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Published on: May 2, 2025
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Low-vacuum negative pressure wound therapy protocol for complex wounds with exposed vessels
Guido Paolini1,2, Michail Sorotos3, Guido Firmani1
1Plastic Surgery Unit, Nesmos Department, Faculty of Medicine and Psychology University Sapienza of Rome, Italy.
Journal of Wound Care
|January 25, 2022
Summary
This study shows a modified negative pressure wound therapy (NPWT) protocol successfully treated complex wounds over exposed blood vessels. The adapted NPWT approach reduced risks, offering a potential new option for challenging wound cases.
Area of Science:
- Vascular Surgery
- Wound Healing
- Regenerative Medicine
Background:
- Treating complex wounds over exposed blood vessels presents significant clinical challenges.
- Current recommendations often contraindicate Negative Pressure Wound Therapy (NPWT) in such cases.
- Guided wound healing may be the sole therapeutic option for these high-risk patients.
Purpose of the Study:
- To evaluate the safety and efficacy of an adapted NPWT protocol for complex wounds with exposed vasculature.
- To challenge existing contraindications for NPWT in high-risk surgical patients.
- To present preliminary clinical experience with a novel NPWT approach.
Main Methods:
- An adapted NPWT protocol using low-vacuum continuous pressure (-80mmHg) with a silicone sheath and gauze/foam dressing was employed.
- Clinical monitoring focused on early detection of bleeding or ischemia.
- Dressing changes were performed every 72-96 hours.
Main Results:
- The protocol was applied to five male patients (23-68 years) with complex wounds over exposed arteries and veins.
- Cases included crush injuries, amputations, and bypass graft infections.
- No severe bleeding or ischemia occurred; mean treatment duration was 37 days.
- All wounds showed stability at 1-year follow-up.
Conclusions:
- A low-vacuum NPWT protocol effectively managed five complex cases involving exposed vessels.
- This regimen appears to mitigate risks typically associated with NPWT in these scenarios.
- Preliminary findings are encouraging and may support expanded NPWT indications for wounds with exposed vessels, warranting further validation.
