A New Focus for Negative Pressure Wound Therapy: Palliative Care, A Case Series

A New Focus for Negative Pressure Wound Therapy: Palliative Care, A Case Series

Authors: Kelly Browning, RN, CWS; Ginger Zeda, LPN, CWCA; Jason Cardin, LPN, CWCA; Laura Dedig, RN, BSN, WCC

Problem:

Palliative care is a patient-centered specialty care that is focused on pain management and symptom relief with a goal to improve the patient’s quality of life. Conservative wound therapy is recommended. The authors utilized NPWT in order to gain an understanding related to wound management with a group of patients requiring palliative care.

Methods:

A case study was conducted with four (4) patients being treated in a long-term acute care facility for wound treatment. Three of the subjects had Stage IV pressure ulcers on admission and one experienced a dehisced abdominal wound.  All patients required palliative care due to chronic, debilitating conditions with a poor prognosis for wound healing when negative pressure wound therapy was initiated.

The wound area, volume and PUSH score were measured and recorded weekly. At the end of four weeks of therapy, the wound area (cm²), the wound volume (cm³) and the PUSH score were evaluated.

Findings:

Three subjects completed the four week trial but one subject expired before the end of the trial with the wound bed completed granulated. All four subjects experienced wound healing during this trial although this was not expected due to the chronic, debilitated, malnourished state of these individuals.

Conclusion:

Based on these findings, the use of NPWT provided a wound care approach that addressed the needs of the palliative care patient by supporting the psychosocial issues of the patient and the family, provided odor control and pain reduction. It was also cost-effective as it reduced the nursing care time and maximized the resources for wound care.