Negative-pressure wound therapy

Negative-pressure wound therapy
Application of a vacuum pump using a foam dressing to a wound
Other namesVacuum assisted closure
Negative pressure wound therapy device

Negative-pressure wound therapy (NPWT), also known as a vacuum assisted closure (VAC), is a therapeutic technique using a suction pump, tubing, and a dressing to remove excess exudate and promote healing in acute or chronic wounds and second- and third-degree burns. The therapy involves the controlled application of sub-atmospheric pressure to the local wound environment using a sealed wound dressing connected to a vacuum pump.[1][2][3] The use of this technique in wound management started in the 1990s and this technique is often recommended for treatment of a range of wounds including dehisced surgical wounds, closed surgical wounds, open abdominal wounds, open fractures, pressure injuries or pressure ulcers, diabetic foot ulcers, venous insufficiency ulcers, some types of skin grafts, burns, sternal wounds. It may also be considered after a clean surgery in a person who is obese.[1][4][5]

NPWT is performed by applying a vacuum through a special sealed dressing. The continued vacuum draws out fluid from the wound and increases blood flow to the area.[1] The vacuum may be applied continuously or intermittently, depending on the type of wound being treated and the clinical objectives. Typically, the dressing is changed two to three times per week.[3] The dressings used for the technique include foam dressings and gauze, sealed with an occlusive dressing intended to contain the vacuum at the wound site.[1] Where NPWT devices allow delivery of fluids, such as saline or antibiotics to irrigate the wound, intermittent removal of used fluid supports the cleaning and drainage of the wound bed.[6]

In 1995, Kinetic Concepts was the first company to have a NPWT product cleared by the US Food and Drug Administration.[7] Following increased use of the technique by hospitals in the US, the procedure was approved for reimbursement by the Centers for Medicare and Medicaid Services in 2001.[8]

  1. ^ a b c d Norman G, Shi C, Goh EL, Murphy EM, Reid A, Chiverton L, et al. (Cochrane Wounds Group) (April 2022). "Negative pressure wound therapy for surgical wounds healing by primary closure". The Cochrane Database of Systematic Reviews. 2022 (4): CD009261. doi:10.1002/14651858.CD009261.pub7. PMC 9040710. PMID 35471497.
  2. ^ Cipolla J, Baillie DR, Steinberg SM, Martin ND, Jaik NP, Lukaszczyk JJ, Stawicki SP (2008). "Negative pressure wound therapy: Unusual and innovative applications". OPUS 12 Scientist. 2 (3): 15–29. Archived from the original on 11 June 2017. Retrieved 2 March 2015.
  3. ^ a b Fogg E (August 2009). "Best treatment of nonhealing and problematic wounds". JAAPA. 22 (8): 46, 48. doi:10.1097/01720610-200908000-00013. PMID 19725415.
  4. ^ Mendez-Eastman S (2001). "Guidelines for using negative pressure wound therapy". Advances in Skin & Wound Care. 14 (6): 314–22, quiz 324–5. doi:10.1097/00129334-200111000-00015. PMID 11794443.
  5. ^ Fitzgerald JE, Gupta S, Masterson S, Sigurdsson HH (April 2013). "Laparostomy management using the ABThera™ open abdomen negative pressure therapy system in a grade IV open abdomen secondary to acute pancreatitis". International Wound Journal. 10 (2): 138–144. doi:10.1111/j.1742-481X.2012.00953.x. PMC 7950789. PMID 22487377. S2CID 2459785.
  6. ^ Moch D, Fleischmann W, Westhauser A (1998). "Instillationsvakuumversiegelung — ein erster Erfahrungsbericht". Vielfalt und Einheit der Chirurgie Humanität und Wissenschaft [Instillation vacuum sealing—report of initial experiences] (in German). Vol. 115. pp. 1197–1199. doi:10.1007/978-3-642-45774-6_279. ISBN 978-3-540-65144-4. PMID 9931834. {{cite book}}: |journal= ignored (help)
  7. ^ "Vacuum Assisted Closure Wound Therapy Cleared for Partial Thickness Burns". Reuters Health Medical News. 27 January 2003.[verification needed]
  8. ^ Lillis K (2003). "Effective wound care requires look at total patient picture". Healthcare Purchasing News. 27 (1): 32. ISSN 0279-4799.