Acosta Julie, Galarza Lydia, Marsh Margaret, Martinez Ricardo R, Eells Mark, Collinsworth Ashley W
Medical Surgical, Solventum, Maplewood, MN, USA.
Wound Repair Regen. 2025 Jul-Aug;33(4):e70059. doi: 10.1111/wrr.70059.
Surgical debridement is a common treatment for complex wounds but can present risks for patients. Negative pressure wound therapy with instillation and dwell (NPWTi-d) using reticulated open cell foam dressings with 1 cm holes (ROCF-CC) provides hydromechanical wound cleaning and preparation and can be applied outside the operating room at the bedside. This systematic literature review examined the effectiveness of NPWTi-d with ROCF-CC in removing nonviable tissue and infectious material, promoting granulation tissue, and reducing surgical debridements. A systematic search was conducted utilising PubMed, Embase, and ClinicalTrials.gov to identify studies conducted from 1 January 2015-31 August 2022. Study outcomes related to nonviable tissue, granulation tissue, and debridement were summarised and analysed using descriptive statistics. Twenty-one studies including 178 patients who received NPWTi-d with ROCF-CC were included. Evidence of reduction in necrotic and infected tissue following treatment was observed in 97.9% of wounds across 17 studies. Formation of granulation tissue after NPWTi-d with ROCF-CC was reported in 99.2% of wounds across 14 studies. Over 63% of patients avoided surgical debridements in 8 studies, and a statistically significant decrease in surgical debridements was noted in 2 comparative studies. This systematic review provides real-world evidence demonstrating the effectiveness of NPWTi-d with ROCF-CC in the hydromechanical removal of infectious materials, non-viable tissue, and wound debris; reduction of surgical debridements; and promotion of granulation tissue. Thus, NPWTi-d with ROCF-CC may potentially reduce or eliminate the need for surgical debridement by removing non-viable tissue through hydromechanical action.
手术清创是治疗复杂伤口的常用方法，但对患者存在一定风险。使用带有1厘米孔洞的网状开孔泡沫敷料（ROCF-CC）进行滴注和停留的负压伤口治疗（NPWTi-d）可提供流体力学伤口清洁和预处理，且可在手术室以外的床边应用。本系统文献综述探讨了NPWTi-d联合ROCF-CC在清除坏死组织和感染物质、促进肉芽组织生长以及减少手术清创方面的有效性。利用PubMed、Embase和ClinicalTrials.gov进行了系统检索，以确定2015年1月1日至2022年8月31日期间开展的研究。使用描述性统计方法总结并分析了与坏死组织、肉芽组织和清创相关的研究结果。纳入了21项研究，共178例接受NPWTi-d联合ROCF-CC治疗的患者。在17项研究中的97.9%的伤口中观察到治疗后坏死和感染组织减少的证据。在14项研究中的99.2%的伤口中报告了NPWTi-d联合ROCF-CC治疗后肉芽组织的形成。在8项研究中，超过63%的患者避免了手术清创，并且在2项比较研究中注意到手术清创有统计学意义的减少。本系统综述提供了真实世界的证据，证明NPWTi-d联合ROCF-CC在流体力学清除感染物质、坏死组织和伤口碎屑、减少手术清创以及促进肉芽组织生长方面的有效性。因此，NPWTi-d联合ROCF-CC可能通过流体力学作用清除坏死组织，从而潜在地减少或消除手术清创的必要性。
