Negative Pressure Wound Therapy

Samantha Kuplicki's picture
comparative research on NPWT devices

by Samantha Kuplicki, MSN, APRN-CNS, ACNS-BC, CWS, CWCN, CFCN

Recently, we've reviewed application and documentation strategies for NPWT, but what about navigating the different systems currently on the market? We know all devices have the mechanism of negative pressure in common, but what other characteristics need to be considered when selecting the right device for your patient? In this installment, we will become better acquainted with the characteristics of NPWT devices and how they differ for various systems.

Samantha Kuplicki's picture
Advancing wound care skills in applying NPWT

by Samantha Kuplicki, MSN, APRN-CNS, ACNS-BC, CWS, CWCN, CFCN

When I was just starting out in wound care, the truth was I really did not have the first clue about how to apply the NPWT dressing system. Foam, gauze, skin prep, drape, tubing, all the buttons on the unit, the different pressure settings; it was so intimidating, which was massively discouraging for me to initiate the learning process.

Bruce Ruben's picture
NPWT affixed to a lower extremity wound

by Bruce E. Ruben MD

Little has been shown by specific randomized controlled trials to effectively speed the healing of a non-healing wound. Biologically, the human body is capable of healing once constitutional barriers are relieved. These barriers include venous and arterial insufficiency, nutritional deficiency, deep-seated infection, and environmental barriers such as repetitive trauma.

Samantha Kuplicki's picture
Pain

by Samantha Kuplicki, MSN, APRN-CNS, ACNS-BC, CWS, CWCN, CFCN

You've been asked to evaluate a patient for negative pressure wound therapy (NPWT). It turns out they're a perfect candidate, so you start the process to have the unit placed immediately! The order is entered into the EHR for the recommended settings, and the initial dressing application is scheduled.

Margaret Heale's picture

Perspective of Nursing Care from Past to Future by Matron Marley

by Margaret Heale, RN, MSc, CWOCN

So after I last wrote, I was to assist with a dressing change, as the resident is more relaxed with somebody having their focus on her and not also trying to do the procedure. I have done a million or two dressings in my time but had not seen a negative pressure wound therapy (NPWT) vacuum till I started helping out at the nursing home where my granddaughter works. I came across the treatment accidentally, very accidentally.

Michael Miller's picture

RAMBLINGS OF AN ITINERANT WOUND CARE GUY, PT. 21

by Michael Miller DO, FACOS, FAPWCA, WCC

For those of you who cannot remember the now deceased comedian Chris Farley, did not find his humor funny or simply cannot remember any of his memorable performances; I suggest you move on to another, less controversial, "here's how to use scissors" type of blog.

Beth Hawkins Bradley's picture

by Beth Hawkins Bradley RN, MN, CWON

Finding the key to unlocking a non-healing chronic wound keeps us awake at night. Though we have, as bedside clinicians, learned much about the physiology and biochemistry of chronic wounds over the past decade, wound healing is not an exact science. Negative pressure wound therapy (NPWT) has become standard care for certain chronic wounds. Sometimes, however, wounds treated with this therapy do not progress as readily as we think that they should. This has led us to consider combining other wound care products with NPWT. This article will examine the rationale for using three products in combination with negative pressure.

Beth Hawkins Bradley's picture

by Beth Hawkins Bradley RN, MN, CWON

We just can’t resist New Year’s resolutions. This is the time of year when we reflect back on aspects of the year that is ending, and determine to do some things differently in the year that is dawning. If you are reading this, then you likely use negative pressure wound therapy (NPWT) in your clinical practice. If you use this valuable therapy to help your patients’ wounds to heal, then you are aware that NPWT comes with risks. Our friends in the legal profession certainly understand this. Look back at the FDA Safety Alert issued in February 2011 in response to increased injuries among patients receiving NPWT. The FDA concluded that many of the injuries and deaths were related to insufficient observation of wound dressings and lack of patient teaching.

Beth Hawkins Bradley's picture

by Beth Hawkins Bradley RN, MN, CWON

How did you acquire your knowledge and skills around the application of NPWT dressings? Most of us learned by observing another clinician doing dressing applications, or from a manufacturer's representative. We likely just imitated what they did, largely winging it. In my work over the past few years, I have been surprised to learn that many excellent clinicians have gaps in technical ability. This article is intended to review principles of NPWT dressing application to increase the accuracy of your techniques. These tips are distilled from principles that are typical of manufacturer guidelines. It is always recommended that you read and follow the manufacturer’s guidelines for the product that you are using.

Beth Hawkins Bradley's picture

by Beth Hawkins Bradley RN, MN, CWON

Wounds treated with negative pressure wound therapy (NPWT) are not often straightforward. They occur in interesting places, have anything from slough to hardware visible in the bases, and have nooks and crannies that are not visible to the clinicians peering into the wound. A gentle probe is necessary during wound assessment to identify tunnels and undermined areas. I prefer to gently probe first with my gloved finger (I have small hands) because I can identify hidden structures and other oddities. Then I will use a swab to measure how far the tunnel or undermining extends. Once hidden dead spaces have been identified, clinicians can select the best strategy to bring them to closure. Herein are several techniques employed by clinicians to close undermined and tunneled areas.