Early Use of a Novel Acrylic-Silicone Hybrid Drape With Negative Pressure Wound Therapy in Lower Extremity Wounds
Negative pressure wound therapy (NPWT) is an advanced wound care strategy that supports healing by removing exudate and stimulating 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. This case series documents the application of this novel hybrid drape with NPWT in 5 patients with 8 lower extremity wounds. In all cases, wounds were debrided. NPWT with instillation 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. 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. 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. 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. Patient-reported pain scores were a median of 2 (range: 1-3) on a 10-point scale. In our experience, the hybrid drape was easy to place and readjust, if necessary, and improved the ease of dressing changes. In this patient population, NPWT with the acrylic-silicone hybrid drape was effective in supporting wound healing, while maintaining a low pain level during dressing changes.
*V.A.C. DERMATAC™ Drape, †V.A.C.® Drape; KCI, now part of 3M Company; San Antonio, TX