The impact of negative-pressure wound therapy with instillation compared with standard negative-pressure wound therapy: a retrospective, historical, cohort, controlled study

Plast Reconstr Surg. 2014 Mar;133(3):709-716. doi: 10.1097/01.prs.0000438060.46290.7a.

Abstract

Background: Negative-pressure wound therapy with instillation is a novel wound therapy that combines negative pressure with instillation of a topical solution.

Methods: This retrospective, historical, cohort-control study examined the impact of negative-pressure wound therapy with and without instillation.

Results: One hundred forty-two patients (negative-pressure wound therapy, n = 74; therapy with instillation, 6-minute dwell time, n = 34; and therapy with instillation, 20-minute dwell time, n = 34) were included in the analysis. Number of operative visits was significantly lower for the 6- and 20-minute dwell time groups (2.4 ± 0.9 and 2.6 ± 0.9, respectively) compared with the no-instillation group (3.0 ± 0.9) (p ≤ 0.05). Hospital stay was significantly shorter for the 20-minute dwell time group (11.4 ± 5.1 days) compared with the no-instillation group (14.92 ± 9.23 days) (p ≤ 0.05). Time to final surgical procedure was significantly shorter for the 6- and 20-minute dwell time groups (7.8 ± 5.2 and 7.5 ± 3.1 days, respectively) compared with the no-instillation group (9.23 ± 5.2 days) (p ≤ 0.05). Percentage of wounds closed before discharge and culture improvement for Gram-positive bacteria was significantly higher for the 6-minute dwell time group (94 and 90 percent, respectively) compared with the no-instillation group (62 and 63 percent, respectively) (p ≤ 0.05).

Conclusion: The authors' results suggest that negative-pressure wound therapy with instillation (6- or 20-minute dwell time) is more beneficial than standard negative-pressure wound therapy for the adjunctive treatment of acutely and chronically infected wounds that require hospital admission.

Clinical question/level of evidence: Therapeutic, III.

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Infective Agents / administration & dosage
  • Betaine / administration & dosage
  • Biguanides / administration & dosage
  • Chronic Disease
  • Cohort Studies
  • Debridement
  • Female
  • Humans
  • Male
  • Middle Aged
  • Negative-Pressure Wound Therapy / methods*
  • Retrospective Studies
  • Surface-Active Agents / administration & dosage
  • Therapeutic Irrigation*
  • Wound Healing
  • Wound Infection / surgery*
  • Wound Infection / therapy
  • Young Adult

Substances

  • Anti-Infective Agents
  • Biguanides
  • Surface-Active Agents
  • polihexanide
  • Betaine