Wolvos Tom
Scottsdale Healthcare Osborn Medical Center, Scottsdale, AZ.
Wounds. 2013 Mar;25(3):75-83.
Introduction. This small pilot study introduces initial clinical experience with a system combining negative pressure wound therapy and negative pressure wound therapy with instillation (NPWT/NPWTi, V.A.C. ULTA™ Negative Pressure Wound Therapy, KCI USA, Inc, San Antonio, TX).
The NPWT system with instillation delivers controlled volumetric fluid instillation, and uses instillation- specific reticulated open-cell foam (ROCF) dressings: Dressing A (ROCF-V, V.A.C. VeraFlo™ Dressing, KCI USA, Inc, San Antonio, TX) or Dressing B (ROCF-VC, V.A.C. VeraFlo Cleanse™ Dressing, KCI USA, Inc, San Antonio, TX). Six patients ranging in age from 26-83 years were treated with either NPWT with instillation and Dressing A or Dressing B, and Microcyn® antiseptic solution (Oculus Innovative Sciences, Petaluma, CA) (n = 5) or quarter- strength Dakin's Solution® (Century Pharmaceuticals, Indianapolis, IN) (n = 1), as the instillate. Negative pressure wound therapy was applied in 1 patient to a single wound using Dressing C (ROCF; V.A.C.® GranuFoam™ Dressing, KCI USA, Inc, San Antonio, TX) in one half of the wound, and Dressing B in the other half. In this patient series, instillation was repeated every 2-4 hours with a 5-10 minute soak time followed by negative pressure at -100 mm Hg to -125 mm Hg. All wounds were closed by skin graft or primary, secondary, or delayed primary intention.
For the wound treated with NPWT only, no difference in degree or quality of granulation tissue formation was observed by either dressing.
The system worked well across multiple wound types in either NPWT mode or NPWT with instillation mode, and no complications were observed. Larger patient studies with controls are needed to validate the clinical observations in this patient series. .
简介。这项小型试点研究介绍了一种将负压伤口治疗与滴注式负压伤口治疗相结合的系统(NPWT/NPWTi,V.A.C. ULTA™ 负压伤口治疗系统,美国KCI公司,得克萨斯州圣安东尼奥)的初步临床经验。
带滴注功能的NPWT系统可实现可控的定量液体滴注,并使用特定的滴注用网状开孔泡沫(ROCF)敷料:敷料A(ROCF-V,V.A.C. VeraFlo™ 敷料,美国KCI公司,得克萨斯州圣安东尼奥)或敷料B(ROCF-VC,V.A.C. VeraFlo Cleanse™ 敷料,美国KCI公司,得克萨斯州圣安东尼奥)。6名年龄在26至83岁之间的患者接受了NPWT滴注治疗,使用敷料A或敷料B,并使用Microcyn® 抗菌溶液(美国Oculus创新科学公司,加利福尼亚州佩塔卢马)(n = 5)或四分之一强度的达金氏溶液®(美国世纪制药公司,印第安纳波利斯)(n = 1)作为滴注液。1名患者的单个伤口,一半使用敷料C(ROCF;V.A.C.® GranuFoam™ 敷料,美国KCI公司,得克萨斯州圣安东尼奥)进行负压伤口治疗,另一半使用敷料B。在这个患者系列中,每2至4小时重复滴注一次,浸泡时间为5至10分钟,随后施加-100 mmHg至-125 mmHg的负压。所有伤口均通过植皮或一期、二期或延迟一期愈合进行闭合。
对于仅接受NPWT治疗的伤口,两种敷料在肉芽组织形成的程度或质量上均未观察到差异。
该系统在NPWT模式或NPWT滴注模式下对多种伤口类型均有效,且未观察到并发症。需要进行更大规模的对照患者研究来验证该患者系列中的临床观察结果。