Fernández Luis G, Matthews Marc R, Ellman Cynthia, Jackson Patricia, Villarreal David H, Norwood Scott
University of Texas Health Science Center, Tyler, TX; University of Texas, Arlington, TX.
Arizona Burn Center, Maricopa Medical Center, Phoenix, AZ.
Wounds. 2020 Oct;32(10):279-282.
Negative pressure wound therapy with instillation and dwell time (NPWTi-d) has been utilized in wounds with positive clinical benefits. A reticulated open cell foam dressing with through holes (ROCF-CC) was developed to assist with wound cleansing by removing thick wound exudate and infectious materials, and it may be used when debridement is not possible or appropriate. Use of NPWTi-d with ROCF-CC dressings has been reported with positive outcomes in complex wounds.
The present study reports the authors' experience using NPWTi-d with ROCF-CC dressings in 19 patients with complex wounds.
Of the 19 patients, 8 underwent sharp debridement. Oral and/or intravenous antibiotic treatment was initiated as needed prior to NPWTi-d. All patients received NPWTi-d with ROCF-CC dressings with instillation of quarter-strength Dakin's solution, hypochlorous acid solution, or saline with a dwell time of 5 to 10 minutes, followed by 2 to 3.5 hours of continuous negative pressure at -125 mm Hg. Dressing changes occurred every 2 to 3 days. Measurements and assessments of wound progression were done as per institutional protocols.
The 19 treated patients consisted of 10 males and 9 females, with an average age of 58.2 ± 15.1 years. Common patient comorbidities included hypertension, diabetes, obesity, and paraplegia. Wound types included pressure injuries, traumatic wounds, and surgical wounds. The average length of NPWTi-d use was 9.5 ± 4.1 days. In all of the patients, the wound beds showed development of healthy granulation tissue following NPWTi-d with ROCF-CC. All patients were discharged to one of the following: another hospital facility, skilled nursing facility, long-term acute care facility, or home.
In the authors' clinical practice, NPWTi-d with ROCF-CC provided effective and rapid removal of thick exudate and infectious materials and promoted development of granulation tissue.
带冲洗和驻留时间的负压伤口治疗(NPWTi-d)已应用于伤口,临床效果良好。开发了一种带有通孔的网状开孔泡沫敷料(ROCF-CC),通过清除浓稠的伤口渗出物和感染物质来辅助伤口清洁,当清创不可行或不合适时可使用。据报道,在复杂伤口中使用NPWTi-d联合ROCF-CC敷料取得了积极效果。
本研究报告作者在19例复杂伤口患者中使用NPWTi-d联合ROCF-CC敷料的经验。
19例患者中,8例接受了锐性清创。在进行NPWTi-d之前,根据需要开始口服和/或静脉抗生素治疗。所有患者均接受NPWTi-d联合ROCF-CC敷料,冲洗四分之一强度的达金氏溶液、次氯酸溶液或生理盐水,驻留时间为5至10分钟,随后在-125 mmHg下持续负压2至3.5小时。每2至3天更换一次敷料。根据机构方案对伤口进展进行测量和评估。
19例接受治疗的患者中,男性10例,女性9例,平均年龄58.2±15.1岁。常见的患者合并症包括高血压、糖尿病、肥胖和截瘫。伤口类型包括压疮、创伤性伤口和手术伤口。NPWTi-d的平均使用时间为9.5±4.1天。在所有患者中,使用NPWTi-d联合ROCF-CC后,伤口床出现了健康的肉芽组织生长。所有患者均出院至以下机构之一:另一家医院、专业护理机构、长期急性护理机构或家中。
在作者的临床实践中,NPWTi-d联合ROCF-CC能有效快速清除浓稠渗出物和感染物质,并促进肉芽组织生长。