9 / 20
MODE OF ACTION
JCN supplement
2015,Vol 29, No 5
9
with lower extremity chronic wounds.
The portable mechanically-powered
system was used in conjunction with
a gauze wound filler, while the larger
system used foam, although pressure
levels were applied equally in both
groups. Over a 16-week study period
there was no significant difference in
wound closure outcomes between the
devices (Armstrong et al, 2012).
Similarly, Hurd et al (2014)
recently published a non-comparative
evaluation of 326 patients treated
with another portable NPWT system
(PICO
™
; Smith & Nephew) for an
eight-week period in a community
setting in Canada. The majority of
patients (68%) achieved complete
wound closure within eight weeks.
When compared to records of
patients in their practice previously
treated with conventional NPWT
systems, the researchers found
equivalent healing outcomes, with a
77% reduction
in wound area in the
portable system compared to 70%
with conventional NPWT over eight
weeks (Hurd et al, 2014).
CONCLUSION
Over the past 20 years, NPWT has
become widely accepted by clinicians
as an efficient treatment for many
different wound types. Research has
shown that for patients living with
chronic wounds the technique helps
to reduce the impact of problems such
as exudate leakage, soiling of clothes
or bedding, and wound odour. From
the clinician’s point of view, NPWT
results in fewer dressing changes due
to its ability to manage exudate, and
the benefits to the wound itself —
including rapid wound contraction,
removal of sloughy material,
appearance of granulation tissue and
overall reduction in wound volume —
are often apparent within days
of application.
As the adoption of single-use
portable NPWT systems becomes
more widespread in a variety of
wound indications and patient
settings, the growing body of evidence
suggests that portable NPWT units
will be able to replicate the clinical
outcomes of larger systems, but with
the additional benefits of simplicity
and affordability.
JCN
REFERENCES
Armstrong DG, Marston WA, Reyzelman
AM, Kirsner RS (2012) Comparative
effectiveness of mechanically and
electrically powered negative pressure
wound therapy devices: a multicenter
randomized controlled trial.
Wound Rep
Regen
20(3):
332–41
Bondokji S, Rangaswamy M, Reuter C,
et al (2011) Clinical efficacy of a new
variant of a foam-based NWPT system.
J Wound Care
20(2):
62–7
Campbell PE, Smith GS, Smith JM (2008)
Retrospective clinical evaluation of
gauze-based negative pressure wound
therapy.
Int Wound J
5(2):
280–6
Dorafshar AH, Franczyk M, Gottlieb LJ,
Wroblewski KE, Lohman RF (2012) A
prospective randomized trial comparing
subatmospheric wound therapy with a
sealed gauze dressing and the standard
vacuum-assisted closure device.
Ann
Plast Surg
69(1):
79–84
Fraccalvieri M, Scalise A, Ruka E, et
al (2014) Negative pressure wound
therapy using gauze and foam:
histological, immunohistochemical, and
ultrasonography morphological analysis
of granulation and scar tissues.
Eur J
Plast Surg
37(8):
411–16
Hurd T, Trueman P, Rossington A (2014)
Use of a portable, single-use negative
pressure wound therapy device in home
care patients with low to moderately
exuding wounds: a case series.
Ostomy
wound Manag
60(3):
30–6
Jones J E, Robinson J, Barr W (2008)
Impact of exudate and odour from
chronic venous ulceration.
Nurs
Standard
22(45):
53–4, 56, 58
Kilpadi DV, CunninghamMR (2011)
Evaluation of closed incision
management with negative pressure
wound therapy (CIM): hematoma/
seroma and involvement of the lymphatic
system.
Wound Rep Regen
19(5):
588–96
Malmsjö M, Gustafsson L, Lindstedt S,
Gesslein B, Ingemansson R (2012)
The effects of variable, intermittent,
and continuous negative pressure
wound therapy, using foam or gauze,
on wound contraction, granulation
tissue formation, and ingrowth into the
wound filler.
Eplasty
12:
e5
Malmsjö M, Huddleston E, Martin R
(2014) Biological effects of a disposable,
canisterless negative pressure wound
therapy system.
Eplasty
14:
e15
Malsiner CC, Schmitz M, Horch RE,
Keller AK, Leffler M (2013)Vessel
transformation in chronic wounds
under topical negative pressure therapy:
an immunohistochemical analysis.
Int Wound J.
Available online: http://
onlinelibrary.wiley.com/doi/10.1111/
iwj.12143/abstract (accessed 23 June,
2015)
Morykwas MJ, Argenta LC, Shelton-
Brown EI, McGuirt W (1997)Vacuum-
assisted closure: a new method for
wound control and treatment: animal
studies and basic foundation.
Ann Plast
Surg
38(6):
553–62
Mouës CM,Van Toorenenbergen AW,
Heule F, Hop WC, Hovius SER (2008)
The role of topical negative pressure
in wound repair: expression of
biochemical markers in wound fluid
during wound healing.
Wound Repair
Regen
16(4):
488–94
Rahmanian-Schwarz A, Willkomm L-M,
Gonser P, Hirt B, Schaller H-E (2012)
A novel option in negative pressure
wound therapy (NPWT) for chronic and
acute wound care.
Burns
38(4):
573–7
SaxenaV, Hwang C-W, Huang S,
Eichbaum Q, Ingber D, Orgill DP
(2004)Vacuum-assisted closure:
microdeformations of wounds and cell
proliferation.
Plast Reconstr Surg
114(5):
1086–96; discussion 1097–8
Schultz GS, Sibbald RG, FalangaV, et
al (2003) Wound bed preparation:
a systematic approach to wound
management.
Wound Repair Regen
March 11(Suppl):
S1–28
Stechmiller JK, Kilpadi DV, Childress B,
Schultz GS (2006) Effect of vacuum-
assisted closure therapy on the
expression of cytokines and proteases
in wound fluid of adults with pressure
ulcers.
Wound Repair Regen
14(3):
371–4
Wackenfors A, Sjögren J, Gustafsson R,
Algotsson L, Ingemansson R, Malmsjö
M (2004) Effects of vacuum-assisted
closure therapy on inguinal wound
edge microvascular blood flow.
Wound
Rep Regen
12(6):
600–6
Wilkes R, ZhaoY, Cunningham K,
Kieswetter K, Haridas B (2009) 3D
strain measurement in soft tissue:
demonstration of a novel inverse finite
element model algorithm on MicroCT
images of a tissue phantom exposed
to negative pressure wound therapy.
J
Mech Behav Biomed Mater
2(3):
272–87
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