The Negative Pressure Revolution: Single-Use Negative Pressure Wound Therapy

Over the past few years, negative pressure wound therapy (NPWT) has undergone a transformation. Single-use NPWT (sNPWT) devices have been developed to allow patients more and better options. Previous data¹ comparing different traditional NPWT (tNPWT) devices suggested that the devices provided similar clinical outcomes. However, new published data^2,3 find that sNPWT devices are superior to tNPWT for commonly encountered wounds in the outpatient wound center setting (eg, in patients with venous leg ulcers or ­­­diabetic foot ulcers). Data⁴ has shown those who received sNPWT had greater wound size reduction, had more complete healing, and preferred sNPWT due to better scores related to quality of life compared with tNPWT.

However, sNPWT is not suitable for all wounds in need of NPWT. Therefore, it is critical that clinicians have a rational way to select the right type of NPWT for their patients. A consensus document was recently developed to help address this issue.⁵ The document includes an algorithm to help choose the right NPWT device. This algorithm suggests that if both options exist, then the first step is to determine whether the size of the wound is suitable for sNPWT; if so, it should be determined if the amount of drainage is suitable to use sNPWT. If both of these answers are yes, the next step is to determine if the wound depth requires the need for a filler. If a filler is to be used, the next step is to determine whether an antimicrobial-impregnated filler is appropriate. Finally, if tNPWT is chosen, continuous monitoring is required because, at some point, it might be appropriate to either discontinue NPWT or transition to sNPWT.⁵ These situations might include a transition from an inpatient to an outpatient setting or a change in wound size or drainage.

References

1. Hurd T, Rossington A, Trueman P, Smith J. A retrospective comparison of two negative pressure wound therapy systems in the management of wounds of mixed etiology. Adv Wound Care (New Rochelle). 2017;6(1):32–37. doi:10.1089/wound.2015.0679

2. Kirsner R, Dove C, Reyzelman A, Vayser D, Jaimes H. A prospective, randomized, controlled clinical trial on the efficacy of a single-use negative pressure wound therapy system, compared to traditional negative pressure wound therapy in the treatment of chronic ulcers of the lower extremities. Wound Repair Regen. 2019;27(5):519–529. doi:10.1111/wrr.12727

3. Armstrong DG, Marston WA, Reyzelman AM, Kirsner RS. Comparison of negative pressure wound therapy with an ultraportable mechanically powered device vs. traditional electrically powered device for the treatment of chronic lower extremity ulcers: a multicenter randomized-controlled trial. Wound Repair Regen. 2011;19(2):173–180. doi:10.1111/j.1524-475X.2010.00658.x

4. Kirsner RS, Hurd T. Assessing the need for negative pressure wound therapy utilization guidelines: an overview of the challenges with providing optimal care. Wounds. 2020;32(12):328–333.