Clinical Experience With Single-Use, Mechanically Powered Negative Pressure Wound Therapy Device for Outpatient Management of Lower Extremity Wounds
Patients discharging from the hospital after a lower extremity 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 are well-suited for negative pressure treatment of low-exudating lower extremity wounds in the outpatient setting. dNPWT 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. This case series presents 8 patients receiving dNPWT for lower extremity wound healing. All the patients were male, with an average age of 62.6 (range: 44-92) years. Wound types included surgical dehiscence, surgical incision after bone resection or reconstruction, and trauma. Patient comorbidities included diabetes, arthritis, neuropathy, and previous foot surgeries. Where necessary, parenteral antibiotics were used to control infection and debridements were performed to remove non-viable tissue. dNPWT was applied at a continuous -125 mmHg setting, and dressings were changed every 2-3 days. Treatment with dNPWT was continued for an average of 2.5 weeks. Closure was achieved for all wounds, with the exception of one patient for whom therapy was ongoing with no adverse events. Wounds were closed secondarily in 6 patients; for the remaining patient, the wound was closed with epidermal grafting created using an epidermal harvesting system.‡ In these patients, the application of dNPWT assisted in the postoperative outpatient care and helped bridge the transition to wound closure.
*SNAP™ Therapy System, ‡CELLUTOME™ Epidermal Harvesting System, KCI, now part of 3M Company, San Antonio, TX
1. Armstrong DG, Marston WA, Reyzelman AM, Kirsner RS. Comparative effectiveness of mechanically and electrically powered negative pressure wound therapy devices: a multicenter randomized controlled trial. Wound Rep Reg. 2012;20(3):332-341