Comparison of Wound Closure in Chronic Lower Extremity Wounds Between Single-Use Negative Pressure Wound Therapy and Traditional Negative Pressure Wound Therapy: A Real-World Analysis

Introduction: Evidence for single-use negative pressure wound therapy (sNPWT) in managing surgical incisions is demonstrated across surgical indications. However, there is limited evidence in chronic wounds. Recently, a randomized clinical trial demonstrated superior clinical outcomes for sNPWT compared to tNPWT in lower extremity ulcers (LEU). The aim of this study was to examine wound closure in sNPWT and tNPWT in chronic LEU patients from a real-world evidence perspective.

Methods: This retrospective cohort study was conducted by identifying diabetic foot or venous leg ulcers from an outpatient wound clinic EMR from 2014 to 2018. The treatment period began with the first application of NPWT and continued until the LEU closed or the patient was lost to follow-up. Patients were excluded if they received both types of NPWT, had missing clinical information, and had their NPWT treatment started more than 60 days from the start of the wound episode. Patients were matched on demographic characteristics, comorbidities, and initial wound surface area using propensity score matching. Wound closure was reported descriptively and estimated using multiple logistic regression analysis controlling for days before NPWT treatment start.

Results: One-to-one propensity score matching method matched 146 sNPWT to tNPWT patients with initial surface area of 10.93 cm² and 10.71 cm², respectively. Descriptive analysis estimated that sNPWT improved wound closure (46.58% vs. 34.93%; p-value=0.0429) while regression analysis estimated sNPWT wounds were 89% more likely to close (OR=1.89; 95% CI=1.02-3.51; p-value=0.0423). Before matching, there were 199 sNPWT and 590 tNPWT patients with mean initial surface area of 9.65 cm² and 28.26 cm², respectively. Still, descriptive analysis estimated that sNPWT had statistically significant higher wound closure rate (51.26% vs. 38.47%; p-value=0.0016).

Conclusions: In chronic LEU patients, sNPWT validated the results of the previously published RCT in demonstrating a higher wound closure rate in a real-world setting to tNPWT.