The utility of low-cost negative pressure wound therapy in Cameroon

Musculoskeletal injuries are common in Cameroon. Negative pressure wound therapy (NPWT) can effectively manage complex wounds including open fractures, however high cost and unavailability prevent its widespread use. We sought to evaluate the feasibility and efficacy in Cameroon of a low-cost NPWT (LCNPWT) device built from an aquarium pump costing less than $100. We performed a prospective case series including all patients with musculoskeletal injuries managed with LCNPWT at Baptist Hospital Mutengene, Mutengene, Cameroon from 15^th March 2021 to 15^th March 2022. Patient demographics, wound characteristics, and wound photographs were collected at intake and at each dressing change (performed every 3 days). All treatment was provided inpatient, and outcomes were recorded at hospital discharge. Forty-one patients (mean age 40 years, 58% male) received LCNPWT. The most common injury mechanisms were road traffic-related accidents (n=16, 42%) and gunshots (n=8, 21%). Wound characteristics were recorded for 38 patients of which 24 (63%) had infected wounds and 3 were bacteremic (13%) on presentation. All patients received antibiotics. The average duration of LCNPWT was 5.9 days (standard deviation 3.1 days). For 15 patients with documented outcome data, LCNPWT was successful in achieving wound closure in 12 (80%). Five patients failed limb salvage, with 4 receiving amputations and 1 dying during hospitalization. Eighty-three percent of providers (15 providers) reported LCNPWT as beneficial in managing wounds. Low-cost NPWT device was effective for managing contaminated and complex wounds in a resource-limited setting.