Comparison of outcomes for normal saline and an antiseptic solution for negative-pressure wound therapy with instillation

Paul J. Kim, Christopher E. Attinger, Noah Oliver, Caitlin Garwood, Karen K. Evans, John S. Steinberg, Larry A. Lavery

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Background: Negative-pressure wound therapy with instillation is an adjunctive treatment that uses periodic instillation of a solution and negative pressure for a wide diversity of wounds. A variety of solutions have been reported, with topical antiseptics as the most frequently chosen option. The objective of this study was to compare the outcomes of normal saline versus an antiseptic solution for negative-pressure wound therapy with instillation for the adjunctive treatment of infected wounds. Methods: This was a prospective, randomized, effectiveness study comparing 0.9% normal saline versus 0.1% polyhexanide plus 0.1% betaine for the adjunctive treatment of infected wounds that required hospital admission and operative débridement. One hundred twenty-three patients were eligible, with 100 patients randomized for the intention-to-treat analysis and 83 patients for the per-protocol analysis. The surrogate outcomes measured were number of operative visits, length of hospital stay, time to final surgical procedure, proportion of closed or covered wounds, and proportion of wounds that remained closed or covered at the 30-day follow-up. Results: There were no statistically significant differences in the demographic profiles in the two cohorts except for a larger proportion of male patients (p = 0.004). There was no statistically significant difference in the surrogate outcomes with the exception of the time to final surgical procedure favoring normal saline (p = 0.038). Conclusion: The authors' results suggest that 0.9% normal saline may be as effective as an antiseptic (0.1% polyhexanide plus 0.1% betaine) for negativepressure wound therapy with instillation for the adjunctive inpatient management of infected wounds.

Original languageEnglish (US)
Pages (from-to)657e-664e
JournalPlastic and Reconstructive Surgery
Volume136
Issue number5
DOIs
StatePublished - Oct 27 2015

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Negative-Pressure Wound Therapy
Local Anti-Infective Agents
Sodium Chloride
Wounds and Injuries
Betaine
Length of Stay
Intention to Treat Analysis
Therapeutics
Inpatients
Demography
Pressure

ASJC Scopus subject areas

  • Surgery

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Comparison of outcomes for normal saline and an antiseptic solution for negative-pressure wound therapy with instillation. / Kim, Paul J.; Attinger, Christopher E.; Oliver, Noah; Garwood, Caitlin; Evans, Karen K.; Steinberg, John S.; Lavery, Larry A.

In: Plastic and Reconstructive Surgery, Vol. 136, No. 5, 27.10.2015, p. 657e-664e.

Research output: Contribution to journalArticle

Kim, Paul J. ; Attinger, Christopher E. ; Oliver, Noah ; Garwood, Caitlin ; Evans, Karen K. ; Steinberg, John S. ; Lavery, Larry A. / Comparison of outcomes for normal saline and an antiseptic solution for negative-pressure wound therapy with instillation. In: Plastic and Reconstructive Surgery. 2015 ; Vol. 136, No. 5. pp. 657e-664e.
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abstract = "Background: Negative-pressure wound therapy with instillation is an adjunctive treatment that uses periodic instillation of a solution and negative pressure for a wide diversity of wounds. A variety of solutions have been reported, with topical antiseptics as the most frequently chosen option. The objective of this study was to compare the outcomes of normal saline versus an antiseptic solution for negative-pressure wound therapy with instillation for the adjunctive treatment of infected wounds. Methods: This was a prospective, randomized, effectiveness study comparing 0.9{\%} normal saline versus 0.1{\%} polyhexanide plus 0.1{\%} betaine for the adjunctive treatment of infected wounds that required hospital admission and operative d{\'e}bridement. One hundred twenty-three patients were eligible, with 100 patients randomized for the intention-to-treat analysis and 83 patients for the per-protocol analysis. The surrogate outcomes measured were number of operative visits, length of hospital stay, time to final surgical procedure, proportion of closed or covered wounds, and proportion of wounds that remained closed or covered at the 30-day follow-up. Results: There were no statistically significant differences in the demographic profiles in the two cohorts except for a larger proportion of male patients (p = 0.004). There was no statistically significant difference in the surrogate outcomes with the exception of the time to final surgical procedure favoring normal saline (p = 0.038). Conclusion: The authors' results suggest that 0.9{\%} normal saline may be as effective as an antiseptic (0.1{\%} polyhexanide plus 0.1{\%} betaine) for negativepressure wound therapy with instillation for the adjunctive inpatient management of infected wounds.",
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