Negative Pressure Wound Therapy

Samantha Kuplicki's picture
Advancing wound care skills in applying NPWT

By Samantha Kuplicki, MSN, APRN-CNS, AGCNS-BC, CWS, CWCN, CFCN

Part 1 in a series exploring topics related to negative pressure wound therapy application.

Negative Pressure Wound Therapy (NPWT), it's so simple, right? Everyone who knows anything about wound care knows how to apply it. Wait…YOU don't? No worries—we were all there at some point. In fact, for the first year or so of my wound care endeavors, I had very little insight as to how to apply NPWT. I understood the basic tenets of therapy: exudate management/removal, increased granulation tissue development, decreased frequency of dressing changes, and decreased cost of wound care, among others.

Bruce Ruben's picture
NPWT affixed to a lower extremity wound

By Bruce E. Ruben MD

Little has been shown by specific randomized controlled trials to effectively speed the healing of a non-healing wound. Biologically, the human body is capable of healing once constitutional barriers are relieved. These barriers include venous and arterial insufficiency, nutritional deficiency, deep-seated infection, and environmental barriers such as repetitive trauma.

Samantha Kuplicki's picture
Wound Care Case Study

By Samantha Kuplicki, MSN, APRN-CNS, AGCNS-BC, CWS, CWCN, CFCN

This is the account of a patient case in which technology, clinician experience, and patient adherence converged to save a limb.

Samantha Kuplicki's picture
Pain

By Samantha Kuplicki, MSN, APRN-CNS, AGCNS-BC, CWS, CWCN, CFCN

The Patient Assessment
You've been asked to evaluate a patient for negative pressure wound therapy (NPWT). It turns out they're a perfect candidate, so you start the process to have the unit placed immediately! The order is entered into the EHR for the recommended settings, and the initial dressing application is scheduled.

Cheryl Carver's picture
Fairground

By Cheryl Carver, LPN, WCC, CWCA, FACCWS, DAPWCA, CLTC

My approach to long-term care education has always been to have fun and leave a lasting impression so that my audience will learn. Anyone that has been to one of my skin and wound care classes will validate this (*wink wink*).

Margaret Heale's picture

By Margaret Heale, RN, MSc, CWOCN

So after I last wrote, I was to assist with a dressing change, as the resident is more relaxed with somebody having their focus on her and not also trying to do the procedure. I have done a million or two dressings in my time but had not seen a negative pressure wound therapy (NPWT) vacuum till I started helping out at the nursing home where my granddaughter works. I came across the treatment accidentally, very accidentally.

Michael Miller's picture

By Michael Miller DO, FACOS, FAPWCA, WCC

For those of you who cannot remember the now deceased comedian Chris Farley, did not find his humor funny or simply cannot remember any of his memorable performances; I suggest you move on to another, less controversial, "here's how to use scissors" type of blog.

Beth Hawkins Bradley's picture

By Beth Hawkins Bradley RN, MN, CWON

Finding the key to unlocking a non-healing chronic wound keeps us awake at night. Though we have, as bedside clinicians, learned much about the physiology and biochemistry of chronic wounds over the past decade, wound healing is not an exact science. Negative pressure wound therapy (NPWT) has become standard care for certain chronic wounds. Sometimes, however, wounds treated with this therapy do not progress as readily as we think that they should. This has led us to consider combining other wound care products with NPWT. This article will examine the rationale for using three products in combination with negative pressure.

Beth Hawkins Bradley's picture

By Beth Hawkins Bradley RN, MN, CWON

We just can’t resist New Year’s resolutions. This is the time of year when we reflect back on aspects of the year that is ending, and determine to do some things differently in the year that is dawning. If you are reading this, then you likely use negative pressure wound therapy (NPWT) in your clinical practice. If you use this valuable therapy to help your patients’ wounds to heal, then you are aware that NPWT comes with risks. Our friends in the legal profession certainly understand this. Look back at the FDA Safety Alert issued in February 2011 in response to increased injuries among patients receiving NPWT. The FDA concluded that many of the injuries and deaths were related to insufficient observation of wound dressings and lack of patient teaching.

Beth Hawkins Bradley's picture

By Beth Hawkins Bradley RN, MN, CWON

How did you acquire your knowledge and skills around the application of NPWT dressings? Most of us learned by observing another clinician doing dressing applications, or from a manufacturer's representative. We likely just imitated what they did, largely winging it. In my work over the past few years, I have been surprised to learn that many excellent clinicians have gaps in technical ability. This article is intended to review principles of NPWT dressing application to increase the accuracy of your techniques. These tips are distilled from principles that are typical of manufacturer guidelines. It is always recommended that you read and follow the manufacturer’s guidelines for the product that you are using.