Department of Plastic, Reconstructive, Hand and Burn Surgery, BG-Trauma Center, Eberhard Karls University Tuebingen, Germany.
Burns. 2012 Jun;38(4):573-7. doi: 10.1016/j.burns.2011.10.010. Epub 2011 Nov 17.
Negative pressure wound therapy (NPWT) has become a widely accepted technique in treatment of all kinds of wounds. After a long period of clinical application of the V.A.C.™ system (KCI Inc., San Antonio, Texas, USA) a number of options for delivery of NPWT are now commercially available. An urgent need exists for evidence demonstrating clinical efficacy of these new devices to support clinicians regarding their choice of NPWT.
42 patients with an acute or chronic wound were randomly assigned to either treatment by V.A.C.™ (group A) or therapy with an alternative newly available polyurethane foam-based NPWT system (RENASYS GO™ - F/P, Smith & Nephew GmbH) (group B). In both groups NPWT was applied after surgical debridement to prepare the wound bed for skin grafting. After skin grafting NPWT was applied additionally to secure skin grafts and improve grafts survival. Primary outcome measures were the time to complete healing (days) and duration of the NPWT application (days). Secondary outcome measures were the number of dressing changes and reported complications. In addition, we evaluated the cost-benefit in the clinical implementation.
There were no significant differences comparing the investigated parameters between both groups. Especially average time to complete healing and average time NPWT was applied did not differ (p>0.05). No complications occurred in either group. By an almost identical supply agreement of both providers for our hospital RENASYS™ system appeared to be more cost-effective.
After a long period of preserving a monopoly market position of the V.A.C.™ system, a new comparable option was successfully tested in this preliminary study. The polyurethane foam-based NPWT system (RENASYS GO™ - F/P, Smith & Nephew GmbH) is an efficient and cost-effective alternative NPWT system, which we effectively implemented in therapeutic management of different kinds of wounds.
负压伤口治疗（NPWT）已成为治疗各种伤口的广泛接受的技术。在 V.A.C.™系统（美国德克萨斯州圣安东尼奥市 KCI 公司）的长期临床应用之后，现在有许多用于提供 NPWT 的选择方案可用于商业用途。迫切需要有证据证明这些新设备的临床疗效，以支持临床医生选择 NPWT。
将 42 例急性或慢性伤口患者随机分为 V.A.C.™治疗组（A 组）或另一种新的即用型聚氨酯泡沫基 NPWT 系统（RENASYS GO™ - F/P，Smith & Nephew GmbH）治疗组（B 组）。两组患者均在手术清创后应用 NPWT 以准备植皮床。植皮后，应用 NPWT 以固定皮片并提高皮片成活率。主要观察指标为完全愈合所需的时间（天）和 NPWT 应用时间（天）。次要观察指标为更换敷料的次数和报告的并发症。此外，我们评估了临床实施中的成本效益。
两组患者之间比较，调查参数没有显著差异。特别是完全愈合所需的平均时间和 NPWT 应用的平均时间没有差异（p＞0.05）。两组均未发生并发症。根据我们医院的两个供应商几乎相同的供应协议，RENASYS™系统似乎更具成本效益。
在 V.A.C.™系统长期保持垄断市场地位之后，本初步研究成功地测试了一种新的可比选择方案。基于聚氨酯泡沫的 NPWT 系统（RENASYS GO™ - F/P，Smith & Nephew GmbH）是一种高效且具有成本效益的 NPWT 替代方案，我们有效地将其应用于不同类型伤口的治疗管理中。
