Use of Mechanically Powered Disposable Negative Pressure Wound Therapy for Managing Dehisced Wounds

Despite advances in perioperative care, operative technique and understanding of risk factors, wound dehiscence remains a national healthcare quality concern such that it is one of the publicly reported outcome measures for the Center for Medicare and Medicaid Services. Early identification and appropriate management of wound dehiscence is key to reducing treatment costs. Standard of care includes debridement and regular cleansing/irrigation as needed, administration of culture-specific antimicrobials and/or antibiotics, protection of periwound tissue, and application of an appropriate dressing or therapy. Use of negative pressure wound therapy (NPWT) to help manage dehisced wounds has been reported in numerous studies with promising results. Patients with smaller, low exudating dehisced wounds may benefit from ultraportable, mechanically-powered disposable negative pressure wound therapy (dNPWT) that may allow a quick return to activities of daily living while receiving the effects of NPWT. A retrospective data analysis was performed to determine outcomes of 4 patients with dehisced wounds that were adjunctively treated with dNPWT. Average age of patients was 63 years old. Patients had undergone total knee arthroplasty, cyst removal, ankle open reduction internal fixation, or abdominoplasty prior to dehiscence. All wounds were debrided prior to dNPWT, and systemic antibiotics were administered in 2 of 4 patients. Disposable NPWT was applied with a foam dressing to each wound at -125 mmHg and changed twice weekly. One wound was primarily closed after 90 days of dNPWT, and the remaining 3 wounds healed via secondary intention after 41, 95 and 150 days of dNPWT. Mechanically-powered disposable negative pressure wound therapy was a convenient adjunctive therapy and resulted in positive outcomes for these patients with dehisced wounds.