Advanced Foot and Ankle Center of San Diego, San Diego, CA, US.
J Wound Care. 2021 Dec 2;30(12):994-1000. doi: 10.12968/jowc.2021.30.12.994.
The short-term application of negative pressure wound therapy with instillation and dwell time (NPWTi-d) enables the delivery of topical wound solutions, the solubilisation of debris and cleansing of the wound bed. The application of NPWTi-d may support the transition of the wound to a more manageable state and minimises the use of more invasive techniques.
In this case series, we describe the process of applying NPWTi-d early as part of a contaminated wound treatment plan.
The case series included 15 patients in the preoperative setting. Wound types included surgical dehiscence, hard-to-heal wounds, heel pressure ulcers, diabetic foot ulcers, a cat bite and an amputation left open. Normal saline or a 0.125% sodium hypochlorite solution were instilled and allowed to dwell for five minutes, followed by 15 minutes of continuous negative pressure at -125mmHg. NPWTi-d was continued for 4-36 hours, or until the operating room became available. After NPWTi-d, we observed a decreased amount of devitalised tissue in the wound bed and reduced oedema and erythema in the periwound area. Patient white blood cells also significantly decreased in all cases after NPWTi-d (p<0.001).
Short-term use of NPWTi-d may be a useful option for supporting the surgical treatment of contaminated lower extremity wounds.
短期应用带灌输和驻留时间的负压伤口治疗（NPWTi-d）可提供局部伤口溶液，使碎片溶解并清洁伤口床。NPWTi-d 的应用可以支持伤口向更易于处理的状态过渡，并最大限度地减少更具侵入性技术的使用。
在本病例系列中，我们描述了在污染性伤口治疗计划早期应用 NPWTi-d 的过程。
该病例系列包括术前 15 名患者。伤口类型包括手术裂开、难以愈合的伤口、足跟压疮、糖尿病足溃疡、猫咬伤和开放性截肢。注入生理盐水或 0.125%次氯酸钠溶液，并停留五分钟，然后在 -125mmHg 持续负压 15 分钟。NPWTi-d 持续 4-36 小时，或直至手术室可用。NPWTi-d 后，我们观察到伤口床中失活组织的量减少，周围区域的水肿和红斑减少。NPWTi-d 后所有患者的白细胞也显著减少（p<0.001）。
短期应用 NPWTi-d 可能是支持下肢污染性伤口手术治疗的有用选择。
