What is Negative Pressure Wound Therapy and How Does it Benefit Patients?
Advanced techniques for improving the rate of wound healing in acute and chronic non-healing wounds have continued to show promise over several decades. One such method is Negative Pressure Wound Therapy (NPWT), which aims to facilitate wound healing by modifying the pressure over a wound surface. This article will discuss NPWT, its efficacy, benefits to patients, as well as some known limitations.
What is Negative Pressure Wound Therapy?
Negative pressure wound therapy (NPWT), also known as vacuum-assisted wound closure (VAC) is a technique for improving the rate of wound healing using wound dressings and a vacuum device to apply intermittent pressure to the wound bed. The amount of pressure applied is usually lower than that of the atmosphere (subatmospheric). NPWT stabilizes the wound environment by draining excess fluid, minimizing edema, and pressurizing the wound bed to induce angiogenesis. The first documented attempt exploring the use of VAC to manage slow-healing wounds was in 1997 by L.C. Argenta and M. J. Morykwas, who used the technique to treat 300 patients, 296 of chronic and acute cases showed favorable results. Today, the procedure remains just as effective, as negative pressure device technology is more efficient.
How Does NPWT Work?
Air is a mixture of gases that exist all around us and exerts some pressure on our body surfaces. Research has shown that lowering the atmospheric pressure over a wound can promote healing. A VAC system consists of suitable wound dressings and a battery-powered device for generating required suction. Let's take a closer look at these elements:
Wound Dressings for NPWT
Several kinds of wound dressings are appropriate for NPWT, including foam dressings, woven gauze, and transparent films. The choice of dressing will depend on the nature of the wound, size, skin integrity, patient's age, and clinical objectives. For example, foam and gauze are suitable for open cavity wounds.
Negative Pressure Devices
VAC devices are battery-powered and consist of a pump and drainage tubing. Vacuum systems may run continuously or intermittently (On/Off) throughout the day. Most devices deliver a pressure of between −200 and −40 mmHg, which aids wound healing. They also contain a disposable canister for collecting exudate from the wound.
A wound care professional applies a primary wound dressing to the open wound (e.g., foam or gauze). Usually, the person cuts these to fit the size and shape of the area. Then, the professional places a drain tube on the dressing and applies an adhesive transparent film over as a secondary barrier and vacuum seal. The other end of the drain tube should connect to the battery-powered negative pressure device. When the unit is on, it should intermittently create suction, causing the foam dressing to collapse inwards and pulling the edges of the wound together. As this occurs, fluid from the wound bed also drains into the canister attached to the device. Depending on the nature of a patient's wounds or quantity of exudate, dressings will need to be changed once a week or up to several times daily.
What Types of Wounds are Appropriate for NPWT?
NPWT has proven to promote healing in both acute and chronic wounds with medium to heavy exudate. Examples include traumatic and dehisced injuries, diabetic foot ulcers, pressure ulcers, and venous insufficiency ulcers. Negative pressure can also improve wound healing in skin grafts and flaps.
Benefits of NPWT
The following are some benefits of negative pressure therapy for wound healing:
- Gradually drains excess fluid (exudate) from the wound bed
- Stimulates antibacterial action to prevent wound infections
- Reduces swelling (edema)
- Improves blood circulation in the wound bed
- Facilitates the growth of new tissue (granulation)
- Promotes a moist wound healing environment
- Helps to pull the edges of wounds together, aiding faster closure
- Minimizes inflammation (redness and swelling)
Negative pressure wound therapy is unsuitable for use in the patients having any of the following conditions:
- Fistula (a medical condition where there is an abnormal connection between the skin and the stomach or intestinal tract)
- Malignant wounds (e.g., those due to skin cancer)
- Untreated osteomyelitis (bone infections)
- Wounds containing necrotic tissue with un-debrided eschar
- Fragile or compromised skin (e.g., in older patients or due to prolonged use of topical steroids
NPWT also has some risks which, although rare, may affect some patients. These include wound infection, bleeding, and enteric fistula. However, wound care experts can mitigate these risks by carrying out a careful evaluation of each patient to determine if they could be good candidates for negative pressure wound therapy.
The Wound Docs: Amputation Prevention At Its Finest
Every three minutes an African American experiences lower extremity amputation that most likely could have been prevented. The Wound Docs is a national network of podiatric surgeons, vascular surgeons, and wound care specialists dedicated to reducing the amputation rate in vulnerable populations across the country. By partnering with the Wound Docs, physicians gain access to a robust automatic wound measuring system as well as advanced biologics (skin substitutes) known to significantly increase the rates of wound closure.
Exercise Routines for Health and Fitness: Moderate and High-intensity Workouts
There are different types of exercises; you get better results when you choose a combination of activities that cater to your needs. Research shows that you can gain tremendous benefits by doing a mix of four types of exercise: endurance activities, strength training.
Foam Dressings: Benefits And Applications
Non-adhesive foam dressings require the use of an additional secondary dressing to be secured in position. In general, thin foam dressings have an adhesive wound contact layer.
Hydrogel Wound Dressings: Benefits And Applications
Hydrogel wound dressings belong to the class of modern wound dressings that actively stimulate the wound healing process. They are composed of synthetic polymers with a high water content formed in the shape of sheets, amorphous gels, and foams.
Alginate Wound Dressings: Benefits And Applications
In the United States, approximately 6 million people are affected by chronic wounds. The number is only expected to increase with the rise in the elderly population. Wound dressings form an essential component of wound care.
How Obesity and Overweight Affects Wound Healing
Obesity and excessive weight are conditions that continue to disproportionately affect Black and African American people in the United States.
Understanding and Tackling Hypertension in African American Communities
Hypertension, also known as high blood pressure, is more prevalent in African American communities than in other racial groups in the United States. A Centers for Disease Control and Prevention (CDC) report indicated that about 5 in 10 non-Hispanic Black adults are hypertensive.
Understanding the Risk Factors for Pressure Ulcers
Pressure ulcers, also called bedsores or decubitus ulcers, are areas of localized damage to the skin and underlying tissue. They result from unrelieved pressure on the skin, friction, shear, or a combination of these.
The Role of Artificial Intelligence in Amputation Prevention
With the various technological advancements, amputation prevention through proper wound care is an attractive area for Artificial Intelligence (AI). In 2002, the whole world was in awe when Google brain, an Artificial Intelligence research team, could find a cat in a YouTube video.
The Role of Advanced Biologics (Skin Substitutes) in Wound Healing
For a long time now, limb amputation has affected the mobility of African Americans living with chronic diseases. Worse still, studies have shown that limb amputation among diabetes
Know Better, Do Better: Adopting Healthy Lifestyles for Amputation Prevention
Black Americans are twice as likely to develop pulmonary artery disease (PAD) – a leading cause of lower limb amputation – as any other race.
Tackling the Education Gap: Encouraging Medical Careers Among Black Students
Black and African American doctors make up 5% of all active physicians in the country – a mere 45,534 healthcare professionals. With the African American population at about 46.9 million, it is clear why Black communities are underserved.
The Amputation Epidemic in Black America: What Everyone Needs to Know
Peer-reviewed studies have revealed that black patients are three times more likely to lose limbs than the national average. In black populated areas with little or no access to quality healthcare...
Why Are Black People Losing Limbs More Often?
Now more than ever, Blacks and African Americans are losing lower extremity limbs. In recent years, there has been a stark difference in the amputation rates in Black and white communities.
Peripheral Arterial Disease (PAD) and Its Impact On Wound Care
Peripheral Artery Disease (PAD) is the narrowing of the arteries in the arms, legs, and internal organs. It’s often caused by atherosclerosis which is the buildup of fat and cholesterol – called plaque – in the arteries.
Promoting Physical Exercise and Mobility in African American Communities
Inadequate physical inactivity has increasingly been recognized as a leading cause of mobility problems and early mortality in the world.
A Spotlight on Healthcare Disparities in African American Communities
Even with promising interventions such as the enactment of the Affordable Care Act, healthcare equality in the U.S. seems like a distant goal. African Americans are still more likely to be burdened with chronic diseases
Avenues for Promoting Health Awareness in African Communities
Disparities in healthcare remain a serious problem in African American communities. The history of slavery and other social determinants like systemic racism and access to healthy foods undoubtedly underlie the inexcusably poor state of African American health.
The State of Black Health in America
Over 150 years from the abolishment of slavery, healthcare in America is stilled marred by systemic racial discrimination and inequality. According to the CDC, 20.2 percent of black American adults are living in fair or poor health. This is a visibly higher population compared to white, non-Hispanic (14.1 percent).
Black Nutrition: Are You Eating The Right Diet?
Blacks have dietary preferences born from cultural influence. A study conducted on 7,000 men and women over 45 years living across the U.S. found that Black participants were more likely to eat a diet comprising highly processed foods compared to their White counterparts. Further, 46% of Blacks and 33% of Whites developed hypertension, with diet being the reason for much of the disparity.
Debridement: A Critical Component of Wound Treatment
Debridement is a part of the standard DIME technique for wound bed preparation in chronic wounds.
What is Negative Pressure Wound Therapy and How Does it Benefit Patients?
Negative Pressure Wound Therapy (NPWT) aims to facilitate wound healing by modifying the pressure over a wound surface.
The Benefits of Telemedicine To Wound Care
Telemedicine is particularly beneficial in long-term care facilities where a significant number of Americans living with chronic conditions such as non-healing wounds reside.
Why are Some Wounds Slow To Heal?
Chronic slow-healing wounds are those that fail to progress through a timely and predictable sequence of repair.
What is Hyperbaric Oxygen Wound Therapy and How Does it Benefit Patients?
Chronic non-healing wounds such as diabetic foot ulcers and venous insufficiency ulcers remain in the inflammatory state despite adequate management, prolonging wound healing, and adversely affecting the quality of life of patients.
Diagnosis and Management of Pressure Ulcers
Leading research estimates a prevalence of up to 27% of pressure ulcers in patients living at long-term care facilities. Elderly patients (above 70 years of age), obese patients, patients with limited mobility, and those with underlying medical conditions e.g., peripheral arterial disease, and multiple sclerosis are the most at risk of developing pressure ulcers.
Compression Therapy for Wound Management
For patients living with chronic wounds such as venous ulcers, compression therapy can help to ease symptoms and aid wound healing.
Democratizing Wound Care in Hospice Care Facilities
Hospice care facilities provide care for the terminally ill, including patients battling late-stage cancer, heart disease, and kidney failure, as well as those living with chronic non-healing wounds.
Dealing With Diabetic Foot Ulcers During The Pandemic
People living with diabetes represent a subset of individuals with special health needs due to the nature of the disease.
What Clinicians Need To Know About Wound Care Dressings
To healthcare experts, choosing the right dressing is critical to improving wound healing outcomes in patients.