The impact of negative-pressure wound therapy with instillation on wounds requiring operative debridement: Pilot randomised, controlled trial

Paul J. Kim, Lawrence A. Lavery, Robert D. Galiano, Christopher J. Salgado, Dennis P. Orgill, Stephen J. Kovach, Brent H. Bernstein, Christopher E. Attinger

Research output: Contribution to journalArticle

Abstract

Presence of bacteria in wounds can delay healing. Addition of a regularly instilled topical solution over the wound during negative-pressure wound therapy (NPWT) may reduce bioburden levels compared with standard NPWT alone. We performed a prospective, randomised, multi-centre, post-market trial to compare effects of NPWT with instillation and dwell of polyhexamethylene biguanide solution vs NPWT without instillation therapy in wounds requiring operative debridement. Results showed a significantly greater mean decrease in total bacterial counts from time of initial surgical debridement to first dressing change in NPWT plus instillation (n = 69) subjects compared with standard NPWT (n = 63) subjects (−0.18 vs 0.6 log10 CFU/g, respectively). There was no significant difference between the groups in the primary endpoint of required inpatient operating room debridements after initial debridement. Time to readiness for wound closure/coverage, proportion of wounds closed, and incidence of wound complications were similar. NPWT subjects had 3.1 times the risk of re-hospitalisation compared with NPWT plus instillation subjects. This study provides a basis for exploring research options to understand the impact of NPWT with instillation on wound healing.

Original languageEnglish (US)
JournalInternational Wound Journal
DOIs
StateAccepted/In press - 2020

Keywords

  • bacterial load
  • negative-pressure wound therapy
  • topical negative-pressure therapy
  • wound cleansing
  • wound healing

ASJC Scopus subject areas

  • Surgery
  • Dermatology

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