negative pressure wound therapy (NPWT)

MoA

macrostrain

microstrain

role of macrostrain

• draws wound edges together

• removes exudate and infectious material

• reduces edema

• promotes perfusion

role of microstrain

creates tissue microdeformation causing cells to stretch and migrate to form granulation tissue

types of wounds indicated

• dehisced

• surgical incisions

• pressure injuries

• traumatic

• diabetic ulcers

• venous leg ulcers

• muscle flaps and skin grafts

  • partial-thickness burns

contraindications

• malignancy

• untreated osteomyelitis

• non-enteric and unexplored fistulas

• necrotic tissue with eschar

What should we not put the foam directly on

• exposed BVs

• anastomotic sites

• organs

• nerves

components of NWPT

• suction tubing

• transparent film

• wound filler (foam)

• collection chamber

• NPWT unit

types of foam

open pore

high density

what type of foam is hydrophobic

open pore

what type of foam is hydrophilic

high density

What type of foam is indicated for tunnels and undermining

high density

purpose of high density foam

• potentially reduce need for additional interposing materials/layers

• reduce the likelihood of adherence to the wound base

• minimize discomfort

types of transparent films

acrylic

silicone/acrylic hybrid

basic dressing change process

1. assess wound

2. protect periwound

3. trim foam to fit the wound

4. place inside wound

5. trim and apply transparent film

6. follow manufacturer guidelines on suction tube placement

7. attach to NPWT unit and turn on