Adjunctive negative pressure wound therapy in the management of a chronic mixed leg ulcer: A single-case study

To report the clinical outcome of using Negative Pressure Wound Therapy (NPWT) and NPWT with instillation and dwell time (NPWTi-d) as adjunct therapies to promote healing of chronic mixed arterial-venous leg ulcers (MAVLUs) under compression therapy.

A single patient case report METHODS: A patient with a recalcitrant MAVLU of the right anterior lower leg unresponsive to conventional wound care for 12 weeks. The wound was managed with NPWTi-d for twelve days, followed by NPWT for eight weeks. Two-layer 20 mmHg compression therapy was used in conjunction with NPWT throughout the eight weeks.

The four-month-old ulcer decreased in size from 81 cm² to 30.1 cm² after treatment, representing a 54.8% reduction (average healing rate of 4.56 cm²/week). Combined NPWTi-d and NPWT effectively controlled exudate, reduced polymicrobial bioburden, and promoted granulation, eliminating the need for surgical debridement.

Sequential use of NPWTi-d followed by NPWT under controlled compression therapy achieved a substantial reduction in wound size and microbial control in a chronic MAVLU without adverse effects, highlighting their value as adjunctive modalities in complex mixed-aetiology leg ulcers.