Increased Quality in Negative Pressure Therapy Research
- Thu, 9/4/08 - 11:52am
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Dear Readers:
Various regimens of subatmospheric pressure, also known as vacuum, negative pressure wound therapy (NPWT), or topical negative pressure (TNP), have been used to manage complex wounds. Limited evidence supports NPWT efficacy on chronic or acute wound healing,1,2 where it was mainly compared to less than optimal3 saline gauze control dressings. One best evidence review found NPWT to be an acceptable adjunct therapy in managing infected sternal wounds following cardiac surgery.4 Reviewers generally agree that large randomized controlled trials (RCTs) are needed to support conclusions of efficacy compared to moist wound dressings (MWD) and to optimize usage regimens. This Evidence Corner summarizes two recent RCTs exploring the effects of different forms of NPWT on partial amputation sites on the feet of patients with diabetes, and split-thickness skin graft take in patients with burns or traumatic wounds, as compared to MWD.
Negative Pressure Wound Therapy Improves Diabetic Foot Amputation Site Healing
1. Evans D, Land L. Topical negative pressure for treating chronic wounds: a systematic review. Br J Plast Surg. 2001;54(3):238–242.
2. Morris GS, Brueilly KE, Hanzelka H. Negative pressure wound therapy achieved by vacuum-assisted closure: Evaluating the assumptions. Ostomy Wound Manage. 2007;53(1):52–57.
3. National Institute for Clinical Excellence. Guidance on the use of debriding agents and specialist wound care clinics for difficult to heal surgical wounds. Technology Appraisal Guidance–No. 24: April 2001.
4. Raja SG, Berg GA. Should vacuum-assisted closure therapy be routinely used for management of deep sternal wound infection after cardiac surgery? Interact Cardiovasc Thorac Surg. 2007;6(4):523–527.
5. Armstrong DC, Lavery LA, Harkless LB. Validation of a diabetic wound classification system. The contribution of depth, infection, and ischemia to risk of amputation. Diabetes Care. 1998;21(5):855–859.
6. Braakenburg A, Obdeijn MC, Feitz R, van Rooij IA, van Griethuysen AJ, Klinkenbijl JH. The clinical efficacy and cost effectiveness of the vacuum-assisted closure technique in the management of acute and chronic wounds: a randomized controlled trial. Plast Reconstr Surg. 2006;118(2):390–397.
7. Etoz A. Negative pressure wound therapy on diabetic foot ulcers. WOUNDS. 2007;19(9):250–254.
8. Armstrong DG, Lavery LA, Boulton AJ. Negative pressure wound therapy via vacuum-assisted closure following partial foot amputation: what is the role of wound chronicity? Int Wound J. 2007;4(1):79–86.
