Initial Experience of Negative Pressure Wound Therapy Using A Novel Hybrid Adhesive Drape

Abstract

Pressure-sensitive adhesives (PSA), such as acrylates and silicone, require minimal force for adherence and leave no residue upon removal.1 PSAs are integral components in transdermal therapeutic systems, surgical drapes, and occlusive dressings.1 Despite a practitioner’s skill, some patients express discomfort upon acrylic PSA drape* removal after the application of negative pressure wound therapy (NPWT). Recently, a novel, hybrid adhesive drape† (HA-drape) with silicone acrylate technology was developed for use with NPWT. Here, we report our initial experience in six patients receiving NPWT‡ with polyurethane foam dressing§ covered with HA-drape. Three female and three male patients with a mean age of 54.0 ± 17.1 years participated. Comorbidities included diabetes (n = 5), obesity (n = 3), hypertension (n = 3), vascular disease (n =2), tobacco use (n = 2), and Charcot-Marie-Tooth disease (n = 1). Wound etiologies included surgical dehiscence (n = 4), acute wound (n = 1), and arterial insufficiency ulcer (n =1). HA-drape application and repositioning was easily accomplished due to the low cohesive force of the drape, and continuous NPWT (-125 mmHg) was applied to all patients with twice-weekly dressing changes. The Global Pain Scale (GPS) was used, and patients received antibiotics, pain medication, and debridement, as necessary. All patients conveyed how comfortable the HA-drape was, and we noted zero complications or reports of skin irritation/sensitization. NPWT was discontinued upon the wound attaining adequate granulation tissue formation. Half of the patients (50%) reported a GPS score of 0. One patient (GPS = 4; GPS = 0 at HA-drape removal) received pain medication unrelated to the wound. In these patients, HA-drape repositioning did not alter the ability to maintain a seal in all applications. Ease of application reduced clinician time applying NPWT, and the ease of HA-drape removal helped yield less discomfort in these patients.

*V.A.C.® Drape, †V.A.C. DERMATAC™ Drape, ‡ACTIV.A.C.™ Therapy System, §GRANUFOAM™ Dressing (KCI, now part of 3M Company, San Antonio, TX)

References
1. Dimas DA, Dallas PP, Rekkas DD, Choulis NH. Effect of Several Factors on the Mechanical Properties of Pressure- Sensitive Adhesives Used in Transdermal Therapeutic Systems. AAPS PharmSciTech. 2000 Jun 18;1(2):E16.