Negative-pressure wound therapy (NPWT) is rapidly becoming a mainstay in chronic wound management. This technique is a topical intervention widely used to treat problematic acute and chronic wounds that do not respond to conventional moist wound healing techniques. A negative pressure, typically -125 mmHg, is applied to the wound bed, removing excess exudate and helping to establish fluid balance. In addition, NPWT is thought to stimulate granulation tissue formation, reduce interstitial edema and improve microvascular blood flow.[2-3]
How NWPT Works
The negative pressure in NPWT is applied via a tube from a vacuum device, threaded through a gauze or foam dressing that has been sealed with a transparent film. The negative pressure may be applied continuously or intermittently, depending on the wound type and the treatment objectives
NWPT is indicated for a wide range of wounds, including chronic, acute, and traumatic wounds, partial-thickness burns, dehisced wounds, pressure ulcers, neuropathic ulcers, muscle flaps, and skin grafts. It is also useful in wounds due to arterial or venous insufficiency, wounds with exposed bone or tendons, orthopedic and degloving injuries, and wounds with exposed hardware.
NWPT Therapy Effects
NWPT therapy exerts many effects on both the gross and microscopic levels, initially reducing edema by removing the interstitial fluid and improving blood flow by allowing vessels, compressed by the excess pressure, to fully expand. NPWT is also able to reduce bacterial contamination within the wound, and offers the further advantage that dressings need to be changed only every 48-72 hours. This allows for improved patient comfort, less time spent changing dressings and a cleaner, more hygienic dressing.
Disadvantages of NWPT
Possible disadvantages of NPWT include some pain sensation on treatment, a risk of developing pressure ulcers in the areas treated, and the relative expense of the treatment, particularly over a short time frame.
Wound care is changing. Adjunctive modalities are playing an increasingly important role in many aspects of wound management, and it is becoming more and more important to understand how these emerging techniques can be used for the benefit of patients. To learn more about adjunctive modalities, consider training for a wound certification exam, then enjoy the benefits of increased knowledge, improved qualifications, and enhanced job prospects.
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- Hess CL, Howard MA, Attinger CE. A review of mechanical adjuncts in wound healing: hydrotherapy, ultrasound, negative pressure therapy, hyperbaric oxygen, and electrostimulation. Ann Plast Surg. 2003 Aug;51(2):210-8.
- Ahearn C. (2009). Intermittent NPWT and Lower Negative Pressures — Exploring the Disparity between Science and Current Practice: A Review; Ostomy Wound Management; 55(6), p.2
- Sibbald RG, Mahoney J, VAC Therapy Canadian Consensus Group. (2003). A Consensus Report on the Use of Vacuum-Assisted Closure in Chronic, Difficult-to-Heal Wounds; Ostomy Wound Management; 49(11), p.52