Management of Pressure Injury with a novel Negative Pressure Device (NPD) in people with Spinal cord injury (SCI)

Introduction: Treatment of Pressure Injury (PI) is an ongoing clinical challenge particularly in people with SCI in developing countries where socio economic conditions often dictate treatment modalities. When negative pressure wound therapy (NPWT) was introduced, there were a series of devices (V.A.C., KCI, San Antonio, TX) manufactured. These devices for NPWT are costly and hard to afford by patients in developing countries like India and others. Considering this limitation, this study was planned to compare NPWT by an indigenized locally constructed NPD and conventional gauze dressing for the treatment of pressure injury.

Material and Methods: Thirty four (34) subjects of traumatic paraplegia having PI of stage 4 were enrolled and allocated in two treatment groups (NPWT Group & standard care group). The outcome measures were surface area (length X width) and depth of PU, exudates, microorganisms and cost effectiveness at week 0, 3, 6 and week 9.

Results: Significantly reduced length of PI in NPWT group was observed at week 6 (p=0.04) which further reduced at week 9 (p=0.001) as compared to conventionally treated group. Similarly significant reduction of width and depth of PI was observed in NPWT at week 9 (p<0.05). The exudate became significantly (p=0.001) lower in NPWT group from 6th to 9th week. Clearance of slough from wound bed and appearance of red granulation tissue was significantly higher in NPWT group (p=0.001). At week 9, the wound culture was negative in all the subjects of NPWT group, while it was positive in 10 (41⋅6%) subjects of conventional group.

Conclusion: NPWT by locally constructed novel NPD is better wound care procedure and cost effective for management of pressure injury.