Science supporting negative pressure wound therapy with instillation.

A new method (V.A.C.ULTA Therapy System, KCI USA, Inc., San Antonio, TX) combines the benefits of negative pressure wound therapy (NPWT; V.A.C. Therapy, KCI USA, Inc.) with regulated, periodic instillation of user-selected topical wound solutions (V.A.C. VeraFlo Therapy, KCI USA, Inc.). In simulated wound model studies comparing solution distribution using NPWT with and without a soak phase, the instillation soak phase allowed for uniform solution distribution across the wound bed, whereas continuous (no soak) irrigation resulted in uneven coverage. Additional in vitro work illustrated that bacterial particle aerosolisation during wound cleansing was significantly decreased using NPWT with instillation (NPWTi) versus commercially available low-pressure wound cleansers (P < 0·05). In porcine studies, NPWT with saline instillation induced 43% more granulation tissue versus NPWT (P < 0·05) and was as effective at wound cleansing as pulsed lavage. These studies have demonstrated that NPWTi may be an effective wound management therapy that provides both wound cleansing and NPWT benefits.