Portable Negative Pressure Wound Therapy Research Articles

Novel Method of Split-Thickness Skin Graft Donor Site Management Using Combined Fenestrated Polyurethane Film and Negative-Pressure Wound Therapy

Background: Split-thickness skin graft (STSG) is a fundamental and versatile technique used in reconstructive surgery. Despite numerous studies addressing the management of STSG donor sites, there is still little consensus on the optimal dressing method. This study aimed to analyze the effectiveness of a novel method that combines a fenestrated polyurethane film with negative-pressure wound therapy (NPWT) over conventional moist dressings.Methods: Between January 2021 and December 2022, 23 patients who received STSG were retrospectively reviewed. In group A, a polyurethane film punctured with a 20-gauge needle was applied to the skin graft donor site. A NPWT system (CuraSys) was subsequently applied over the film. The conventional NPWT was replaced with a portable NPWT (PICO system) on the day of discharge. On the 14th postoperative day, the NPWT and film were removed. In group B, patients were administered a traditional moist dressing until epithelization. Postoperative pain, reepithelization rate, and dressing cost per cm² were compared.Results: Group A exhibited a lower mean pain score on all the measured days. Furthermore, group A demonstrated a significantly shorter time required for complete reepithelization (18.07±8.43 days vs. 28.20±5.25 days, P=0.003) and a lower dressing cost per square centimeter (6,517±6,162 KRW [4.82±4.56 USD] vs. 23,036±27,157 KRW [17.05±20.11 USD], P=0.006).Conclusion: The combination of fenestrated polyurethane film and NPWT resulted in reduced pain caused by dressing, a faster reepithelization rate, and lower dressing cost than that of conventional moist dressing.

Use of a portable negative pressure wound therapy device on a hard-to-heal wound with exposed bone: a case study.

This case study examines the effectiveness of using negative pressure wound therapy (NPWT) in the management of a hard-to-heal (chronic) wound with exposed ankle bone to reduce associated wound exudate and promote production of granulation tissue. A 60-year-old male patient who was able to attend wound follow-up diligently twice weekly for eight weeks, and weekly thereafter, was selected from a private hospital to take part. During each dressing change, the wound was cleansed with superoxidised cleansing solution, and minimal sharp debridement was performed. In the authors' opinion, the NPWT device used in this study is light and convenient for use in the community or home care setting. The NPWT wound dressing was connected to the NPWT machine via a connecting tube and the device then switched on using the default setting of a negative pressure of 125mmHg. Following the application of the NPWT device, the exposed ankle bone was successfully covered with healthy granulation tissue and healed within 20 weeks with minimal exudate formation in the wound. In the authors' opinion, NPWT is able to promote progress to wound healing; to minimise unnecessary dressing changes and, based on feedback from the patient, is comfortable to wear and when in use.

Portable negative pressure wound therapy (NPWT) is an effective therapy for hard-to-heal-wounds in the community: a case series

Portable negative pressure wound therapy (NPWT) is an effective therapy for hard-to-heal-wounds in the community: a case series

Effective Single-Use Portable Negative Pressure Therapy Used in Acute Morel-Lavallee Lesions: A Case Report

Morel-Lavallee (ML) lesions are closed degloving injuries characterized by post-traumatic fluid collection and nonspecific clinical features, such as pain and soft, fluctuant appearance. Though often misdiagnosed, they can be identified by analyzing the patient’s clinical trauma history, fluid collection in a typical location, and imaging findings. After diagnosis, various treatments can be attempted, from conservative treatment to surgery, depending on the condition of the wound. Acute ML lesions can be treated conservatively. If traditional compression therapy, such as using gauze and elastic bandage, is difficult to maintain due to the patient’s daily activities, negative pressure wound therapy may be an effective choice of treatment. Herein, we introduce an effective treatment case using a single-use portable negative pressure wound therapy device for an acute ML lesion.

The use of negative-pressure wound therapy after total knee arthroplasty is effective for reducing complications and the need for reintervention

BackgroundWound healing complications are causal factors of prosthesis infection and poor postoperative evolution of patients after total knee arthroplasty (TKA). Negative-pressure wound therapy (NPWT) can be an option to minimize these complications. The aim of this study is to compare the complications of patients undergoing TKA who used a portable NPWT device in the immediate postoperative period with those of a control group.MethodsA total of 296 patients were evaluated. Patients were divided into two groups: those who used NPWT for seven days in the postoperative period (Group 1 – prospective evaluated) and those who used conventional dressings (Group 2 – historical control group). Epidemiological data, comorbidities, local parameters related to the surgical wound and complications were evaluated.ResultsThe groups did not differ in regard to sex, age and clinical comorbidities. Overall, 153 (51.7%) patients had at least one risk factor for wound complications. Patients who used NPWT had a lower rate of complications (28.5% vs. 45.7%, p = 0.001) and a lower rate of reintervention in the operating room (2% vs. 8.5%, p = 0.001). Patients in group 1 had a lower incidence of hyperaemia (14.7% vs. 40.2%, p = 0.01), skin necrosis (2.1% vs. 8.5%, p = 0.04) and wound dehiscence (3.1% vs 10.1%, p = 0.03). The use of NPWT was a protective factor for the presence of complications, with an odds ratio of 0.36 (95% CI 0.206–0.629).ConclusionThe number of complications related to the wound after TKA is high; however, most of them are minor and have no impact on the treatment and clinical evolution of patients. The use of NPWT decreased the number of surgical wound complications, especially hyperaemia, dehiscence and necrosis, and reduced the need for reintervention.

Negative pressure wound therapy in the management of complex lower limb wounds: a case series highlighting outpatient care with small single-use devices

Background: Traditionally, the treatment of exposed tendon has required vascularised tissue coverage, usually with complex surgical intervention. The introduction of negative pressure wound therapy (NPWT) has challenged this traditional reconstructive concept. Unfortunately, standard NPWT units are usually bulky, noisy and curtail the mobility and lifestyle of patients. The introduction of small, modern, lightweight, portable, single-use NPWT units have therefore revitalised the use of NPWT and provided a solution to the many problems encountered with the larger devices. Case series: This study highlights three cases of patients with complex lower limb wounds with tendon exposure who were successfully treated with single-use NPWT in an outpatient setting. The median time for complete wound granulation was 5–10 weeks. Minor sharp debridement of wounds was required to encourage granulation tissue formation and this was well tolerated in the outpatient setting. Conclusion: Portable NPWT units provide an alternative to surgical reconstruction in patients with lower limb wounds with exposed tendon. These devices can be utilised in a purely outpatient setting, thus avoid long-term hospitalisation. Older patients with high anaesthesia risk or who lack alternative reconstructive options due to vascular co-morbidities are the most appropriate candidates for this treatment option.

Portable Negative Pressure Wound Therapy: A Case Study of a Patient Treated in the Community in Jersey

The aim of this case study is to describe the authors' experience with the use of portable negative pressure wound therapy (pNPWT) in a non-NHS community health care environment. In this context, wound care products are funded by the individual patient. Nurses struggle to reconcile best practice and current evidence-based care when cost implications limit treatment options. In this case, funding for pNPWT was provided by a local charity. This afforded the patient the opportunity to receive best-practice wound care, and significant wound healing, pain reduction and improved patient satisfaction were achieved. Further investigation is required around the suitability of developing a strategic plan to facilitate delivery of pNPWT within the authors' community nursing service.

Negative-pressure wound therapy for high-risk surgical incision wounds using an ultra-portable device: 11 cases

Negative-pressure wound therapy (NPWT) involves the application of subatmospheric pressure to a wound to help in the healing process. The objective of this case series was to evaluate the clinical...

Miniaturized Negative-Pressure Wound Therapy for Split-Thickness Skin Graft Donor Sites

Background Multiple therapeutic options exist for the treatment of split-thickness skin graft (STSG) donor sites, but there is no clear consensus among surgeons about the best option. Negative-pressure wound therapy (NPWT) has rapidly gained in popularity since its invention. Recently, several miniaturized, single-patient NPWT (SP-NPWT) devices have become available. Compared with traditional NPWT devices, SP-NPWT devices are associated with equal wound healing capability and reliability, but offer several advantages. We present a series of 10 consecutive patients whose STSG donor sites were treated with a commercially available SP-NPWT device. Methods We performed a retrospective review for 10 consecutive patients who underwent STSG procedures and were treated with SP-NPWT devices. Results From 2015 to 2017, 10 consecutive patients underwent oncologic reconstruction using STSG and had their donor sites treated with SP-NPWT devices. The SP-NPWT dressing had been left in place for 2 weeks after surgery. The average donor site area measured 80 cm 2 (range: 76–106 cm 2 ). In all 10 patients, the donor sites healed uneventfully and with no complications. Conclusion Off-the-shelf, miniaturized, SP-NPWT systems appear to be at least as effective as traditional dressings for STSG donor sites and require no maintenance (skilled nursing or dressing changes). Compared with larger and less portable standard NPWT devices, SP-NPWT dressing systems provide a potential cost benefit as well as enhanced convenience and portability.

Using negative pressure wound therapy to prevent surgical site infection.

It is estimated that, at the very least, 5% of patients who undergo surgery develop a surgical site infection (SSI). There has been much interest in the use of negative pressure wound therapy (NPWT) as a prophylactic treatment to reduce the risk of SSI. Evidence suggests it can accelerate healing times, reduce both the length of hospital stay and the frequency of dressing changes, and improve patients' quality of life. The efficacy of traditional and portable NPWT systems is similar. However, the latter has an advantage in that it increases patient mobility and does not hinder individuals from carrying out activities of daily living. There are also economic data suggesting that portable NPWT devices are associated with long-term cost savings.

Innovation in wound management with disposable, portable, cost-effective and non-powered NPWT device: Experience in general surgery

Wound management is vital part of surgery. We used a non-powered, disposable, portable Negative Pressure Wound Therapy dressing (NPWT) (“Nanova™”, KCI™) on different types of surgical wounds treated in one Secondary Care Hospital in Ireland. It is easy to use and is self-operated by patients. It was trialled on three patients, was well tolerated, resulting in early mobility and return to daily activities, along with rapid recovery. There was no non-compliance or adverse effects to surrounding skin. The recovery time ranged from 2-3 weeks. The use of this device positively affected the clinical outcome and resulted in early discharge from hospital, quicker recovery and early return to daily activities.

Portable Negative Pressure Wound Therapy Leading to Rapid Resolution of Pain Associated with Poorly Healing Wounds of the Lower Limbs

Negative Pressure Wound Therapy (NPWT) has been in use for over 15 years. It has been shown to promote granulation tissue and stimulate angiogenesis thereby improving wound healing. Traditionally NPWT is bulky making it use in the outpatient setting a challenge. A portable negative pressure wound system has been developed, facilitating its use in the outpatient setting. We present 4 cases highlighting our experience with portable NPWT. Rapid resolution of pain was observed in ¾ cases following the application of portable Negative Pressure Wound Therapy (NPWT). We believe portable NPWT is a valuable therapeutic option in the management of painful chronic wounds.

The Use of a Novel Canister-free Negative-Pressure Device in Chronic Wounds: A Retrospective Analysis.

Negative-pressure wound therapy (NPWT) is a mainstay in the treatment of acute and chronic wounds. Following the success of the Vacuum-Assisted Closure system (Kinetic Concepts Inc [KCI], an Acelity Company, San Antonio, Texas), many similar systems were developed with minor variations. However, these systems are best suited to wounds with soft-tissue defects. Moreover, the need for a canister to collect wound exudate adds to the size and weight of the device. A canister-free (CF) NPWT device was cleared by the FDA for the treatment of chronic wounds (Kalypto Medical, Mendota Heights, Minnesota). A retrospective study was designed to evaluate the effectiveness of the CF-NPWT device in promoting wound healing. The authors examined the records of 51 patients treated with the CF-NPWT device over a 21-month period. Study participants were treated in an outpatient setting, had at least 30 days of prior treatment, and carried insurance coverage through Medicare or Medicaid. The comparison of time to heal between groups was conducted using the log-rank, Breslow, and Tarone-Ware tests in conjunction with a Kaplan-Meier analysis. In the study population, 65% of the wounds achieved complete closure. For unhealed wounds, the mean wound area reduction was 31.9%, and the mean wound depth reduction was 57.5%. The mean time to heal was 56.9 days (95% confidence interval, 46.4-67.4 days). The results show that the CF-NPWT system meets or exceeds healing rates previously reported in the literature for canister-based systems. This CF device offers a more portable NPWT option, particularly effective in the treatment of shallow wounds.

A portable, disposable system for negative-pressure wound therapy.

Negative-pressure wound therapy (NPWT) imparts a number of clinical effects that promote a healing response and, as such, is a well-established means of treating a variety of wound types. Historically, the technique has been primarily used in the hospital setting; however, the introduction of more portable devices has led to an increase in the use of NPWT in the homecare setting, thereby facilitating early discharge of patients from hospital and continuity of care in the community. Portable NPWT devices also have the potential to impact positively on patients' quality of life, allowing increased mobility and freedom to undertake normal activities of daily living. Following the development of its standard Avance® NPWT system and associated dressing kits, Mölnlycke Health Care (Gothenburg, Sweden) has introduced a single-patient-use, disposable NPWT system; Avance Solo. This has been developed with a view to maximising patient freedom and mobility, providing a single-patient-use NPWT solution for multi-week treatment to allow quick and easy discharge of patients from hospital to home, and reducing some of the challenges of logistics and administration associated with the provision of NPWT for the caregiver. As with the standard NPWT system, the single-patient use system is supplied with a number of products incorporating Safetac® adhesive technology to minimise the risk of patients suffering unnecessary pain and trauma associated with dressing changes. This article presents a series of case studies describing procedures and outcomes following the application of the Avance Solo single-patient-use system.

Using portable negative pressure wound therapy devices in the home care setting

Using portable negative pressure wound therapy devices in the home care setting Joshua R Burke, Rachael Morley, Mustafa Khanbhai Academic Surgery Unit, Education and Research Centre, University Hospital of South Manchester, Manchester, UK Abstract: Negative pressure wound therapy (NPWT) is the continuous or intermittent application of subatmospheric pressure to the surface of a wound that improves the wound environment, accelerates healing, and reduces wound closure time. Since its first documented use, this technology has lent itself to a number of adaptations, most notably, the development of portable devices facilitating treatment in the home care setting. With advancing surgical standards, wound healing is an important rate-limiting factor in early patient discharge and often a major cost of inpatient treatment. The efficacy of NPWT in the home care setting has been investigated through rate of wound closure, time in care, and patient experience. Rate of wound closure is the most appropriate primary end point. Much can be gleaned from patient experience, but the future success of portable NPWT will be measured on time in care and therefore cost effectiveness. However, there is a lack of level 1a evidence demonstrating increased efficacy of portable over inpatient NPWT. The development of portable NPWT is an encouraging innovation in wound care technology, and extending the benefits to the home care setting is both possible and potentially more beneficial. Keywords: portable, negative pressure wound therapy, vacuum-assisted closure, topical negative pressure therapy

Exploring portable negative pressure wound therapy devices in the community

Case studies and clinical reviews support the use of negative pressure wound therapy (NPWT) for managing a range of wound types, yet very few scientific studies fully support its effectiveness. However, it has been argued that NPWT can provide excellent symptom management, reduce the frequency of dressing changes and provide a cost-effective alternative to traditional wound therapies due to faster healing times, leading to a reduction in overall treatment costs. Use of NPWT within community environments is increasing as length of hospital in-patient stay decreases, and many patients who would have traditionally been admitted to an acute setting with a complex or highly exuding wound are now managed by community nurses. This article presents a narrative review of NPWT, identifies safety precautions that require consideration and explores the application of smaller/disposable NPWT systems that are now available.

A Case of Pressure Sore Successfully Cured with the SNaP® Wound Care System: A Portable Negative Pressure Wound Therapy

A Case of Pressure Sore Successfully Cured with the SNaP^® Wound Care System: A Portable Negative Pressure Wound Therapy

Feasibility of Negative Pressure Wound Therapy During Intercontinental Aeromedical Evacuation of Combat Casualties

The objective of this study was to assess the feasibility of utilizing negative pressure wound therapy (NPWT) for the treatment of wartime soft-tissue wounds during intercontinental aeromedical evacuation. Attempts to use NPWT during early phases of overseas contingency operations resulted in occasional vacuum system failures and potentially contributed to wound complications. These anecdotal episodes led to a perception that NPWT during aeromedical evacuation carried a high risk of wound complications and limited its use. As a result, NPWT was not frequently applied in the management of soft-tissue wounds before US casualty arrival in the continental United States (CONUS) for wounds sustained in the combat theaters. Concurrently, early NPWT on the traumatic wounds of host nation casualties not requiring aeromedical evacuation seemed to provide many benefits typically associated with the therapy such as decreased infection rates, earlier wound closure, and improved pain management. On a daily basis, study investigators reviewed the trauma in-patient census at Landstuhl Regional Medical Center, Germany, to identify patient candidates with soft-tissue extremity or torso wounds that required packing. Patient demographics, injuries, and previous wound treatments were recorded. Surgeons inspected wounds in the operating room and applied a NPWT dressing if deemed appropriate. NPWT was continued throughout the remainder of the patient's hospitalization and also during aeromedical evacuation to CONUS. A study investigator escorted the patient during aeromedical evacuation to educate the flight crews, to record the impact on crew workload, and to troubleshoot the system if necessary. Thirty enrolled patients with 41 separate wounds flew from Germany to CONUS with a portable NPWT system (VAC Freedom System; Kinetic Concepts Incorporated, San Antonio, TX). All 30 patients arrived at the destination facilities with intact and functional systems. No significant in-flight complications were identified, impact on flight crew workload was negligible, and subjective feedback from both flight crews and patients was uniformly positive. For 29 patients, the NPWT dressing was replaced (frequently with serial exchanges) during initial surgical treatment in CONUS; the 30th patient underwent delayed primary closure of his right forearm fasciotomy. Receiving care teams reported no complications attributable to NPWT during aeromedical evacuation. NPWT is feasible during intercontinental aeromedical evacuation of combat casualties without an increase in wound complications or a significant impact on air crew workload. Further studies are indicated to evaluate the efficacy of NPWT in combat wounds compared with other wound care techniques.