Negative pressure wound therapy (NPWT) is becoming more and more common in clinical practice as the body of evidence supporting its use grows. The KCI wound vac is perhaps the best known of the NPWT devices currently available for commercial use. What exactly does NPWT do, how does it work and who can benefit most from NPWT?
What is NPWT?
Negative pressure wound therapy uses vacuum therapy in the form of a dressing applied to an acute or chronic wound. The vacuum pressure is controlled at a sub-atmospheric pressure and may be intermittent or constant. In NPWT, the wound is covered by a dressing which is sealed and then connected to a vacuum pump.[ssboost]
How does NPWT promote wound healing?
NPWT promotes healing of acute and chronic wounds by:
- removing infectious materials
- removing any barriers to cell proliferation/migration, thereby promoting granulation
- providing a moist, protected wound care bed
- promoting tissue perfusion
- removing wound exudate, which can lead to maceration and a delay in wound healing
- reducing tissue edema (interstitial fluid)
Who Can Benefit from NPWT?
Many of us are probably familiar with the use of NPWT on diabetic ulcers or other chronic, non-healing wounds, where NPWT is used as a “last resort”. However, a wide variety of wounds can benefit from NPWT, including:
- acute/chronic wounds
- traumatic wounds
- dehisced wounds
- partial-thickness burns
- pressure ulcers
- diabetic ulcers
- grafts and flaps
Many wounds can benefit when NPWT is used earlier, rather than as a measure of last resort.
Is There Anyone Who Should Not Use NPWT?
Patients who have the following conditions would not/should not be considered as candidates for NPWT:
- osteomyelitis which has not been treated
- necrotic tissue which has eschar present (eschar must first be removed)
- malignancy in the wound (i.e. fungating wounds)
- unexplored and/or non-enteric fistulas
The KCI wound vac is perhaps the most well-known vacuum-assisted closure device currently available. The KCI wound vac has been the subject of more than 850 peer-reviewed articles. What separates the KCI wound care system from its competitors is its Granufoam dressing, which contains thousands of open and reticulated cells that help to promote wound healing and prevent wound infection under an atmosphere of negative pressure.
Suissa, D, Danino, A & Nikolas, A. (2011). Negative-pressure therapy versus standard wound care: a meta-analysis of randomized trials. Plast Reconstr Surg. 2011 Nov;128(5):498e-503e.