Clinical Experience With the Use of Gauze-based Negative Pressure Wound Therapy
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Index: WOUNDS. 2012;24(8):227–233.
Abstract: Purpose. In this preliminary study, gauze-based negative pressure wound therapy (NPWT) was used to accelerate granulation tissue formation and promote closure in a number of wound types. The authors aimed to evaluate the efficacy of gauze-based NPWT using the Chariker-Jeter technique for wounds requiring delayed closure. Methods. A retrospective review was conducted of 50 patients with wounds not suitable for immediate primary closure. After initial irrigation, debridement, and antibiotic therapy, Chariker-Jeter technique NPWT was used and dressings were changed at 24- to 48-hour intervals before secondary closure or primary closure. In addition, a 4-point category scoring system (severe, moderate, mild, and none) was used to evaluate pain. Semi-quantitative data also were obtained. Results. Wound size decreased considerably, granulation tissue formation was accelerated, and exudate was reduced and removed by the end of the treatment.
The patients were followed for 12 months. Pre- and post-treatment averages of the wound surface areas were 90.21 ± 74.97 cm2 and 35.71 ± 53.63 cm2, respectively (P < 0.001). Average duration of treatment was 12.98 ± 3.18 days and average wound size reduction following the treatment was 64.61% ± 30.42%. Granulation tissue was clinically observed in all wounds by day 5. Six cases healed without any operation; the others required various reconstructive methods to cover the wounds. After surgical intervention, only 3 patients treated with gauze-based NPWT had a recurrence. No infections were observed during the follow-up period. According to the pain form, only 2 patients had severe pain. Conclusion. The gauze-based NPWT was found to be a safe and cost-effective method in temporary soft-tissue management of chronic nonhealing wounds suitable delayed closure.
Negative pressure wound care (NPWC) has been known to have the potential to promote wound healing, alleviate concerns such as increasing exudate and odor, and improve quality of life for patients. Various studies reported this method offers fewer dressing changes, decreased total hospitalization time, and reduced wound pain compared with conventional therapy.1
Several reports regarding polyurethane foam dressing show newly formed granulation tissue may grow into the polyurethane foam, making its removal painful during dressing changes. Foam dressing removal also can lead to damage to the wound bed.1 Various strategies by several authors have been adopted to reduce pain during dressing changes.2 However, the strategies applied did not solve the problem of pain, and the foam-based negative pressure wound therapy was not less expensive in the treatment of chronic nonhealing wounds until now.
In this study, the authors used gauze-based negative pressure wound therapy (NPWT) for the treatment of chronic nonhealing wounds suitable for delayed closure, and evaluated the efficacy of gauze-based NPWT using the Chariker-Jeter technique before delayed primary or secondary closure. The authors recorded wound dimension, patient complaints of pain, and cost at the end of the treatment period.