Negative Pressure Wound Therapy (NPWT) has proven itself as a useful adjunct to wound care.  We have taken this a step further and have utilized this wound care modality to treat partial thickness skin loss and facilitate a secure pouching system in our more extreme peristomal disasters.  This has enabled us to rehabilitate severely compromised peristomal skin quickly and safely.  Marked improvements are seen within three to four days of initiation.  Almost complete peristomal re-epithelialization is noted within the first week. 

We have presented two case studies that demonstrate this modality and their outcomes.  These patients, prior to the initiation of NPWT, were requiring ostomy pouch changes four to six times a day. 

Summary

While NPWT has a proven track record in wound care, its use in ostomy care has never been fully utilized or explored.  These cases are two examples where we were able to establish a secure pouching system that allowed severely compromised peristomal skin to heal utilizing NPWT.  Additionally, both patients were able to continue their therapies with secure pouching systems, no further leakage and without further compromise of the peristomal surface.  While this approach is not intended or advocated for long term use, we believe it has its place for short term, acute peristomal rehabilitation.  We acknowledge that there may be cost related concerns to using NPWT in this manner.  However, when evaluating the costs and benefits of this type of therapy, we can not help but point out the number of pouch changes that were avoided, the nursing hours that were saved, the number of hospital days that were avoided and most importantly allowing these patients to fully participate in their rehabilitation opportunities and promoting the best possible outcome for these patients.