The History and Effectiveness of Negative Pressure Wound Therapy - Part One

In part one of this three-part NPWT educational series offered in partnership with ExtriCARE USA, we will explore the history of NPWT, what makes it clinically effective and who can benefit from this promising treatment as it continues to advance.

Negative pressure wound therapy (NPWT) uses controlled negative pressure to remove fluid from open wounds¹. This is done through a sealed or foam dressing connected to a vacuum pump and canister¹. Closed-system negative pressure is relatively new in modern medicine and will continue to evolve for better patient outcomes.

Although NPWT has increased in utilization over the past decade due to positive results and data showing its effectiveness in healing many acute and chronic wounds, it has potential for even more growth and innovation.

It is essential to understand the first iterations of NPWT and the timeline on how it has become a staple in modern wound care. Delving into a brief history of NPWT will explain how it has become a key player in improving patient outcomes and clinician satisfaction.

A Brief History of NPWT

The origins of NPWT can be traced to ancient times. Although its most current form was initially developed in the early 1990s, its roots date back to the earliest civilizations. During the Roman era, individuals believed to have hereditary powers of healing would give direct suction by mouth to a wound³. This was proved so successful that it became an indispensable resource for the Roman army³.

By the 18th century, mouth sucking, also known as “lip service,” became a highly effective approach to wound healing³. This approach inspired Dr. Anel to invent a suction syringe to replace the need for direct mouth contact and eventually became the alternative to lip service³.

In the 20th century, the Soviet-Afghanistan War served as a significant catalyst to advancements in wound care. Dr. Nail Bagaoutdinov, a Soviet surgeon, began using a negative pressure unit to treat infected war wounds³. In 1985, Dr. Katherine Jeter used wall suction to administer negative pressure to a wound, which helped showcase the benefits². Fast forward to the 1990s, Drs. Louis Argenta and Michael Morykwas of Wake Forest University School of Medicine pioneered the first rendition of the modern NPWT system³.

Since then, and with the boost of technology, NPWT has steadily advanced and become one of the most promising treatments in wound care. ExtriCARE USA strongly believes modern NPWT is still in its infancy stage, and its effectiveness, along with innovation, will continue to increase its utilization in years to come.

Because this therapy is relatively new in modern medicine, it gives us a prime opportunity to innovate, healing wounds simpler and more efficient. However, that leads us to ask—what makes it so effective in the first place?

NPWT Effectiveness

There are three main components we focus on when thinking about NPWT effectiveness.

1. The protection of the wound bed
2. The reduction in healing time
3. Patient comfort and confidence

Protection

Because NPWT is a closed system, it helps protect the wound bed from external contaminants. NPWT also maintains a perfect moisture balance in the wound for a more optimal healing environment. There are fewer dressing changes, which protects the wound by decreasing the risk of going back to an inflammatory stage.

Healing

NPWT has been proven to reduce the wound healing time. The therapy promotes granulation, which reduces edema and creates new capillary beds. This brings nutrients to the wound bed. By administering NPWT, data has proven to heal wounds faster than traditional methods⁴.

Confidence

NPWT increases the mobility of patients, allowing them to continue living with confidence. NPWT shields the wound, giving patients privacy and comfort. Because of fewer dressing changes and the privacy this gives patients, they can focus more on living a comfortable life and less on managing the wound. With NPWT, the wound is taken care of 24/7, bringing less worry and burden to the patient.

NPWT removes bacteria and excess exudate, keeps the perfect moist wound bed environment, and promotes quicker healing. The ease of use with NPWT makes it better for patients to be mobile, living their life with more integrity. Patients can feel confident knowing their wound is being attended to and taken care of.

Who Can Benefit From NPWT?

We firmly believe NPWT can be used on many different types of wounds and should be used as the first line of defense in wound healing. Traditionally, NPWT has been seen as a last resort for many patients with non-healing wounds. This is starting to change with new data and innovation.

In part one, we have looked at the past to understand the scope of NPWT’s potential. In part two, we will dive into what is currently happening with NPWT, the different types of wounds NPWT can treat, and the challenges we face with this promising therapy. Part two will be published in September on the Wound Care Learning Network.

About ExtriCARE USA:

ExtriCARE USA is a national medical device distribution company specializing in negative pressure wound therapy (NPWT). Our products save clinicians time and benefit patients by introducing solutions that are mobile and provide a more flexible therapy. To learn more, visit www.extricareusa.com.

References:

1. Goonoo N, Bhaw-Luximon A. Nanomaterials combination for wound healing and skin regeneration. In: Du Toit LC, Kumar P, Choonara YA, Pillay V, eds. Advanced 3D-Printed Systems and Nanosystems for Drug Delivery and Tissue Engineering. Elsevier; 2020:159–217. doi:10.1016/b978-0-12-818471-4.00007-8

2. Kucharzewski M, Mieszczański P, Wilemska-Kucharzewska K, Taradaj J, Kuropatnicki A, Sliwiński Z. The application of negative pressure wound therapy in the treatment of chronic venous leg ulceration: authors experience. Biomed Res Int. 2014;2014:297230. doi:10.1155/2014/297230

3. Miller C. The History of Negative Pressure Wound Therapy (NPWT): From "Lip Service" to the Modern Vacuum System. J Am Coll Clin Wound Spec. 2013;4(3):61-62. Published 2013 Nov 28. doi:10.1016/j.jccw.2013.11.002

4. Seidel D, Diedrich S, Herrle F, et al. Negative Pressure Wound Therapy vs Conventional Wound Treatment in Subcutaneous Abdominal Wound Healing Impairment: The SAWHI Randomized Clinical Trial. JAMA Surg. 2020;155(6):469-478. doi:10.1001/jamasurg.2020.0414