Early Use of a Novel Acrylic-Silicone Hybrid Drape With Negative Pressure Wound Therapy in Lower Extremity Wounds

Abstract

Background

  • Negative pressure wound therapy (NPWT) is an advanced wound care strategy that supports healing by removing exudate and promoting the growth of granulation tissue.
  • During application, a foam dressing is placed onto the wound bed and covered with an acrylic drape to enable the creation of a vacuum seal.
  • Recently, an acrylic-silicone hybrid drape* has become available for use with NPWT devices.

Purpose

  • This case series documents the application of this novel hybrid drape with NPWT in 5 patients with 8 lower extremity surgical dehiscences.

Methods

  • In all cases, wounds were debrided.
  • NPWT with instillation and dwell time (NPWTi-d)† was used with standard drape‡ in 4 patients before initiating conventional NPWT.§
  • NPWT with the hybrid drape was applied at -125 mmHg.
  • Dressings and drapes were changed every 2-3 days, at which point pain assessments were conducted.

Results

  • The patients comprised one male and 4 females with a mean age of 60 years (range: 42-74).
  • Comorbidities included arthritis, foot deformity, neuropathy, hypertension, osteoporosis, and thyroid disease (Table 1).
  • The wound types were dehiscences following foot reconstruction (n=6), transmetatarsal amputation (n=1), and surgery for ankle stabilization and balancing (n=1).
  • NPWT with the hybrid drape was used for a mean of 22.2 days (range: 9-31), after which the wounds exhibited a reduction in fibrous tissue and increased granulation.
  • Wound volume also decreased in all wounds.
  • Representative cases are shown in Figures 1-3.
  • At dressing changes, the patients noted that NPWT with the hybrid drape was markedly more comfortable compared to standard drape, both while worn and during dressing changes.
  • In our experience, the hybrid drape was easy to place and readjust upon initial placement, if necessary, and improved the ease of dressing changes.
  • The hybrid drape was also able to be placed over delicate periwound tissues. In these cases, the periwound appeared healthy throughout wound management with NPWT.
  • The maximum pain score during dressing changes of NPWT with hybrid drape was reported for each patient in Figure 4. Pain scores did not exceed 3/10.

Conclusions

  • In this patient population, use of an acrylic-silicone hybrid drape as part of an NPWT system was effective in supporting wound healing, while maintaining a low pain level during dressing changes.

Acknowledgments

  • Nicholas A. Cheney, DO provided initial surgical care for cases 1, 2, 3, and 5.
  • Jeffrey E. Gittins, DO provided initial surgical care for case 4.
  • 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.