Journal of Community Nursing

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NPWT IN THE COMMUNITY
JCN supplement 2015,Vol 29, No 4 ?? JCN su ple ent 2015,Vol 29, No 5 15
and symptoms of the wound. It is also
imperative that the patient involved is
able to make an informed choice about
the therapy, and also that his/her overall
health and wellbeing is considered in
the holistic assessment to ascertain if he/
she can safely cope with the technique.
These considerations may also differ
dependent on the care setting, nurses’
knowledge, patients’physical and
mental infirmities, and patients’actual
and perceived support mechanisms.
In the author’s experience,
disposable NPWT is a useful addition
to the woundcare tool box, as it
can successfully and cost effectively
achieve wound healing goals. In
some instances, such as pilonidal
disease, leg ulcers failing to respond
to compression alone and sub-acute
surgical wounds, it can re-stimulate
healing in an otherwise stalled wound.
In general, it is acceptable to patients,
and the rapid improvements seen in
terms of size and volume reduction can
offer immeasurable reassurance that
progress is being made. Wound exudate
is also well managed, as it is diverted
away from the skin and contained in
the dressing. This not only protects
the wound edges and surrounding
skin from maceration, but also reduces
the frequency of dressing changes,
compared with conventional dressings.
This, in turn, can lead to reduced pain
for the patient, as well as less wound
exposure to the external environment.
Earlier patient mobilisation also
contributes towards a sense of patient
wellbeing, such as in skin grafts treated
with NPWT (Ousey and Milne, 2009;
Timmons and Dowsett, 2012).
There are few tools to aid nurses’
treatment choices. As a result, these
can become intuitive and based on
past experience of managing patients
with wounds. Nurses using NPWT
should regard wound measurement
as a method of feeding back clinical
information to patients and family, as
a measure of progress, and also
to justify treatment choice versus
cost-effectiveness. JCN
REFERENCES
Borgquist O, Gustafsson L, Ingemansson
R, Malmsjö M (2010) Micro- and
macromechanical effects on the wound
bed of negative pressure wound therapy
using gauze and foam. Ann Plast Surg
64(6): 789–93
Campbell PE, Smith GS, Smith JM (2008)
Retrospective clinical evaluation of gauze-
based negative pressure wound therapy.
Int Wound J 5: 280–6
Chadwick P, Haycocks S, Bielby A, Milne
J (2009) A dynamic care pathway to
coordinate the use of advanced therapy
in diabetic foot ulceration. J Wound Care
18(10): 433–7
Department of Health (2009) Transforming
community services: ambition, action,
achievement. Transforming services for acute
care closer to home. DH, London. Available
online:
uploads/system/uploads/attachment_
data/file/215781/dh_124196.pdf
Dowsett C, Davis L, HendersonV, Searle R
(2012) The economic benefits of negative
pressure wound therapy in community-
based wound care in the NHS. Int Wound
J 9(5): 544–52
Dowsett C, Newton H (2004) Wound bed
Preparation: TIME in practice. Wounds UK
1(1): 58-70.
Drew P, Posnett J, Rusling L (2007) The cost
of wound care for a local population in
England. Int Wound J 4(2): 149–55
FalangaV (2005) Advanced treatment for
non-healing and chronic wounds.World
Wide wounds. Available online: www.
worldwidewounds.com/2005/april/
Falanga/Advanced-Treatments-Chronic-
Wounds.html
Flanagan M (2003) Wound measurement:
can it help us to monitor progression to
healing? J Wound Care 12(5): 189–94
Gethin G (2005) Evidence base for wound
measurement.World of Irish Nursing 13(8
Suppl): S6–S8
Hon J, Jones C (1996) The documentation of
wounds in an acute hospital setting. Br J
Nurs 5(17): 1040–5
Kantor J, Margolis DJ (2000) A multicentre
study of percentage change in venous leg
ulcer area as a prognostic index of healing
at 24 weeks. Br J Dermatol 142(5): 960–4
Keast DH, Bowering CK, Evans AW,
Mackean GL, Burrows C, D’Souza L
(2004) MEASURE: a proposed assessment
framework for developing best practice
recommendations for wound assessment.
Wound Repair Regen 12(3 Suppl): S1–S17
Malmsjö M, Ingemansson R, Martin R,
Huddleston E (2009) Wound edge
microvascular blood flow: effects of
negative pressure wound therapy using
gauze or polyurethane foam. Ann Plast
Surg 63(6): 676–81
Margolis DJ, Berlin JA, Strom BL (2000)
Which venous leg ulcers will heal with
limb compression bandages? Am J Med
109(1): 15–19
Morgan T (2014) Wound care in the
community: infection, exudate and
conformability. J Community Nurs 28(5):
43–8
Ousey K, Milne J (2009) Negative pressure
wound therapy in the community: the
debate. Br J Community Nurs 14(12
Supplement): S4–S10
Posnett , Gottrup , Lundgren H, Saal G
(2009) The resource impact of wounds on
health-care providers in Europe. J Wound
Care 18: 154–61
SaxenaV, Hwang S, Eichbaum Q, Ingber D,
Orgil DP (2004)Vacuum-assisted closure
microdeformation of wounds and cell
proliferation. Plast Reconstr Surg 114:
1086–98
Schultz G, Mozingo D, Romanelli M,
Claxton K (2005) Wound healing and
TIME: new concepts and scientific
applications. Wound Repair Regen 13(4
Suppl): S1–S11
Searle R, Milne J (2010) Tools to compare
the cost of NPWT with advanced wound
care: an aid to clinical decision-making.
Wounds UK 6(1): 106–9
Sheehan P, Jones P, Caselli A, Giurini J,Veves
A (2003) Percent change in wound area
of diabetic foot ulcers over a four-week
period is a robust predictor of complete
healing in a 12-week prospective trial.
Diabetes Care 26(6): 1879–82
Sterling C (1996) Methods of wound
assessment documentation: a study. Nurs
Standard 11(10): 38–41
Tallman P, Muscare E, Carson P,
Eaglstein WH, FalangaV (1997) Initial
rate of healing predicts complete healing
of venous ulcers. Arch Dermatol 133(10):
1231–4
Timmons J, Dowsett C (2012) NPWT in the
community Made Easy. Wound Essentials
7(1): 1–4
Vig S, Dowsett C, et al (2011) Evidence-
based recommendations for the use
of negative pressure wound therapy
in chronic wounds: Steps towards an
international consensus. J Tissue Viability
20: S1–S18
World Union of Wound Healing Societies
(WUWHS) (2007) Principles of best
practice: wound exudate and the role
of dressings . A consensus document.
London: MEP Ltd. Available online: www.
woundsinternational.com
Wounds UK (2008) Best Practice Statement:
gauze-based negative pressure therapy.
Wounds UK, Aberdeen