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      KCI등재후보 SCOPUS

      Clinical Outcomes of Negative-Pressure Wound Therapy with Instillation without Commercial Devices in the Treatment of Complex Wounds

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      https://www.riss.kr/link?id=A107297850

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      다국어 초록 (Multilingual Abstract)

      Background: Negative-pressure wound therapy with instillation (NPWTi) is an adjunctive treatment modality for complex and infected wounds. However, commercial devices are expensive and not readily available in many countries. The objective of this stu...

      Background: Negative-pressure wound therapy with instillation (NPWTi) is an adjunctive treatment modality for complex and infected wounds. However, commercial devices are expensive and not readily available in many countries. The objective of this study is to introduce an NPWTi method that is applicable where commercial NPWTi devices are not available and to report the clinical outcomes of the NPWTi method for the adjunctive treatment of complex wounds.Methods: This prospective clinical experimental study included 51 patients who had wounds on which operative debridement was performed between January 2017 and March 2019. A negative-pressure wound therapy (NPWT) device was applied with an intravenous (IV) line for continuous instillation of 0.9% normal saline plus 1% povidone-iodine solution for chronic wounds. The outcomes measured were the number of operating room visits, time to final surgical procedure, number of infected wounds, time to resolution of infection, type of reconstruction operation, and occurrence of complications.Results: The average number of operations performed was 2.5±0.8, and the time to final surgical procedure was 28.4±15.4 days. The number of infected wounds was 35 (68.6%), and the time to resolution of infection was 15.0±14.6 days. All wounds were closed or covered. Though partial graft failure occurred in two cases, they healed completely by secondary healing in 2 weeks.Conclusion: A continuous-instillation NPWT system using an IV line could be an adjunctive modality in treating complex wounds at institutions where commercial NPWTi systems are not readily available.

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      참고문헌 (Reference)

      1 Fleischmann W, "Vacuum sealing as carrier system for controlled local drug administration in wound infection" 101 : 649-654, 1998

      2 Gabriel A, "Use of negative pressure wound therapy with automated, volumetric instillation for the treatment of extremity and trunk wounds : clinical outcomes and potential cost-effectiveness" 14 : e41-, 2014

      3 Back DA, "Recommendations on negative pressure wound therapy with instillation and antimicrobial solutions - when, where and how to use: what does the evidence show?" 10 (10): 32-42, 2013

      4 Kiyokawa K, "New continuous negative-pressure and irrigation treatment for infected wounds and intractable ulcers" 120 : 1257-1265, 2007

      5 Timmers MS, "Negative pressure wound treatment with polyvinyl alcohol foam and polyhexanide antiseptic solution instillation in posttraumatic osteomyelitis" 17 : 278-286, 2009

      6 Goss SG, "Negative pressure wound therapy with instillation(NPWTi)better reduces post-debridement bioburden in chronically infected lower extremity wounds than NPWT alone" 4 : 74-80, 2014

      7 Kim PJ, "Negative pressure wound therapy with instillation : review of evidence and recommendations" 27 : S2-S19, 2015

      8 Gabriel A, "Negative pressure wound therapy with instillation : a pilot study describing a new method for treating infected wounds" 5 : 399-413, 2008

      9 Sakakibara S, "Negative pressure wound therapy with focal irrigation using a preexisting instrument" 7 : 110-117, 2016

      10 Cortell-Fuster C, "Negative pressure therapy with instillation for the treatment of infected wounds : recommendations of utilization based on evidence" 43 : 6-12, 2019

      1 Fleischmann W, "Vacuum sealing as carrier system for controlled local drug administration in wound infection" 101 : 649-654, 1998

      2 Gabriel A, "Use of negative pressure wound therapy with automated, volumetric instillation for the treatment of extremity and trunk wounds : clinical outcomes and potential cost-effectiveness" 14 : e41-, 2014

      3 Back DA, "Recommendations on negative pressure wound therapy with instillation and antimicrobial solutions - when, where and how to use: what does the evidence show?" 10 (10): 32-42, 2013

      4 Kiyokawa K, "New continuous negative-pressure and irrigation treatment for infected wounds and intractable ulcers" 120 : 1257-1265, 2007

      5 Timmers MS, "Negative pressure wound treatment with polyvinyl alcohol foam and polyhexanide antiseptic solution instillation in posttraumatic osteomyelitis" 17 : 278-286, 2009

      6 Goss SG, "Negative pressure wound therapy with instillation(NPWTi)better reduces post-debridement bioburden in chronically infected lower extremity wounds than NPWT alone" 4 : 74-80, 2014

      7 Kim PJ, "Negative pressure wound therapy with instillation : review of evidence and recommendations" 27 : S2-S19, 2015

      8 Gabriel A, "Negative pressure wound therapy with instillation : a pilot study describing a new method for treating infected wounds" 5 : 399-413, 2008

      9 Sakakibara S, "Negative pressure wound therapy with focal irrigation using a preexisting instrument" 7 : 110-117, 2016

      10 Cortell-Fuster C, "Negative pressure therapy with instillation for the treatment of infected wounds : recommendations of utilization based on evidence" 43 : 6-12, 2019

      11 Lehner B, "First experiences with negative pressure wound therapy and instillation in the treatment of infected orthopaedic implants : a clinical observational study" 35 : 1415-1420, 2011

      12 Huang C, "Effect of negative pressure wound therapy on wound healing" 51 : 301-331, 2014

      13 Kim PJ, "Comparison of outcomes for normal saline and an antiseptic solution for negative-pressure wound therapy with instillation" 136 : 657e-664e, 2015

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