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What is Negative Pressure Wound Therapy?

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  • Written By: Hillary Flynn
  • Edited By: Bronwyn Harris
  • Last Modified Date: 01 November 2016
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Negative pressure wound therapy (NPWT) is a technique used to facilitate faster wound healing. The basic goal of NPWT is to use a suction or vacuum procedure to draw excess fluid from a wound, thereby improving circulation and disposing of cellular waste. This technique is used for several types of wounds, especially large and chronic wounds as well as burns. Based on the type of wound involved, NPWT may employ the use of gauze, foam pads, or a special sponge placed atop or within the wound and a tubing system connected to a vacuum pump.

It is generally believed that negative pressure wound therapy benefits wound healing in several areas. It creates a moist and closed wound environment, balances fluids, removes dead tissue, increases circulation, decreases bacteria, and promotes growth of white blood cells. However, the physiological effects of this therapy are still not completely understood, and some have questioned whether or not it truly speeds wound healing faster than other methods.

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Without knowing the details of how the vacuum pressure causes the different biological mechanisms to interplay, it is difficult to establish the most appropriate protocol for using the technique on individual patients. Nevertheless, many health practitioners have had success with NPWT and simply experiment with the length of time the vacuum pressure is applied and the level of intensity with which it is administered. Dressing changes occur when the negative pressure wound therapy ends, which may be anywhere from every 48 to 72 hours, and doctors select the spongy material used to absorb the fluids based on what size and density of pore is appropriate for a particular wound.

A common setup for negative pressure wound therapy is to cut a piece of porous black polyurethane foam designed for NPWT to fit the size and shape of a wound. Then, tubing is placed on top of the foam or inside the foam and a clear piece of plastic adhesive covering is placed over both to hold the foam and tube against the wound bed to ensure everything is properly sealed. The tubing is connected to the vacuum pump, the pump is turned on, then the pump sucks the excess liquid from the wound and drains it into an attached container for a prescribed amount of time. The suction may be constant or periodic, depending on the type of wound and type of vacuum pump or suction device attached.

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anon289385
Post 4

I had severe ankle break in Nov 2011 had surgery to place two plates and screws into my ankle. In June 2012 I developed severe infection requiring another surgery to remove all hardware and bone debridement.

I was placed on IV therapy and a wound vac to heal the wound to the outside of the leg. The healing seems to be helping, however, I am experiencing severe pain. Has anyone had issues with a wound vac causing severe pain?

SteamLouis
Post 3

@fify-- That's true, NPWT really does make healing faster. I have a wound on my abdomen that's almost closed up right now thanks to the NPWT. I don't think that there is a risk factor at all with this system as long as the foam is clean and the wound dressing is sterile and changed often enough.

The only issue I've had with my KCI Negative Pressure Wound Therapy vacuum was that it was not sealing properly at first because I had the wrong size foam for my wound. Apparently, I needed the black foam, not the white one because I have a deep wound. This was preventing the pump from sealing completely. After I got the right foam

though, it's been working just fine.

I've had a lot of progress with my wound thanks to it. I had a wound that was over 6cm deep starting out and now it's 3cm after using the NPWT for one month. I think it will be completely closed in several weeks which I'm really happy about.

fify
Post 2

@alisha-- Negative pressure wound therapy manufacturing companies generally make them to function at around 130mmHg and at 150 at most. This is not strong enough to cause any kind of trauma to the injury. You would need more than 200mmHg for something like that. So it's completely safe in that regard.

I have heard about a few rare cases of infection after use of NPWT but most of the time, it works against infection and is an excellent way to speed up healing and close open wounds. I know someone whose limb was actually saved thanks to the use of NPWT. If you had an open wound due to a traumatizing injury, I'm sure you would want that closed and healed as soon as possible. So why not utilize an NPWT which can do that?

discographer
Post 1

I'm sure that negative pressure wound therapy wouldn't be used if there weren't benefits. But it does sound a bit intrusive to me, especially for sensitive injuries like burns.

I've had a second degree burn before and I know how badly it hurts. I cannot imagine having a suction placed over a fresh burn wound. How strong is the negative pressure wound therapy pump suction anyway?

Since it's able to suck away liquids and dead skin, it can't be too weak right? Isn't it better to leave the wound alone for it to heal on its own? I feel that our body knows what it's doing and every mechanism has a reason. Pressure wound therapy is not something I would easily agree to unless someone really convinced me of its benefits.

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