Negative pressure wound therapy (NPWT) is a popular treatment option for a variety of chronic wounds, surgical incisions, and related conditions such as enterocutaneous or enteroatmospheric fistulae.1–8 The primary principle underlying NPWT, application of suction to a wound to promote healing, traces its roots to antiquity.1 The technology has evolved beyond the use of dedicated people who would use their mouths to suck on open skin wounds to the use of bell jars and hand pumps, which would mitigate the unsanitary practice of wound sucking. Modern technology now employs systems that range from simple manually actuated pumps (“mechanical” NPWT) or electrically powered and control system-regulated pumps … read more
Chronic wound care is a wound that persists after 4-6 weeks, and a complex wound is one that a health care professional is the one who needs to take care of it. The lack of progression and the complex nature of the wounds are due to multiple reasons and can be explained by the following factors1:
- patient-related factors (lack of assessment of comorbidities or factors contributing to the wound, and difficulties related to the patient’s behavior and cooperation);
- factors related to the wound (surface, volume, damage to the noble tissues, misdiagnosis of the etiology of the wound, and lack of diagnosis of infectious or ischemic complications of the wound);
- factors related to the skills and knowledge of health professionals (absence of standardized or appropriate care protocols);
- factors related to environmental or social difficulties in terms of resources available for the treatment of the wound.
Tertiary Hospital Over a Four-Year Period in China
Deep neck infections (DNIs) are a group of serious bacterial infections occurring in the potential spaces and fascia of the neck. The incidence of DNIs is not clear. Although many studies have shown that the incidence of DNIs has decreased due to the use of antibiotics and improvements in sanitary conditions, reports also indicate an increased incidence of DNIs in the last 10 years. Deep neck multiple-space infections (DNMIs) are the most serious among all types of DNIs and often spread further to cause mediastinal infections, invade the carotid sheath, and possibly compromise the airway, resulting in life-threatening conditions.
Treatments for DNMIs include life-supporting measures, surgical drainage, and appropriate use of antibiotics. Among these treatments, surgical drainage is key. Although traditional extensive surgical drainage is effective for treating DNMIs, some limitations remain for this approach, ie, drainage depends on gravity, the locations for the drainage tube and incision are limited, dressing changes and wound irrigation more than once a day may increase patient suffering, and secondary wound infection may occur. In recent years, vacuum-assisted closure (VAC)
Nurses are tasked with managing an array of complex wounds. Negative pressure wound therapy (NPWT) is often viewed as a highly specialized skill, but it does not have to be complex. Join this webinar to learn how NPWT’s mechanism of action can address acute wounds, chronic wounds, and closed incisions. This session will provide education on the types of wounds appropriate for the various types of NPWT and equip nurses to confidently manage a patient with NPWT … read more
You know me, you’ve heard me say it before—wound care is important for all DMEPOS providers because every patient has skin, and skin health affects each of us. The skin is our largest organ. Not only does it protect us against the ever-changing environment, it also maintains our integrity. Without proper treatment to lacerations, surgical incisions, burns and injuries, the “wound” could lead to life threatening consequences. All providers see patients who are prone to skin issues because of co-morbidities, surgeries or advanced age.
If you can’t tell, I’m trying to make the case that everyone should be in wound care. If you haven’t considered expanding or elevating your business with wound care, you should. It’s human nature to shy away from wounds, and you may not know what to ask or how to get started (VGM Wound Care can help with that). But your patients have health issues which put them at an increased risk for skin breakdown. Respiratory issues, cardiovascular problems, diabetics, and para- and quadriplegics are just a few of the conditions that … read more
Join Dr. Klein as he shares his experience transitioning NPWT patients to the post-acute care setting.
– Examine the prevalence of hospital readmissions, the economic impact, and the importance of preventing readmissions to improve wound healing.
– Discuss common challenges associated with discharging a NPWT patient to the post-acute care setting and the steps to develop a comprehensive discharge plan.
– Review strategies for educating patients and empowering them to be an active participant in their treatment plan as they transition from the acute to post-acute care setting.
– View case studies utilizing negative pressure wound therapy to optimize wound healing.
Read more and register
Indications for the use of negative pressure wound therapy (NPWT) are broad and include prophylaxis for surgical site infections (SSIs). Existing evidence for the effectiveness of NPWT on postoperative wounds healing by primary closure remains uncertain … To assess the effects of NPWT for preventing SSI in wounds healing through primary closure, and to assess the cost‐effectiveness of NPWT in wounds healing through primary closure … read more
Negative pressure wound therapy (NPWT) is applied using a foam dressing and an adhesive acrylic drape to create a seal. Removal of this drape can be painful and may play a role in periwound skin breakdown during dressing changes. A novel silicone-acrylic hybrid drape (HA-drape) has been developed for use with NPWT to allow for repositioning after initial placement and easier removal. Objective. This retrospective case series reports on the use of HA-drape in 4 patients who experienced periwound skin breakdown. The goal was to minimize skin breakdown while maintaining a seal on the dressing. Materials and Methods. Four patients with mild to moderate periwound skin breakdown were selected to receive NPWT with HA-drape … read more
Negative pressure wound therapy (NPWT) uses controlled negative pressure to remove fluid from open wounds. This is done through a sealed or foam dressing connected to a vacuum pump and canister1. Closed-system negative pressure is relatively new in modern medicine and will continue to evolve for better patient outcomes.
Although NPWT has increased in utilization over the past decade due to positive results and data showing its effectiveness in healing many acute and chronic wounds, it has potential for even more growth and innovation … read more
INTRODUCTION: The treatment of intractable toe ulcer with critical limb ischemia (CLI) is a challenge because of its poor blood flow and the wound. Here, a novel fixation technique for artificial dermis with negative pressure wound therapy (NPWT) was reported.
METHOD: After the amputation of toe, artificial dermis made of collagen-gelatin sponge (CGS) was grafted onto the wound where human recombinant basic fibroblast growth factor (bFGF) was sprayed. The foot was put on adhesive iodine-impregnated drape, the artificial-dermis area was covered with a sponge dressing of which another end reached to the drape, and the vacuum port was applied on the dressing sponge sandwiched with two drapes … read more
Surgical wound dehiscence (SWD) is a significant issue that affects large numbers of patients and
is almost certainly under-reported. The impact of SWD can be considerable: increased mortality,
delayed hospital discharge, readmission, further surgery, delayed adjuvant treatment, suboptimal
aesthetic outcome and impaired psychosocial wellbeing … download PDF
In the outpatient setting, combining remote therapy monitoring (RTM) with negative pressure wound therapy (NPWT) can support improved adherence to prescribed therapy. A recent study reported that patients receiving NPWT with RTM required fewer therapy days than patients receiving NPWT alone, possibly reducing costs of care. Our objective was to determine whether RTM reduced 90-day costs in patients undergoing NPWT … read more
A patient with a diabetic foot wound who underwent negative pressure wound therapy experienced good healing, reduced amputation risk, and no wound infection, suggesting the treatment method could be effective in other patients with similar wounds.
A patient who received negative pressure wound therapy (NPWT) after undergoing surgical debridement for a diabetic wound saw improvements in healing capabilities and reduced risks of limb amputation, according to a recent case report published in SAGE Open Medical Case Reports.
The report lends further support to previously published research that has shown NPWT to be effective at decreasing healing time, reducing ulcer area, and increasing healing rates of ulcers. NPWT has also been shown to aid patients with foot ulcers in achieving complete ulcer closure better than advanced moist wound therapy … –
Traumatic wounds (wounds caused by injury) range from abrasions and minor skin incisions or tears, to wounds with extensive tissue damage or loss as well as damage to bone and internal organs. Two key types of traumatic wounds considered in this review are those that damage soft tissue only and those that involve a broken bone, that is, open fractures. In some cases these wounds are left open and negative pressure wound therapy (NPWT) is used as a treatment. This medical device involves the application of a wound dressing through which negative pressure is applied and tissue fluid drawn away from the area. The treatment aims to support wound management, to prepare wounds for further surgery, to reduce the risk of infection and potentially to reduce time to healing … read more
For open traumatic wounds involving fracture or soft tissue, there is “no clear difference” between standard care and negative pressure wound therapy (NPWT), and the latter is unlikely to be cost-effective, according to a recent Cochrane Review.
“All (of our) research led us to conclude there is no clear difference in the rate of healing of open fracture wounds treated with NPWT and those treated with standard care,” she said, “and also that NPWT is likely not a cost-effective treatment for (these) wounds,” Dr. Joanne Dumville of the University of Manchester, UK, told Reuters Health by email on behalf of her colleagues.
Dr. Dumville and colleagues searched the literature and various registries and reports through June 2018 for published and unpublished randomized controlled trials using NPWT for open traumatic wounds involving either fractures or soft tissue.
coexisting rheumatoid arthritis: a case study
We present a case of a 69-year-old woman with rheumatoid arthritis. The patient’s condition was managed with steroid therapy for more than 12 years. She had a coexisting infected chronic ulceration in the left leg, which was treated with negative pressure wound therapy for 52 days. Use of this therapy within the wound reduced exudate and the bacterial count, which dramatically accelerated the process of wound healing.
The introduction of negative pressure wound therapy (NPWT) in the early 1990s resulted in a change in the concept of care and treatment of wounds of various aetiologies in the hospital and outpatient care settings. NPWT is increasingly being used in primary and home health care because of its non-invasiveness, high efficacy, shortening the time of wound healing, and improving wound healing, thereby greatly reducing the need for hospital treatment.1–3 NPWT requires specialized equipment with manual control of negative pressure. Negative pressure is maintained in the wound bed with ready-made sterile sets (sponge, proper dressing, adapter, polyurethane foil). Negative pressure causes wound shrinkage and reduction of the bacterial count by evacuating the effusion into a disposable canister placed on the device.4,5 Although the potential of NPWT … read more
Negative Pressure Wound Therapy Dressing
SAN ANTONIO–(BUSINESS WIRE)– KCI, an Acelity Company, today announced the launch of the V.A.C. VERAFLO CLEANSE CHOICE™ Large Dressing designed for use with V.A.C. VERAFLO™ Therapy to cleanse larger wounds with thick, fibrous exudate and infectious material such as slough, and may be used on patients when surgical debridement must be delayed or is not possible or appropriate. With a unique, three-layer foam design with an array of holes, V.A.C. VERAFLO CLEANSE CHOICE™ Dressing allows for selective wound cleansing beyond traditional negative pressure wound therapy (NPWT) dressings, and provides flexibility in treating wounds of various depths.
“As an industry leader, we understand that wound care is incredibly complex and clinicians need more options – the combination of our core V.A.C.® Therapy technology with these new dressings shows remarkable potential for upending the traditional wound care approach, as illustrated by a growing body of clinical data,” said R. Andrew Eckert, President and CEO of Acelity. “Since launching V.A.C. VERAFLO CLEANSE CHOICE™ Dressing last year, we have seen tremendous response from clinicians with rapid adoption of the platform. Innovating for patients and customers is a driving force for our company, and we continue striving to revolutionize wound healing.”
Chris Farley Wound Care, “Stupid, Stupid, Stupid!”
by Michael Miller DO, FACOS, FAPWCA, WCC
For those of you who cannot remember the now deceased comedian Chris Farley, did not find his humor funny or simply cannot remember any of his memorable performances; I suggest you move on to another, less controversial, “here’s how to use scissors” type of blog.
Chris Farley was a genius. His insights covered many, many topics but their pertinence, I have found, is particularly suited to wound care. Those of you who work in the vicinity of a wound care dabbler, I invite you to cut this blog out and surreptitiously leave it where they cannot miss it or send them the link. I am betting that one or two of the following will strike home but even if not, at least they will get the message that someone (probably many-one) wants them to reconsider their current as-yet-unrecognized (you may substitute the words barbaric, substandard, fraudulent or wasteful) practices. Recently, the shenanigans of several 4-hour-per-week wound management company puppets have led a handful of patients to file complaints with their clinics, hospitals and in two cases, demand that they not be charged (believe it or not, with no coercion, suggestion or turbo charging and actually with a second or two of feigned disbelief on my part).
The basics are simple, so let’s get them out on the table. The keys to success are not just avoiding making mistakes but recognizing that one was made and avoiding making it again. While Mr. Farley inadvertently but repeatedly insults Sir Paul McCartney during an adoration-fueled interview, he rewards each faux pas he commits with a smack to his forehead accompanied by his self-acknowledged cry of “Stupid, Stupid, Stupid.” The resultant laughter from the audience and his embarrassment should result in Chris’ reminding himself not to act stupidly again. Of course, the key to the comedic bit is his ability to say the wrong thing again and again and punish himself for the wrong thing again and again. If only Chris had a check list on which to remind himself what things were safe to ask and what questions or actions would take him into treacherous territory. Fortunately for his audience, he just never got it right … read more
Since its introduction almost 20 years ago, negative-pressure wound therapy (NPWT) has become a leading technology in the care and management of acute, chronic, dehisced, traumatic wounds; pressure ulcers; diabetic ulcers; orthopedic trauma; skin flaps; and grafts. NPWT applies controlled suction to a wound using a suction pump that delivers intermittent, continuous, or variable negative pressure evenly through a wound filler (foam or gauze). Drainage tubing adheres to an occlusive transparent dressing; drainage is removed through the tubing into a collection canister. NWPT increases local vascularity and oxygenation of the wound bed and reduces edema by removing wound fluid, exudate, and bacteria … read more
At the ongoing American Academy of Orthopaedic Surgeons Annual Meeting in Las Vegas, Smith & Nephew has just introduced a new negative pressure wound therapy system called RENASYS EZ.
Features and functions according to the manufacturer …. In addition to a simple control that varies pressure from 40 to 200 mmHg and the ability to use both foam and gauze dressings, Smith & Nephew designed RENASYS EZ with additional features that enhance the patient experience and facilitate its ease of use … read more