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Positive Outcomes with Negative Pressure Wound Therapy

Positive Outcomes with Negative Pressure Wound Therapy. Laurie S. Stelmaski BSN,RN,CWOCN. Objectives. Understand the healing science behind negative pressure wound therapy (NPWT). Identify the indications and contraindications for use of NPWT in acute and chronic wounds.

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Positive Outcomes with Negative Pressure Wound Therapy

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  1. Positive Outcomes withNegative Pressure Wound Therapy Laurie S. Stelmaski BSN,RN,CWOCN

  2. Objectives • Understand the healing science behind negative pressure wound therapy (NPWT). • Identify the indications and contraindications for use of NPWT in acute and chronic wounds. • Identify treatment endpoints for NPWT.

  3. NPWT – How Does It Work? • The use of subatmospheric pressure to promote wound healing. • Subatmospheric pressure causes mechanical stress to the tissue and the wound is drawn closed. • Basic components of a NPWT system include the dressing, sealing mechanism, tubing and a suction pump.

  4. NPWT – Mechanisms of Action • Stimulation of wound edge retraction • Moist wound environment • Decrease in peripheral edema • Increase in local circulation at the site of the wound • Reduced bacterial load • Stimulation of granulation tissue formation

  5. Indications for NPWT • Acute wounds • Chronic wounds • Traumatic wounds • Partial-thickness burns • Dehisced wounds • Pressure ulcers • Diabetic ulcers • Flaps and skin grafts

  6. Contraindications for NPWT • Malignancy in the wound • Untreated osteomyelitis • Non-enteric or unexplored fistulas • Necrotic tissue with eschar or slough present • Exposed blood vessels or organs

  7. Patient Candidates • Appropriate patient selection will prevent complications and ensure success of NPWT. • Need to optimize the patient’s ability to heal: • Manage comorbidities • Hemodynamic stability • Nutritional status • Blood sugar • Infection

  8. Safe Use of NPWT • Patient assessment • Physician orders • Wound preparation • Debridement and cleansing • Device application • Documentation • Monitoring and assessment • Procedure and protocol

  9. Treatment Endpoints • Based on wound progress and/or achievement of treatment goal. • Planned surgical closure with flap or skin graft. • Healing by secondary intention • Failure to progress after 2-4 weeks of NPWT.

  10. Case Study #1

  11. Case Study #2

  12. References Gupta, S. (2004). Guidelines for managing pressure ulcers with negative pressure wound therapy. Advances in Skin & Wound Care, 17(S2), 2-16. Long, M.A. & Blevins, A. (2009). Options in negative pressure wound therapy: Five case studies. Journal of Wound Ostomy and Continence Nursing, 36(2), 202-211. Martindell, D. (2012). The safe use of negative- pressure wound therapy. American Journal of Nursing, 112(6), 59-63.

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