Consensus Statements on Hypochlorous Acid as a Solution for Negative Pressure Wound Therapy with Instillation

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Dr. Paul Kim discusses key points from his article, "Multidisciplinary Expert Consensus Statements and Recommendations for use of Hypochlorous Acid as a Solution for Negative Pressure Wound Therapy With Instillation"; coauthors included Luis Fernandez, MD; Mary Ann Obst, RN, BSN, CCRN, CWON; Abigail Chaffin, MD, CWSP; Elizabeth Faust, MSN, CRNP, CSWS, CWOCN-AP, MAPWCA; John Lantis, MD; Kara Couch, MS, CRNP, CWCN-AP; Michael Desvigne, MD, CWS; Mark Suski, MD, CWSP; Neilendu Kundu, MD; Marc Mathews, MD, MS; Richard Simman, MD; Christine Murphy, PhD, RN, WOCC; Natalie E. Nierenberg, MD, PhD; and Luc Téot, MD, PhD. Read the full paper here.

Transcript:

Paul J. Kim, DPM, MS:

Hello everyone, my name is Paul Kim. I'm a professor in the departments of plastic surgery and orthopedic surgery at the University of Texas Southwestern here in Dallas, Texas. I'm also the medical director of the wound program here. I just want to get your attention to a new article that's coming out in Wounds. The title is “Multidisciplinary Expert Consensus Statements and Recommendations for use of Hypochlorous Acid as a Solution for Negative Pressure Wound Therapy with Instillation.”

I'm very excited to be the primary author on this. I'm also co-authored by multiple different disciplines and specialties, including 15 members of an expert consensus panel that was convened discussing the topic of using negative pressure wound therapy with installation with a specific type of solution hypochlorous acid. In this manuscript, there are 10 consensus statements that address some of the questions and concerns that users may have of using the 2 technologies in combination. There have been 6 prior consensus guidelines published to date, and this will be the 7th. And I think this will really put a bookend on some of the questions that you may have.

This was a collaborative effort, and really, truly reflects the wound care community. There were 15 members, as I had mentioned earlier, and they represent all kinds of disciplines including those in the surgical specialties and the non-surgical specialties, as well as nursing and nurse practitioners. I invite you guys to read this informative article, and I think you're going to recognize a lot of the names. They're the top experts in both the negative pressure wound therapy with installation and on antiseptics in general. Thank you very much.

Negative pressure wound therapy with installation has been more widely adopted in the last several years, and a lot of people use a lot of different types of solutions in conjunction with this device. And one of the commonly used solutions was hypochlorous acid. But one of the concerns that some people had was there was concern that the solution would precipitate or crystallize into the tubing. And so we can, one of the reasons we convened this panel is to really investigate that piece of it.

And it turns out that it doesn't do that. But what we think happens is the combination of that solution specifically and negative pressure wound therapy with installation, what that does is it synergistically causes more emulsification of non-viable tissue. Therefore, that debris looks like crystallization when it's actually not crystallization. It's just debris from the wound bed. And hopefully, that will address some of these concerns people have of this solution used in combination with negative pressure wound therapy with installation.

And now that's one of the statements that we cover and there are other questions that you may have had with using the combination of those 2 technologies. Along with the consensus statements, we do actually provide some technique recommendations. If you do have that issue of the solid debris causing alarms and leaks, we do have some technique recommendations, if that happens to you, including one of using the 2 different ingress and egress ports versus the single lily pad, so to speak. And so I think that will be very helpful to clinicians in practice.

As far as the other consensus guideline statements that we created in this document, they're pretty consistent with the other observations and other statements that have been made in the past. So you're not going to see anything that will be extraordinarily different or that you should think about when using hypochlorous acid in combination with negative pressure wound therapy with installation.

I think there's a lot of opportunity in the future to study this more closely. The question of solution choice has always been one that is basically based on the user preference. I think there should be perhaps a larger registry built on using different types of solutions to optimize the solution choice with the use of negative pressure wound therapy with installation.