Use of Negative Pressure Wound Therapy with Instillation and a Reticulated Open Cell Foam with Through Holes During Early-stage Management of Nonviable TissueSaeed A. Chowdhry, MD, FACS; and Cynthia A. Miller, RN
BACKGROUND: Treatment of complex wounds includes assessment, cleansing, debridement, primary closure or secondary intervention, and antimicrobial therapies. However, proper wound management can be complicated by the presence of nonviable tissue within certain regions of the wound bed. Recently, negative pressure wound therapy (NPWT) with instillation and dwell time (NPWTi-d) using a novel reticulated open-cell foam dressing with through holes (ROCF-CC) was reported to aid in the loosening and removal of thick exudate such as slough and nonviable tissue from wounds.
OBJECTIVE: This study describes the authors’ initial experiences using NPWTi-d with ROCF-CC to help manage wounds in 3 patients before early-stage assessment for nonviable tissue.
MATERIALS AND METHODS: There was no free flow of instillation solution into the thoracic cavity, and when indicated, all patients underwent serial debridement, which was guided by bedside wound assessment. After placing a ROCF-CC dressing, NPWTi-d was applied by instilling one-eighth-strength Dakin’s solution with a 20-minute dwell time followed by the negative pressure at -125 mm Hg for 2 hours. The total duration of NPWTi-d ranged from 7 to 10 days with ROCF-CC dressings changed every 2 to 3 days.
CASES: Patient 1 was a 37-year-old man with a sternal wound that had persisted for 7 weeks following a sternotomy for coronary artery bypass graft. In addition to coronary artery disease, comorbidities included morbid obesity, diabetes mellitus (DM), and hypertension (HTN). Patients 2 and 3 were a 52-year-old woman and a 44-year-old woman, respectively, with necrotizing soft tissue infections of a breast. Comorbidities included DM, HTN, obesity, and chronic kidney disease.
RESULTS: In each case, slough and/or nonviable tissue was removed following NPWTi-d with ROCF-CC, which allowed the authors to identify and distinguish nonviable areas within the larger wound beds.
CONCLUSIONS: In these cases, the use of NPWTi-d with ROCF-CC was a viable option in the early-stage cleansing of complex wounds.
Chowdhry SA, Miller CA. Use of negative pressure wound therapy with instillation and a reticulated open cell foam with through holes during early-stage management of nonviable tissue. Poster presented at: Symposium on Advanced Wound Care Fall; November 2-4, 2018; Las Vegas, NV.
Products: V.A.C. VERAFLO Therapy (KCI, an Acelity Company, San Antonio, TX); and V.A.C. VERAFLO CLEANSE CHOICE Dressing (KCI, an Acelity Company)
This abstract was not subject to the WOUNDS peer-review process.