EFFICACY OF A SIMPLIFIED NEGATIVE PRESSURE WOUND DRESSING IN MANAGEMENT OF INFECTED WOUNDS

Abstract

Background: Negative-pressure wound therapy (NPWT) or Vacuum assisted closure (VAC) is an established modality for management of infected wounds. However, it has a complex technology of real time pressure feedback system to provide intermittent suction which markedly increases its cost, thus limiting its routine use in low resource settings. The intermittent suction can also be provided by connecting a readily available portable suction machine to a timer switch. This unit works on the same principle as VAC and can serve as an effective simplified negative pressure wound dressing (SNPWD). Methods: Thisprospective observational studyinvolved24patients having highly exudative and infected wounds whoweremanagedwith low cost, indigenously developed SNPWD. The SNPWD consists of a portable suction machine connected to a timer switch and a pre sterilized dressing material consisting of a foam, adhesive material to cover the foam and connecting tube. The efficacy of this dressing was evaluated on basis of percentage reduction in wound surface area after the last SNPWD, the time taken and the number of dressings required for wound coverage by adequate healthy granulation tissue, decrease in amount of exudates after the last dressing and comparison of pre-SNPWD and post-SNPWD pus culture sensitivity reports. Results: The SNPWD was effective in improving the rate of wound healing. All the patients achieved healthy granulation tissue after application of SNPWD. The mean duration of SNPWD application was 16.5 days and mean number of dressings applied per patient was 5.3. There was a mean decrease of wound surface area by 27.2%. There was a 58% decrease in amount of exudates after SNPWD application. There were no significant adverse effects after SNPWD application. Also the cost per dressing of SNPWD was lesser than that of commercially available other NPWT options. Conclusions: The low-cost, indigenously developed SNPWD can achieve a comparable rate of wound healing to VAC and has an advantage that it is highly cost effective and the components are readily available which makes it a potential alternative to VAC in low resource settings. Study design: Prospective observational study.

Key words: Vacuum assisted closure, simplified negative pressure wound dressing