Complex stage IV pressure ulcers heal at home with a combination of Negative Pressure Wound Therapy and Pulsed Radio Frequency Energy

Two spinal cord patients with large, complex pressure ulcers fulfilled their adamant desire to heal at home through the use of Negative Pressure Wound Therapy (NPWT) and Pulsed Radio Frequency Energy (PRFE).

NPWT is well known to promote wound healing.  Pulsed Radio Frequency Energy is less known, but similarly to NPWT, utilizes energy to stimulate the patient’s own biologic healing.  It is extremely easy to use. 

Our first patient was a paraplegic with a history of a stage IV pressure ulcer requiring a surgical flap that developed two stage IV ulcers at home.  The patient pleaded to remain at our local facility verses transfer to the regional SCI center.  We honored his request and initiated care per NPUAP guidelines as well as NPWT and PRFE.  The patient was discharged 1 month later, on the same regime and home health visitations.  Although we were concerned, we felt we must try to honor the patient’s wishes.  In 16 weeks of NPWT in combination with PRFE therapy, the patient’s wound was essentially closed.

Another patient, a C6 Quadriplegic with a 2 year history of pressure ulcers developed an abscess requiring hospitalization and surgical debridement.  The patient insisted on discharge after only 4 days of IV antibiotics and was subsequently managed at home on oral antibiotics.   Due to ongoing patient resistance, regression continued.  NPWT and PRFE were initiated.  Within 2 months, the wound was healed.

 The Veterans and their families were extremely appreciative of the customized care. We have found through clinical practice that the combining NPWT and PRFE early in the care of stage III and IV pressure ulcers  improves outcomes greatly, is cost effective in decreasing hospitalization days, decreases skill care time, long-term wound product use and the need for surgical intervention.  Patient/caregiver satisfaction improves since the wound(s) heals quicker.