- #Contraindications for negative pressure wound therapy pdf#
- #Contraindications for negative pressure wound therapy skin#
Level of mobility and risk of tripping - drain tubes can create a trip hazard for those with reduced mobility, who may also find the larger pumps too cumbersome. The following factors should be considered: Patients whose wounds are suitable for NPWT need to be assessed for their ability to live with the device. The use of gauze also requires fewer dressing changes and, without the need to sculpt the foam, less nursing time at dressing change (Dorafshar et al, 2012). Little difference has been demonstrated between the two, although patient-reported pain on dressing change has been consistently significantly lower with gauze (Dorafshar et al, 2012 Fraccalvieri et al, 2011b). DressingsĪ range of studies evaluating gauze-based and foam-based NPWT have considered the difference in tissue formation (Malmsjö et al, 2012 Fraccalvieri et al, 2011a) and deformation (Malmsjö et al, 2012), healing rates (Dorafshar et al, 2012) pain at dressing change (Dorafshar et al, 2012 Fraccalvieri et al, 2011b), contraction (Anesäteret al, 2011 Malmsjö et al, 2009b), scar tissue depth (Fraccalvieri et al, 2011a), and effect on microvascularity (Malmsjö et al, 2009a). However, access in community setting is variable (Othman, 2012). Until recently, funding for NPWT was restricted to the acute sector, but it is increasingly available in the community due to the introduction of competing devices, the availability of consumable dressings on prescription, and the drive to prevent hospital admissions and facilitate early discharge. Others have reported fluctuations in blood flow (Borgquist et al, 2011 Malmsjö et al, 2009a), which may be useful in patients with compromised vascularity. The treatment is thought to assist healing by providing a moist environment and removing interstitial fluid and exudate (Schintler, 2012 Mouës et al, 2011) and enhancing granulation tissue formation (Schintler, 2012), angiogenesis (Mouës et al, 2011) and tissue perfusion (Schintler, 2012 Mouës et al, 2011). The benefits of NPWT include:Įnhanced healing and granulation tissue formation (Othman, 2012 Schintler, 2012) management of highly exuding wounds (Schintler, 2012 Mouës et al, 2011) reduced dressing changes compared with more conventional dressings (Wu and Armstrong, 2008) reduced nurse time (Dowsett et al, 2012) reduced costs (Othman, 2012) and improved quality of life (Othman, 2012). Negative pressure (suction) is applied to the wound bed through a foam or gauze contact medium using an electrically, battery or mechanically powered pump this involves achieving an airtight, vacuum, seal. Source: European Wound Management Association (2007) Compromised micro-vascular blood flow to wound. #Contraindications for negative pressure wound therapy skin#
Skin malignancy and excised skin malignancy - except for palliative care.Wounds exposing blood vessels or organs or with an unexplored fistula.Wounds involving untreated osteomyelitis.Unlike many other wound treatments and dressings, it has a relatively good evidence base to demonstrate its effectiveness, but manufacturers list some contraindications and situations requiring caution (Box 1). Negative pressure wound therapy (NPWT) can be used to aid healing in acute, chronic, closed incisional, closed skin graft and open abdomen wounds.
Wound healing does not always follow a simple path some acute wounds fail to heal and some become chronic.
#Contraindications for negative pressure wound therapy pdf#
Scroll down to read the article or download a print-friendy PDF including any tables and figures.This article has been double-blind peer reviewed.Nursing Times 108 36, 16-20.Īuthors: Heidi Guy is tissue viability clinical nurse specialist and honorary lecturer, East and North Herts Hospital Trust and University of Hertfordshire Lorraine Grothier is clinical nurse specialist tissue viability, Central Essex Community Services, Maldon. This article considers its application in both primary and acute care.Ĭitation: Guy H et al Grothier L (2012) Using negative pressure therapy in wound healing. Negative pressure wound therapy, also referred to as topical negative pressure therapy, is a useful treatment for a variety of acute and chronic wounds and, unlike many other wound treatments and dressings, has a relatively good evidence base to demonstrate its effectiveness.
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