Utilizing Disposable, Mechanical NPWT Devices to Aid Wound Management at Home: Cost Savings Considerations

In this clinical case presentation, Dr Napolitano describes 3 cases using mechanically powered, disposable negative pressure wound therapy. The cases covered in this presentation include an open wound after hematoma excision, Charcot foot deformity presenting with a diabetic foot ulcer, and an open wound after ankle fusion surgery. Data from this poster were presented at the SAWC Fall in Las Vegas, Nevada (October 29-31, 2021).

For more information, see Utilizing Disposable, Mechanical NPWT Devices to Aid Wound Management at Home: Cost Savings Considerations here.

Transcript

Hello. I'm Ralph Napolitano, podiatrist and wound care specialist with OrthoNeuro, a multi-specialty orthopedic and neurology practice based out of Central Ohio. Thank you very much for your time today.

Today, we're going to discuss an abstract that was presented at the Symposium on Advanced Wound Care this past fall. It looks at negative wound therapy devices and costs. Specifically, the title of this abstract is "Utilizing Negative Pressure Mechanical Wound Therapy Devices to Aid in Wound Management at Home—Cost Savings Considerations."

Three cases are highlighted. Our first case is that of an 85-year-old gentleman who presented with an open wound after an excision of a hematoma. Fairly healthy, he did have peripheral vascular disease and was a smoker.

He was started on this device, but therapy was interrupted due to a femur fracture. We utilized negative pressure wound therapy, and we had eventually transitioned to an antimicrobial wound matrix. Our total wound therapy treatment time was 10 weeks.

Our second case is a very complex orthopedic reconstruction case. I have to give credit to my partner, Dr Nicholas Cheney, an orthopedic foot and ankle surgeon in our group. He did the orthopedic work together with my assistance regarding wound management.

A 59-year-old gentleman who underwent ankle fusion surgery sometime back prior to presenting to our group, he needed complex further revisional reconstruction.

We knew we were going to deal with a large dermal defect, hence us needing to use negative pressure wound therapy. We started traditional negative pressure wound therapy, a power device, and transitioned to disposable mechanical negative pressure wound therapy when time was right.

He wound up taking off his external fixator for reasons not entirely known, so we had no choice but to proceed further with intervention. The reason why we needed to use external fixation is because we couldn't fuse the ankle joint intraoperatively because of a large dermal defect.

He did very well. Eventually, his primary surgical wound was closed utilizing negative pressure wound therapy mechanical as well as some other advancement therapies. He did have a small plantar heel wound that was managed with autologous skin grafting. Ultimately, he did very well and he's ambulatory today.

Our third case is that of a diabetic gentleman with a diabetic foot ulceration and Charcot foot deformity. He received traditional serial debridements chairside and eventually was started on disposable negative pressure wound therapy. Adjunctive therapy included hyperbaric oxygen. We've had some interruptions of therapy due to infection, but ultimately, he did very well and did close.

As stated earlier, this abstract was presented at this past fall Symposium on Advanced Wound Care. Jacob Grimmer—I absolutely must give credit to him—a medical student at the Heritage College of Osteopathic Medicine, was our primary researcher and interned with my group this past summer. Well done, Jacob.

Again, thank you, all, very much for your time.