Negative pressure wound therapy (NPWT) for difficult wounds


Negative pressure wound therapy (NPWT) for difficult wounds

Delayed wound healing particularly in difficult wounds and in elderly with co morbidities is a major concern. It leads to the pain, morbidity, prolonged treatment, and require major reconstructive surgery which imposes enormous social and financial burden. Suction-assisted closure (SAC) is an alternative method of wound management, which uses the negative pressure to prepare the wound for spontaneous healing or by lesser reconstructive options. Method of SAC application includes thorough debridement, adequate homeostasis and application of sterile foams dressing. A fenestrated tube is embedded in the foam and wound is sealed with adhesive tape to make it air tight. The fenestrate tube is connected to a vacuum pump with fluid collection container. The SAC dressings are changed on 5th day. Negative pressure therapy stabilizes the wound environment, reduces wound edema/bacterial load, improves tissue perfusion, and stimulates granulation tissue and angiogenesis. All this improves the possibility of primary closure of wounds and reduce the need for plastic procedures. SAC therapy appears to be a simple and more effective than conventional dressings for the management of difficult wound in terms of reduction in wound volume, depth, treatment duration and cost. The application of vacuum reduces edema, infection and increases local blood flow which promotes healing. It is used as an adjunct or alternate to surgery for wide range of wounds with an aim to decrease morbidity, cost, duration of hospitalization and increase patient comfort.

Many studies on different wounds suggests that SAC may be more economical as compare to conventional wound care methods as it requires fewer dressing changes and lesser reconstructive options for wound healing. Wound healing is faster and overall short duration of treatment and hospitalization. SAC/NPWT stabilize the wound, reduce edema, reduces the bacterial load, improve tissue perfusion, and stimulate granulation tissue. It will improve the possibility of spontaneous wound healing and reduce the need for major plastic surgical procedures. SAC therapy is simple and effective substitute for the management of various wounds than conventional dressings in terms of reduction in wound size, treatment duration and cost.

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