What Is Negative Pressure Wound Therapy Used For?

Negative pressure wound therapy (NPWT), also known as vacuum-assisted closure (VAC) therapy or wound VAC, is a treatment method that uses a vacuum to promote wound healing by applying negative pressure to the wound bed. This therapy is commonly used for complex wounds, burns, and other acute and chronic wounds, and it is beneficial in promoting healing and reducing the risk of complications.

NPWT has several therapeutic benefits, which may include the following:

• Reducing edema or swelling around the wound, which can impede healing.
• Removing excess fluid and exudate from the wound bed, providing an environment that promotes healing.
• The negative pressure promotes blood flow to the wound area, which helps deliver oxygen and nutrients to the wound bed, which are essential for healing.
• NPWT has been shown to reduce the risk of infection by removing bacteria and debris from the wound bed.

NPWT can be used in various settings, including hospitals, outpatient clinics, and home care. It is typically used for wounds that have failed to heal using traditional wound care methods or for wounds at risk of complications, such as infection. NPWT is usually applied for several days to weeks, depending on the nature and severity of the wound.

In general, negative pressure wound therapy (NPWT) is used when other wound-care techniques have failed or when a wound does not heal as quickly as desired. It is important to note that NPWT is not appropriate for all types of wounds, and a healthcare professional should be consulted to determine if it is an appropriate treatment option.

• Promotes wound healing: Negative pressure wound therapy (NPWT) promotes wound healing by increasing blood flow to the wound site. This helps stimulate the growth of new tissue and speeds up the healing process. The negative pressure also removes excess fluids from the wound, reducing swelling and promoting the removal of dead tissue.
• Treats acute and chronic wounds: NPWT helps treat acute and chronic wounds, including surgical wounds, pressure ulcers, diabetic foot ulcers, and venous leg ulcers. The therapy helps reduce the risk of infection and can prevent the wound from becoming chronic.
• Reduces wound infection: Removing excess fluid and bacteria from the wound can reduce the risk of wound infection. NPWT helps create an environment less conducive to bacterial growth, reducing the risk of infection.
• Manages exudate: NWPT may manage excessive exudate (fluid) production in the wound site. The negative pressure helps remove the excess fluid from the wound, reducing the risk of infection and promoting healing.
• Reduces scarring: NWPT can help reduce scarring by promoting the growth of new tissue and reducing the risk of infection. The therapy can help prevent the formation of keloid scars.
• Prepares the wound for surgery: The therapy can be used to prepare a wound site for surgery. The therapy can help reduce the risk of infection, promote healing, and prepare the wound for closure.
• Reduces pain: NWPT reduces pain associated with wound healing. Negative pressure can help reduce swelling and inflammation, alleviating pain.

Negative pressure wound therapy (NPWT) works by applying negative pressure to a wound bed to promote healing, remove excess fluid and bacteria and stimulate tissue regeneration.

Steps involved in NPWT include the following:

1. Wound preparation: Before the application of NPWT, the wound is cleaned and debrided to remove any debris or dead tissue that may hinder healing. This is essential to ensure that negative pressure is evenly distributed throughout the wound bed.
2. Wound dressing application: A specialized foam or gauze dressing is applied to the wound bed, and a transparent adhesive film is placed over the top. The dressing is designed to wick away any excess fluid from the wound while providing a barrier against external contaminants.
3. Vacuum pump application: The vacuum pump is connected to the wound dressing through a tube, and negative pressure is applied to the wound bed. The pressure can be adjusted, according to the wound's requirements.
4. Suctioning of exudate: As negative pressure is applied, it creates suction that removes any excess fluid, exudate, and bacteria from the wound bed. The vacuum also promotes increased blood flow to the wound, which helps deliver oxygen and nutrients to the healing tissue.
5. Stimulation of tissue regeneration: NPWT stimulates tissue regeneration by encouraging the growth of new blood vessels and granulation tissue. This process helps fill the wound bed and promotes faster healing.
6. Wound closure: Once the wound has healed sufficiently, the NPWT dressing can be removed, and the wound can be closed using sutures, skin grafts, or other techniques.

NPWT is a noninvasive and effective technique for treating complex wounds that do not respond to conventional treatment methods.

Negative pressure wound therapy (NPWT) can be used in various clinical scenarios to promote wound healing, reduce the risk of infection and improve patient outcomes.

Here are some specific situations when NPWT may be used:

• Chronic wounds
  • NPWT is often used to manage chronic wounds, such as venous leg ulcers, diabetic foot ulcers, and pressure ulcers. Chronic wounds are wounds that have failed to heal within a reasonable time frame and are typically associated with underlying conditions such as diabetes or vascular disease.
  • NPWT can help promote wound healing by removing excess fluid from the wound bed, increasing blood flow to the wound, and promoting the growth of new tissue. The negative pressure applied to the wound bed can also help reduce the bacterial load and prevent infection.
• Acute wounds
  • NPWT may also be used to manage acute wounds, such as surgical incisions, traumatic wounds, and burns. Acute wounds occur suddenly and usually heal within a few weeks.
  • NPWT promotes wound healing by removing excess fluid from the wound, reducing the risk of infection, and promoting the growth of new tissue.
• Dehisced wounds
  • A dehisced wound is a wound that has opened up along the surgical incision or suture line. This can occur due to increased tension or pressure in the wound, infection, or poor wound healing.
  • NPWT can be used to manage dehisced wounds by promoting the growth of new tissue and preventing further separation of the wound edges. The negative pressure applied to the wound bed can also help remove excess fluid and promote wound healing.
• Open abdominal wounds
  • NPWT can be used in the management of open abdominal wounds, such as those caused by trauma or surgery. These wounds can be complex to manage and associated with a high risk of infection.
  • NPWT can help promote wound healing by removing excess fluid from the wound bed, reducing the risk of infection, and promoting the growth of new tissue.
• Infected wounds
  • NPWT can be used in the management of infected wounds to reduce the bacterial load in the wound bed and promote wound healing. 
  • The negative pressure applied to the wound bed can help remove excess fluid and reduce bacterial colonization, making it an effective adjunct to antibiotic therapy.

NPWT should be used under the guidance of a healthcare professional and in conjunction with other appropriate wound care techniques.

The level of pain experienced during negative pressure wound therapy (NPWT) can vary depending on several factors, including the patient's pain tolerance, the type and location of the wound being treated, and the settings used during the therapy.

During the application of the therapy, the wound is cleaned and then covered with a foam dressing. The dressing is connected to a vacuum pump that creates negative pressure and removes fluids from the wound. Some patients may experience discomfort during the application of dressing and attachment of the vacuum pump. The vacuum pump may also make a noise that some patients may find irritating.

However, once the dressing is in place and the therapy is started, most patients report feeling a sense of relief. This is because the negative pressure created by the vacuum helps remove excess fluid from the wound, reducing swelling and promoting blood flow to the area. The vacuum also creates a barrier that protects the wound from outside contaminants and accelerates healing.

Some patients may experience mild to moderate discomfort during the therapy, which can be managed with over-the-counter pain medications. In rare cases, patients may experience more significant pain, which can indicate that the therapy is not working as intended and should be reevaluated.

The success rate of negative pressure wound therapy (NPWT) varies depending on the type of wound being treated, but studies have reported that NPWT can be highly effective for a range of acute and chronic wounds.

• In a study of patients with newly transferred flaps, NPWT was applied to facilitate flap attachment and relieve flap infection and venous congestion. The success rate was 97.1 percent and the complication rate was 5.7 percent.
• In cases of enterocutaneous fistulas, NPWT showed a high success rate between 90 and 100 percent.
• In patients with pressure ulcers, NPWT was found to improve patient comfort and decrease wound care requirements.
• In patients at high risk of graft loss, NPWT was found to improve the rate of skin graft success.
• Level II NPWT reduces the wound closure time in acute open wounds.

Overall, NPWT is a highly effective treatment option for various wounds. The success rate of NPWT is generally reported to be between 70 to 90 percent. However, it's important to note that success rates can vary based on individual patient factors and the specific wound being treated. Patients should work closely with their healthcare providers to determine the best treatment plan for their needs and monitor their progress throughout the healing process.

Although negative pressure wound therapy (NPWT) is an effective treatment for various types of wounds, it also has several potential disadvantages and complications that must be considered.

The most common disadvantages and complications associated with NPWT:

• Pain and discomfort: NWPT can cause pain and discomfort in some patients, especially during the initial stages of treatment. The suction pressure can sometimes be too high, causing the patient to experience a pulling sensation or discomfort. This can be addressed by adjusting the suction pressure or using additional pain management techniques.
• Bleeding: In some cases, NPWT can cause bleeding or oozing from the wound site. This is typically due to the removal of fluids and debris from the wound, which can dislodge blood clots or cause small blood vessels to rupture. If this occurs, the suction pressure may be reduced or the dressing may be changed to prevent further bleeding.
• Infection: Although NPWT can help prevent infection by removing bacteria and other contaminants from the wound, it can increase the risk of infection if not used properly. The suction pressure can cause tissue damage or necrosis, creating a favorable environment for bacterial growth. Therefore, it is important to follow strict protocols for dressing changes and to monitor the wound for signs of infection.
• Skin irritation and maceration: NWPT can cause skin irritation and maceration around the wound site, especially if the dressing is not applied properly or the suction pressure is too high. This can lead to skin breakdown and infection if not addressed promptly.
• Cost: NPWT is a relatively expensive treatment compared to other wound care methods. The cost of the equipment and supplies, as well as the need for frequent dressing changes, can be a significant financial burden for patients and healthcare facilities.
• Device-related complications: Using NWPT devices can lead to various complications, such as blockages in the tubing, malfunction of the device, or dislodgment of the dressing. These complications can delay wound healing and require additional interventions to address.

Although NPWT can be an effective treatment for wound healing, it is important to weigh the potential disadvantages and complications before initiating treatment. Proper patient selection, dressing selection, and monitoring can help minimize the risks associated with this therapy.