Lumpkins April, Stanton Tamara
KCI, an Acelity Company, San Antonio, TX.
Wounds. 2019 Aug;31(8):E49-E53.
Patient nonadherence to wound care protocols may impact the efficacy of modalities, such as negative pressure wound therapy (NPWT). Recently, a remote therapy monitoring (RTM) system has been devised for use with NPWT for home care patients.
Three home care patients receiving NPWT are presented to examine the relationship between patients using the RTM system and Virtual Therapy Specialists (VTS).
Consent was secured from patients with either multiple comorbidities and/or wounds of varying complexity. Wounds were assessed as per their initial presentation, and all patients were discharged home with an RTM-equipped NPWT system to apply continuous subatmospheric pressure to their wound. Dressings were changed every 2 to 3 days.
All 3 patients were women (age range, 53-72 years), who presented with the following wound types: recalcitrant abdominal wound, acute wound following ventral hernia repair, and dehisced wound following a hysterectomy. Patient 1 was treated with RTM-equipped NPWT for a duration of 88 days (6 nonadherent vs. 82 adherent days) and was adherent to the therapy 93.2% of the time. Patient 2 was treated with RTM-equipped NPWT for a duration of 57 days (8 nonadherent vs. 49 adherent days) and was adherent to the therapy 86.0% of the time. Patient 3 was treated with RTM-equipped NPWT for a duration of 16 days (2 nonadherent vs. 14 adherent days) and was adherent to the therapy 87.5% of the time. Each patient presented with a barrier to therapy adherence (eg, lack of access to residential clinical support, technical issues, or work demands) that was managed by VTS interactions.
In these 3 cases, RTM-equipped NPWT and the patient-centric exchanges with the VTS through adherence calls helped promote consistent usage of RTM-equipped NPWT to address the patients' therapeutic needs and increase therapy adherence.
患者不遵守伤口护理方案可能会影响诸如负压伤口治疗（NPWT）等治疗方式的疗效。最近，已设计出一种远程治疗监测（RTM）系统，用于居家护理患者的NPWT治疗。
介绍3例接受NPWT治疗的居家护理患者，以研究使用RTM系统的患者与虚拟治疗专家（VTS）之间的关系。
获得了患有多种合并症和/或伤口复杂程度各异的患者的同意。根据伤口的初始表现进行评估，所有患者均携带配备RTM的NPWT系统出院，以便对其伤口施加持续的负压。每2至3天更换一次敷料。
所有3例患者均为女性（年龄范围53 - 72岁），伤口类型如下：顽固性腹部伤口、腹疝修补术后急性伤口、子宫切除术后切口裂开伤口。患者1接受配备RTM的NPWT治疗88天（6天未依从治疗，82天依从治疗），治疗依从率为93.2%。患者2接受配备RTM的NPWT治疗57天（8天未依从治疗，49天依从治疗），治疗依从率为86.0%。患者3接受配备RTM的NPWT治疗16天（2天未依从治疗，14天依从治疗），治疗依从率为87.5%。每位患者都存在治疗依从性障碍（例如，无法获得住院临床支持、技术问题或工作需求），这些问题通过与VTS的互动得到解决。
在这3个病例中，配备RTM的NPWT以及通过依从性电话与VTS进行的以患者为中心的交流，有助于促进配备RTM的NPWT的持续使用，以满足患者的治疗需求并提高治疗依从性。
