Clinical Experience With Single-Use, Mechanically Powered Negative Pressure Wound Therapy Device for Outpatient Management of Lower Extremity Wounds

Abstract

Background

  • Patients discharging from the hospital after a lower extremity surgical procedure should be accompanied with an appropriate treatment plan to reduce the risk of amputation and to preserve patient mobility.
  • Mechanically powered, disposable negative pressure wound therapy (dNPWT*) devices are small, wearable units that deliver negative pressure to low-exudating lower extremity wounds in the outpatient setting.
  • Disposable NPWT retains the wound healing mechanisms that are at work in conventional negative pressure wound therapy,1 while its versatility minimizes interference with patient mobility when placed on a lower limb wound.

Purpose

  • This case series presents 8 patients receiving dNPWT for lower extremity wound management.

Methods

  • Disposable NPWT was applied at a -125 mmHg setting.
  • Dressings were changed every 2-3 days.
  • After application of dNPWT, the wounds were closed or therapy was continued until eventual closure using conventional NPWT† or applications of an antimicrobial skin substitute.
  • Where necessary, parenteral antibiotics were used to control infection and wounds were debrided to remove non-viable tissue.
  • In one patient, wound closure was achieved using epidermal grafting. In this case, an epidermal harvesting system‡ was utilized to obtain the epidermal graft.

Results

  • All 8 patients were male, with an average age of 62.6 (range: 44-92) years.
  • Wound types included surgical wounds, surgical dehiscence, and trauma.
  • Patient comorbidities included diabetes, arthritis, neuropathy, and previous foot surgeries.
  • Disposable NPWT was applied for an average of 2.5 weeks.
  • Closure was achieved in 7 of 8 patients via secondary intention; in one patient the wound was closed with epidermal grafting.

Conclusions

  • In these patients, the application of dNPWT was part of the postoperative outpatient treatment plan and helped bridge the transition to wound closure.

Acknowledgments

  • Nicholas A. Cheney, DO provided initial surgical care for 4 of the patients.
  • Jeffrey E. Gittins, DO provided initial surgical care for 2 of the patients.
  • Healthcare support was provided by wound and ostomy nurses and clinical and administrative staff at St. Ann’s Hospital Wound Clinic and Licking Memorial Hospital Wound Clinic.