The Role of Negative Pressure Wound Therapy with Instillation and Dwell Time in the Preparation of Wound Bed
DOI:
https://doi.org/10.17140/CTPOJ-3-115Keywords:
Negative pressure wound therapy (NPWT), Negative pressure wound therapy with instillation dwell time (NPWTi-d), Ionic silver solution, Wound bed preparation, Amputation stumpAbstract
Introduction
Although the negative pressure wound therapy (NPWT) is a time tested method of wound preparation, the role of NPWT with
instillation and dwell time (NPWTi-d) in decreasing the downtime of wound preparation needs to be evaluated.
Objective
The objective of this study is assess the role of NPWTi-d in wound bed preparation.
Materials and Methods
This study was conducted in a tertiary care center, after getting informed consent and ethical clearance. NPWTi-d was done
on a 36-years-old female with no known co-morbidities admitted with infected raw area over the right below knee amputation
stump and exposed bone who was not responding well to conventional wound dressing. NPWT was applied with the help of
sterile polyurethane sponge and two tubes. The antimicrobial solution used was ionic silver solution, just enough to wet the
sponge completely and up to the point when the transparent occlusive covering begins to lift. Negative pressure was applied at
125 mmHg. The wound was bathed with ionic silver solution and it was allowed to stay in the wound for 10-minutes, after every
2-hours of negative pressure application. This was continued for 1-week. The dressing was opened at the end of 1-week, wound
irrigated with normal saline, exudate swabs for culture taken and debrided, following which fresh NPWTi-d was applied. This
was repeated for the next 3-weeks.
Result
By the end of third week, the wound became clean, fully covered with healthy granulation and the wound bed was ready to undergo
the definitive wound cover procedure.
References
Argenta LC, Morykwas MJ. Vacuum-assisted closure: A new-method for wound control and treatment—clinical experience. Ann Plast Surg. 1997; 38: 563-576; discussion 577.
Fleischmann W, Strecker W, Bombelli M, Kinzl L. Vacuumseal-ing as treatment of soft tissue damage in open fractures [In: Ger-man]. Unfallchirurg. 1993; 96: 488-492.
Fleischmann W, Lang E, Kinzl L. Vacuum assisted woundclo-sure after dermatofasciotomy of the lower extremity [In: German]. Unfallchirurg. 1996; 99: 283-287.
Morykwas MJ, Argenta LC, Shelton-Brown EI, McGuirt W. Vac-uum-assisted closure: A new method for wound controland treat-ment—animal studies and basic foundation. Ann Plast Surg. 1997; 38: 553-562. doi: 10.1097/00000637-199706000-00001
Borgquist O, Ingemansson R, Malmsjö M. The effect ofinter-mittent and variable negative pressure wound therapy on wound edge microvascular blood flow. Ostomy/Wound Management. 2010; 56(3): 60-67.
Ryssel H, Kloeters O, Germann G, Schäfer T, WiedemannG, Oehlbauer M. The antimicrobial effect of aceticacid: An alterna-tive to common local antiseptics? Burns. 2009; 35: 695-700. doi: 10.1016/j.burns.2008.11.009
Koburger T, Hübner NO, Braun M, Siebert J, Kramer A.Stand-ardized comparison of antiseptic efficacy of triclosan, PVP-iodine, octenidinedihydrochloride, polyhexanideand chlorhexidine diglu-conate. J Antimicrob Chemother. 2010; 65: 1712-1719. doi: 10.1093/ jac/dkq212
Kim PJ, Attinger CE, Steinberg JS, Evans KK, Lehner B, Wil-ly C, et al. Negative-pressure wound therapy with instillation: In-ternational consensus guidelines. Plast Reconstr Surg. 2013; 132(6): 1569-1579. doi: 10.1097/PRS.0b013e3182a80586
Yang CK, Alcantara S, Goss S, Lantis JC II. Cost analysis of-negative-pressure wound therapy with instillation for wound bed-preparation preceding split-thickness skin grafts for massive(>100 cm(2)) chronic venous leg ulcers. J Vasc Surg. 2015; 61: 995-999. doi: 10.1016/j.jvs.2014.11.076
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