CLINICAL CASE SERIES OF THE EFFICACY OF USING NEGATIVE PRESSURE WOUND THERAPY WITH INSTALLATION AND RETICUALTED OPEN CELL FOAM FOR TRAUMA WOUNDS

INTRODUCTION: Negative pressure wound therapy (NPWT) is used to promote granulation tissue and faster wound healing. Local blood supply is improved increasing granulation tissue formation and promoting tissue contraction.¹ NPWT with instillation (NPWTi) was introduced in 2002 to help relieve bioburden and remove exudate. NPWTi utilizes a period of negative pressure and a period of soak time, Normal saline is usually solution chosen¹. NPWT and NPWTi are limited to wounds that do not have thick exudate and slough. Therefore, NPWTi with reticulated open foam (ROFC) was introduced in 2016 to debride wounds that were difficult to debride or when surgery is not an option for the patient. NPWTi with ROFC utilizes the reticulated foam with 1cm diameter holes placed 0.5cm apart to help remove thick exudate, fibrotic tissue, and slough.² The combined use of NPWTi and ROFC provides rapid cleansing of wounds and supplement wound healing.³ CASE SERIES: All patients were elderly. All have a history of poor healing and multiple co-morbidities. All the wounds were due to trauma. Patients were seen during inpatient stay and then in the outpatient wound clinic. Surgical debridement of the wounds was performed before the NPWTi with ROFCC was applied. The ROFC was applied directly to the wound bed. A cover layer without holes was applied over the reticulated foam, followed by clear drape. The instillation was connected to the dressing. NPWTi was started with negative pressure at -125mmHg for 3.5 hours and 10 minutes normal saline soak. The dressings were changed 3x/week. CONCLUSION: Rapid improvement was shown by all wounds on the first dressing change. All wounds went on to complete healing. The ROFC with NPWTi in conjunction with surgical debridement provided excellent wound healing in all three cases.