Negative pressure wound therapy for open traumatic wounds

Area of Science:

• Trauma care
• Wound healing
• Medical device efficacy

Background:

• Traumatic wounds vary from minor injuries to severe damage involving bone and organs.
• Open fractures and soft tissue wounds are key types of traumatic injuries.
• Negative pressure wound therapy (NPWT) is a treatment involving a sealed dressing and suction to manage wounds.

Purpose of the Study:

• To assess the effectiveness of NPWT for treating open traumatic wounds in various care settings.
• To evaluate NPWT's impact on wound healing, infection, and adverse events.

Main Methods:

• Systematic review of published and unpublished randomized controlled trials (RCTs).
• Searched multiple databases including Cochrane, MEDLINE, Embase, and CINAHL up to June 2018.
• Included RCTs comparing NPWT with standard care for open fracture or soft tissue traumatic wounds.

Main Results:

• For open fractures, moderate-certainty evidence shows no clear difference in wound healing at six weeks between NPWT and standard care.
• Uncertainty exists regarding NPWT's effect on wound infection, adverse events, and quality of life for all open traumatic wounds.
• Moderate-certainty evidence indicates NPWT is unlikely to be cost-effective for open fractures in the UK.

Conclusions:

• NPWT does not demonstrate a clear advantage over standard care for healing open fracture wounds.
• Current evidence suggests NPWT is not a cost-effective treatment for open fractures.
• More research is needed to clarify NPWT's role in managing infection and improving quality of life for traumatic wounds.