SLR - October 2020 - Jason H. Bahng

Early Results of Negative Pressure Wound Therapy in Treatment of Chronic Wounds

Reference: Elrahman A. Early Results of Negative Pressure Wound Therapy in Treatment of Chronic Wounds. Clin Surg. 2020; 5: 2711

Scientific Literature Review

Reviewed By: Jason H. Bahng, DPM
Residency Program: St. Joseph Medical Center – Houston, TX

Podiatric Relevance: Whether it be from a surgical complication or secondary to trauma, non-healing wounds are frequently encountered by foot and ankle surgeons. There are many treatment modalities for chronic wounds but the utilization of negative-pressure wound therapy devices has increased dramatically. The initial clinical impression for use of NPWT has been favorable due to significant acceleration of wound closure. Limited clinical evidence proves the benefits of using a NPWT, therefore this study assesses the effect of negative pressure wound therapy in management of chronic wounds in a sample of 60 patients. 

Methods: Sixty patients (40 male, 20 female) were prospectively enrolled in this study, between the ages of 18 and 60 years. Patients were examined for comorbidities such as peripheral arterial disease, wound infection, diabetes, and venous insufficiency and neuropathy. Primary outcome measures were non-healing, healing, and healed after treatment with a negative pressure wound therapy device. 

Results: Approximately 73 percent of patients in the study healed after treatment, 16 percent were still actively healing and 10 percent continued to have nonhealing wounds. Those who continued to have nonhealing wounds presented to the ICU and died, although their wounds were slowly healing after revascularization. Therefore, all patients when alive, had wounds that were either healed or healing with treatment. 

Conclusions: A significant number of patients in this study have healed after treatment with negative pressure wound therapy. Authors suggest that with the combination of periodical surgical wound debridement, wound vac therapy can successfully promote and accelerate wound healing in foot lesions. Many limitations accompany the article such as the sample size, lack of follow up, length of treatment and no control group. Treatment protocols should be documented, reported and tested to further prove the efficacy of negative pressure wound therapy. 

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