antibiotics, nutritional support, and imaging follow-up is vital for optimizing outcomes. Innovative approaches, including vascularized muscle flaps and hyperbaric oxygen therapy, show promise in enhancing healing and reducing infections. Our review underscores the need for future meta-analyses to strengthen evidence and refine protocols. As surgical techniques evolve, so too must our diagnostic, surgical, and postoperative strategies to minimize complications and improve patient outcomes.

Patient preference with regard to negative pressure wound therapy and participation in wound care: a qualitative study.

To explore the experiences and preferences of patients with wounds treated with negative pressure wound therapy (NPWT) regarding shared decision-making and patient participation. Semi-structured interviews were conducted with adult patients treated with NPWT. Interview topics included shared decision-making and patients' active participation in wound treatment. Thematic analysis was applied to identify themes. The interview cohort comprised ten patients. Four themes emerged: (1) Having a wound makes patients uncertain and thus influences their quality of life; (2) NPWT influences patients' daily lives; (3) Patients consider professional treatment decisions most important in the decision-making processes; (4) Self-management of wounds is accepted by patients only for low-complexity and well-healing wounds under supervision. Participants emphasised their worries about the future and the impact of the wound/treatment on their families. After being thoroughly informed, participants preferred that health professionals decide on the treatment choice. In addition, participants and/or their relatives did not want to actively participate in complex wound care. As well as expressing a need for qualified wound care professionals, participants reported that they did not want to be or feel responsible for the wound treatment. Shared decision-making and active patient participation are underused and underexposed topics in wound care. Patients' recognition of the importance of their personal preferences can facilitate shared decision-making.

Development of a Benchtop Model for Evaluating the Compatibility of Wound Dressing Materials with Negative Pressure Wound Therapy Systems

Development of a Benchtop Model for Evaluating the Compatibility of Wound Dressing Materials with Negative Pressure Wound Therapy Systems

"Sucking the trouble" out of troubleshooting wound vacs: Video based curriculum development and implementation in a live tissue model.

"Sucking the trouble" out of troubleshooting wound vacs: Video based curriculum development and implementation in a live tissue model.

A Prospective, Controlled, Randomised, Clinical Study of Negative Pressure Device Without Foam or Gauze for Skin and Soft Tissue Defects.

All common negative pressure wound therapy (NPWT) systems include a filler material usually foam or gauze at the wound/device interface. The filler material distributes the negative pressure evenly to all parts of the wound. The foam or gauze may fragment contributing to foreign material being retained in the wound, becoming colonised with bacteria over time, and painful dressing changes. To mitigate these, negative aspects, an impermeable embossed single-layer NPWT membrane dressing has been developed. The dressing has been coined Negative Pressure-Platform Wound Device (NP-PWD) and a foam or gauze is not required to deliver negative pressure. Rather, the pressure is permeated via the spaces between the embossed pyramids and the wrinkles in the membrane. The purpose of this study was to compare the NP-PWD to the standard of care (SOC) NPWT system in the treatment of skin and soft tissue defects. This was a prospective, randomised, controlled clinical trial. The wounds were treated with the NP-PWD or SOC NPWT system. The randomised treatment was applied for 2 days to up to 9 days after the initial application. Follow-up data were collected at each dressing change/removal and included photographs, and assessments for wound healing, infection, and adverse events. In total 24 subjects (12 NP-PWD and 12 SOC) completed the study. The NP-PWD was easy to use and fast to apply and the patients tolerated it well. The transparency of the NP-PWD allowed the provider to see the wound without removing the dressing which is an improvement over traditional NPWT. In terms of wound healing, inflammation, pain, and infection, no differences were observed between the NP-PWD and the SOC NPWT system. The NP-PWD is a simplified, single component NPWT system eliminating the use of the filler material that commonly causes challenges during treatment.

Towards optimized donor site closure of radial forearm flaps: A cohort study of two techniques.

Towards optimized donor site closure of radial forearm flaps: A cohort study of two techniques.

Literature review and experience in treatment of multidrug-resistant bacterial infection in operative area after cochlear implantation

Objective:Multi-drug resistant bacterial infection（MRSA） complications occurring in cochlear implant recipients is rare and of serious consequence. This paper aimed to summarize the treatment experience of a patient with MRSA infection after cochlear implantation. A patient with nasopharyngeal malignant tumor after radiotherapy developed to severe sensorineural deafness. She suffered MRSA infection nine days after cochlear implantation. Since the wound failed to heal after weeks of topical and systemic sensitive antibiotic therapy, the patient underwent surgery for wound debridement. The stimulator-receiver and the electrode of the implant was removed, negative pressure wound therapy was applied, and systemic anti-infection treatment with sensitive antibiotics for weeks, the patients recovered and was discharged from hospital 69 days after infection.

Efficacy of Hyperbaric Oxygen Therapy Combine with Negative Pressure Wound Therapy in Chronic Wound: A randomized controlled trial

Efficacy of Hyperbaric Oxygen Therapy Combine with Negative Pressure Wound Therapy in Chronic Wound: A randomized controlled trial

Negative pressure wound therapy for surgical wounds healing by secondary intention is not cost-effective.

Negative pressure wound therapy (NPWT) has been used in clinical practice for surgical wounds healing by secondary intention (SWHSI), despite limited evidence regarding its clinical effectiveness and cost-effectiveness. The aim of this study was to evaluate the cost-effectiveness of NPWT for SWHSI, compared with standard dressings, from the perspective of the UK healthcare system. An economic model was used to extrapolate the effectiveness results of a meta-analysis over a patient's lifetime and estimate the costs and outcomes (quality-adjusted life-years (QALYs)) of NPWT and standard dressings. The probability of NPWT being cost-effective was estimated, with extensive scenario analyses conducted to evaluate the robustness of results and the degree of uncertainty. On average, NPWT was associated with higher costs and marginally higher QALYs than standard dressings. The cost difference was mainly driven by the additional intervention costs associated with NPWT. The estimated probability of NPWT being cost-effective was <30%. There was considerable uncertainty in the findings, driven largely by uncertainty in the estimated pooled relative effect from the meta-analysis. Results were robust to different scenario analyses. No evidence was found demonstrating that NPWT was a cost-effective alternative to standard dressings for SWHSI.

Negative pressure wound therapy: does it suck?

Negative pressure wound therapy: does it suck?

Incisional Negative Pressure Wound Therapy devices applied after Total Ankle Arthroplasty: A Hospital-Based Health Technology Assessment.

A portable, single-use incisional Negative Pressure Wound Therapy (iNPWT) device could be used directly on the wound incision following Total Ankle Arthroplasty (TAA). In order to support local decision-making in a French university hospital for the adoption of such device in this indication, a three-dimensional (clinical, economic and organizational) Hospital Based-Health Technology Assessment (HB-HTA) was conducted. The HB-HTA was based on: a literature review; results from the PICO-PTC single-site randomized controlled trial (ClinicalTrial.gov identifier NCT03886818); and semi-structured interviews with healthcare professionals. Two comparative retrospective cohort studies were retrieved from the literature review. They suggested a decreased incidence of wound healing complications with iNPWT compared to standard dressings, although no difference was found in the PICO-PTC study. There was no significant difference in the PICO-PTC study on Medicine-Surgery-Obstetrics hospital costs between the two strategies: €10,639.65 [CI 95% (7,997.45; 17,988.68)] in the iNPWT group versus €9,672.59 [CI 95% (7,966.29; 13,393.65)] in the standard dressings group. Adoption of this prophylactic strategy would result in an approval to pay a 1.5% supplement to the Medicine-Surgery-Obstetrics hospitalization costs. It could also improve professionals' workflow, and facilitate wound healing monitoring for nurses in orthopedic departments compared to standard dressings. The clinical effectiveness of the iNPWT single-use portable device could not be demonstrated compared to standard dressings for prophylactic use, in terms of the incidence of wound healing complications, in patients scheduled for TAA and not selected on the basis of risk factors. However, as this strategy may bring organizational benefits and has not been associated with significant economic costs, the adoption of iNPWT in orthopedic departments could be made according to the surgeon's clinical expertise, based for instance on the patient's risk factors for complications.

What is the Impact of Negative Pressure Wound Therapy on Healing in Patients Post Excision of Pilonidal Sinus? A Systematic Review and Meta-Analysis.

This systematic review aimed to determine the impact of negative pressure wound therapy on healing in patients with pilonidal sinus following surgical excision. Using systematic review methodology, we included original research studies written in English. The search was conducted using CINAHL Plus, Ovid, PubMed, EBSCO Host and Cochrane databases. Quality appraisal was undertaken using the Cochrane Collaboration tool for assessing risk of bias and the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Data were analysed using meta-analysis where appropriate; otherwise, the data are presented narratively. Ten studies were included with a mean sample size of 61 (SD: 33). Three studies were randomised control trials, four were retrospective studies, two were prospective cohort studies and one was pre-post study. Studies showed reduction in healing time, recurrence rates and postoperative pain, as well as higher patients' satisfaction with the use negative pressure wound therapy, however, the certainty of the evidence was very low. The evidence for the intervention is uncertain thus, it is unclear whether NPWT makes any difference when compared to any other dressings, on time to healing, recurrence, pain or patient's experience. Further high-quality research with larger sample sizes is recommended to clearly explore the impact of NPWT on PS healing, recurrence, pain and patient's satisfaction.

Concerns Regarding the Use of Negative Pressure Wound Therapy After Fasciotomy for Compartment Syndrome.

Concerns Regarding the Use of Negative Pressure Wound Therapy After Fasciotomy for Compartment Syndrome.

Efficacy and safety of negative pressure wound therapy in the treatment of patients with cardiovascular implantable electronic devices pocket infection

ObjectivesTo evaluate the efficacy of negative-pressure wound therapy (NPWT) for cardiac implantable electronic device (CIED) pocket infection, eliminating the need for CIED and leads extraction.MethodsThe NPWT cohort consisted of 42 patients with CIED infection who were treated with NPWT from 2013 to 2023. Among them, 3 patients had a systemic infection and 1 patient had incomplete data. We performed a case-control study in which the NPWT group was compared with the conservative treatment group (40 patients). Main outcomes included failure rate (CIED/lead extraction during the 1-year follow-up, 30-day mortality/chronic infection, or infection-related mortality/recurrence) and infection-free time, with cure defined as absence of failure criteria.ResultsA total of 38 patients with pocket infections were treated with NPWT from 2013 to 2023. NPWT was curative in 78.9% (n = 30 of 38) of patients who remained free of infection [median follow-up 12.63 months, interquartile range (IQR): 12.30–34.10 months]. Compared with patients who were treated conservatively, the two groups demonstrated balanced baseline characteristics. Patients who were treated with NPWT had a significantly higher cure rate (78.9% vs. 55.0%, n = 22 of 40; p = 0.025) and a longer mean infection-free time at the 1-year follow-up (338.00 vs. 285.20 days, p = 0.034).ConclusionNPWT is an effective alternative for patients with CIED pocket infections who are unsuitable or unwilling to undergo CIED and leads extraction.Trial registrationThis study was approved by the Chinese Clinical Trial Registry (Clinicaltrials.gov number: ChiCTR2300073560) on July 07, 2023.

Negative Pressure Wound Therapy in Surgical Wound Management: Mechanisms, Clinical Outcomes, and Comparative Analysis of Modern NPWT Systems

Negative Pressure Wound Therapy in Surgical Wound Management: Mechanisms, Clinical Outcomes, and Comparative Analysis of Modern NPWT Systems

The Use of Negative Pressure Wound Therapy and Substrate Antihypoxant in the Treatment of an Elderly Polymorbid Patient (Clinical Observation)

The article presents a clinical observation of an elderly polymorbid patient with a complicated course of the underlying disease, which led to an expanded scope of surgical intervention. The effectiveness of inclusion in the complex treatment regimens of negative pressure wound therapy (NPWT systems in the mode of 120–160 mm Hg, 7-day course) and 1.5% reamberin infusions (400.0, intravenous drip, daily, general course No. 6) is shown. It manifested in the acceleration of reparative processes and a decrease in the area of the wound surface and contributed to the stabilization of the general condition of the patient: a decrease in the severity of clinical symptoms and vascular disorders. The obtained results can serve as a basis for a more in-depth study in this direction.

Salvage of the Mastectomy Pocket in Infected Implant-Based Breast Reconstruction Using Negative-Pressure Wound Therapy with Instillation and Dwell: A Systematic Review and Meta-Analysis

Background: Breast cancer, irrespective of gender, stands as the most prevalent cancer globally, with an annual estimate of 2.3 million new cases. Surgical intervention, including therapeutic mastectomy (excluding prophylactic procedures), is performed on approximately 28% of patients, necessitating subsequent breast reconstruction. Although implant-based breast reconstruction (IBBR) is frequently employed due to its relative ease compared to autologous methods, it presents a notable risk for complications at mid-term such as peri-prosthetic infections. These complications can lead to implant loss and the eventual compromise of the mastectomy pocket. To address these complications, negative pressure wound therapy with instillation and dwell (NPWTi-d) emerges as a promising rescue intervention, known for its capacity to significantly reduce bacterial load and potentially salvage compromised soft tissues. However, the evidence supporting its effectiveness in infected pockets after mastectomy is currently insufficient. This study aims at investigating the efficacy of NPWTi-d in the management of peri-prosthetic mastectomy pocket infection. Methods: A thorough literature search has been concluded through PubMed, Web of Science, and Cochrane databases up until 18th March 2025 on evaluating NPWTi-d’s ability to manage peri-prosthetic infections and preserve mastectomy pockets for subsequent reconstruction. Furthermore, a meta-analysis on the salvage rate of the mastectomy pocket was carried out, while for other outcomes, a descriptive analysis was applied. Results: Nine studies (n = 230 patients) were included, investigating whether the us NPWTi-d was successful in treating peri-prosthetic infection and preserving the mastectomy pocket for subsequent reconstruction by expander or implant. The pooled salvage rate of the implant-based BR due to the use of NPWTi-d was 86.1% (95%CI: 80.6–91.6%). Preservation of the skin envelope avoided secondary reconstruction after a defined time interval, reducing number and complexity of surgeries and related costs. Conclusions: This innovative surgical approach should be considered in selected cases of infected implants after breast reconstruction in breast cancer centers. However, the actual low level of evidence is based on case series, and it is not possible to define generally accepted recommendations for the use of NPWTi-d to save the mastectomy pocket.