Negative Pressure Wound Therapy Combined with Advanced Modalities: Does It Make Sense?

Objective. We evaluated cases of NPWTi-d alone or NPWT with C/ORC or C/ORC/silver dressings to successfully close complex wounds of different etiologies Methods10 patients with wounds of different etiologies (age range 40-90 years old) were evaluated in this case se­ries. Patients were treated with either NPWTi-d or NPWT with C/ORC or C/ORC/silver dressings. NPWTi-d was initiated using a reticulated open cell foam (ROCF-V**). NPWTi-d protocol (depending on wound location) con­sisted of sodium hypochlorite (1:20 to 1:80) that was instilled until the foam was filled, followed by a 3-10 minute dwell time and 2-12 hours of continuous nega­tive pressure therapy at -125 mmHg.10 patients with wounds of different etiologies (age range 40-90 years old) were evaluated in this case se­ries. Results All wounds were closed between Day 14-Day 90.Patients reported decreased pain with each subsequent dressing change. Reduced visits for debridement in the operating room (OR) and reduced time to the split tissue skin graft (STSG) application were reported in applicable cases. In most cases, wound size reduced by 50% within 2 weeks of therapy start. When C/ORC/silver dressing was added to NPWT there were no subsequent signs or symptoms of local infec­tion in any of the presented cases, and time to closure in these patients seemed to be expedited. Conclusions The presented case series suggest that NPWTi-d or NPWT with C/ORC or C/ORC/silver dressings is attrac­tive for inpatient adjunctive treatment of acutely infect­ed wounds. When wounds were debrided, early initiation of C/ORC/silver dressing in combination with NPWT improved healing rates and decreased local infection rates. The limitation of this case series is the lack of case con­trols to compare debridement times, healing times, and infection rates. Thus, comparisons were made to the general practice of the observers.