This document summarizes negative pressure wound therapy (NPWT), also known as vacuum-assisted wound closure therapy. It discusses the mechanism of action, components of a vacuum dressing, indications and contraindications for use, complications, and examples of wounds that were successfully treated with NPWT. NPWT works by optimizing blood flow, decreasing tissue edema and removing excess fluid to promote formation of granulation tissue and wound contraction. It is commonly used to treat acute surgical wounds, pressure ulcers, and chronic wounds like diabetic foot ulcers. The presentation includes before and after photos demonstrating reduced wound size and improved healing with NPWT.
3. INTRODUCTION
Negative pressure wound therapy refers to wound
dressing systems that continuously or intermittently apply
subatmospheric pressure to the surface of a wound to assist
healing. Negative-pressure wound therapy is also called
vacuum-assisted wound closure therapy, It has become a
popular treatment modality for the management of many
acute and chronic wounds.
4. MECHANISM OF ACTION
⢠Optimoze blood flow
⢠Decrease tissue edema
⢠Remove excessive fluid from bed
⢠Formation of granulation tissue
⢠Encourages wound contracture
5. CONTENT IN A VAC DRESSING
⢠Sterile open cell wound interface
⢠Flexible vaccum tubes
⢠Occlusive adhesive dressing
⢠Canister
⢠Vaccump pump
6. Pressure ulcer &
acute wound
125 mm of Hg 5 mins on then 2
min off
Mesh graft 50-75 mm of Hg 4-5 days
Chronic ulcers 50-75 mm of Hg Continously
Compromised
tissue flaps
125 mm of Hg
7. INDICATIONS
⢠The main reasons for using a mains-powered negative-pressure
wound therapy unit are:
1. Acute surgical and traumatic wounds
2. Subacute and dehisced wounds
3. Pressure ulcers
4. Chronic and open wounds (e.g., venous stasis ulcers and diabetic
foot ulcers)
5. Meshed grafts, to secure the graft in place and/or to accelerate the
epithelialisation of the donor site
6. An adjunct to skin grafts/flap procedures.
8. ⢠A battery-powered ambulant negative-pressure unit is
recommended for:
1. Venous stasis ulcers
2. Lower extremity ulcers
3. Pressure ulcersLower extremity flaps
4. Dehisced incisions i.e. a condition where the wound has a
premature opening or splitting along natural or surgical
suture lines due to improper healingGrafts.
9. CONTRAINDICATIONS
⢠Negative-pressure wound therapy is unsuitable for some
wounds.
1. Fistulas (tunnels) to organs and body cavities (non-enteric
and unexplored fistulas)
2. Necrotic (dead) tissue or eschar that has not been debrided
(sloughed-off dead tissue, or a scab)
3. Osteomyelitis (inflamed bones)
4. Wounds due to skin cancer
5. Beeding wound
6. Fungating tumors
11. This is Picture of before and after of 18 Yrs old open grade IIIb of right hand. He had
wound in anterior surface of wound. Through debribement then fixation was done then
VAC dressing was done.
Before application of VAC dressing his wound was 14*13 cm but after vac dressing the
wound became 13*11 cm with newly formed blood vessels and Dense fibrocolllagenous
tissue only after 7 days.
12. 57 yrs old male with open grade IIIa on dorsal surface of
elbow joint. Debribement was done and VAC was applied.
Before VAC his wound was 14* 6 cm but after VAC wound
was 13* 5 cm with healthy granulation tissue without exudate
thrn secondary closure was done
13. Ri Kumari Shrestha a diagnosed case of
diqbetic foot ulcer with HTN with DM with CKD
under medication. This is the wound after
debribement and VAC dressing.
14. CONCLUSION
⢠Vacuum assisted closure therapy appears to be a viable adjunct for
the treatment of open musculoskeletal injuries. Application of
subatmospheric pressure after the initial debridement to the wounds
results in an increase in local functional blood perfusion, an
accelerated rate of granulation tissue formation, and decrease in
tissue bacterial levels. Although traditional soft tissue reconstruction
may still be required to obtain adequate coverage, the use of this
device appears to decrease their need overall.
