Negative-pressure wound therapy for hospitalised patients: a paradigm shift
Keywords:
negative-pressure wound therapy, wall suctionAbstract
Background: Negative-pressure wound therapy (NPWT) is widely available, but due to the high cost of the treatment, it is not used to its full potential. Worldwide, wound care providers are trying to facilitate a more practical and cost-effective way of providing this essential therapy. Thus far, none of the low-cost solutions could solve the “tethered to the bed” problem of the wall suction technique. We designed a tubing (Woundprep®) that works with Luer connectors, which is well known by nursing staff. The connectors allow the patient or medical staff to easily and electively disconnect and reconnect the tubing for bathroom breaks, special investigations, or daily linen changes. We aimed to determine if NPWT can be provided with Woundprep® safely and practically in the hospital setting.
Method: A prospective observational study was undertaken that included 16 patients who required NPWT in the hospital. Data was collected prospectively regarding adverse events, pain level, interval of dressing changes, elective disconnection periods, and pressure settings. The tubing pressure was measured daily by a digital manometer in mmHg.
Results: No serious adverse events were recorded. No active bleeding occurred, even though 15 of the 16 patients received low-molecular-weight heparin (LMWH) thromboprophylaxis. No wound sepsis occurred whilst on NPWT with Woundprep®, and the average pain level was 2 out of 10 during treatment. The median interval of dressing changes was 72 hours (range 42–120 hours). The average pressure measured by the digital manometer was slightly higher (7%) than the regulator setting (112.5 vs. 121 mmHg). All patients actively participated in their wounds being connected or disconnected.
Conclusion: NPWT with wall suction and Woundprep® tubing is safe and practical in the hospital setting when standard guidelines are followed. This clinical study may stimulate further work on developing a protocol advising on NPWT in hospitalised patients.
