Wound instillation--the next step in negative pressure wound therapy. Lessons learned from initial experiences

Area of Science:

• Wound Healing
• Medical Devices
• Infectious Diseases

Background:

• Negative pressure wound therapy (NPWT) utilizes subatmospheric pressure and a reticulated sponge to promote wound healing.
• NPWT aids healing by reducing bacterial load, edema, and facilitating granulation tissue formation.
• A novel development allows for the instillation of solutions into the wound during NPWT.

Observation:

• A retrospective analysis of five cases explored initial experiences with NPWT and instillation (NPWTi).
• Treatment duration with NPWTi averaged 15 days (range, 5-24 days).
• Infected wounds showed improvement with negative cultures after antibiotic instillation in two cases.

Findings:

• Instillation of a topical anesthetic effectively minimized wound pain associated with NPWT.
• Antibiotic instillation in saline solution improved infected wounds and cleared cultures in two cases.
• NPWTi demonstrated potential in managing high-risk, severely infected, limb-threatening wounds.

Implications:

• NPWTi may be initiated early for severe, infected wounds, potentially alongside hyperbaric oxygen therapy.
• Further controlled clinical studies are necessary to confirm the efficacy and cost-effectiveness of NPWTi.
• This modality offers a new approach to wound care, particularly for complex and infected cases.