Gaps in Education on Negative Pressure Wound Therapy with Instillation

In a recent interview with the Wound Care Learning Network, Paul Kim, DPM, MS, discussed the areas of wound research that are needed to fill the gaps in education for use of negative pressure wound therapy with instillation (NPWTi), especially when considering clinical use and economic practices.

Dr. Kim explains that novice and intermittent use of NPWTi appear to be challenged with estimating the volume of solution needed. Clinicians that are seasoned users of NPWTi can use their experience and knowledge to estimate the instillation volume needed. The clinicians who are less experienced with NPWTi may rely on “guesswork,” says Dr. Kim. Unfortunately, there have been adverse effects (eg, leaks in macerations) with that approach, which is why the upgraded computer software (where it automatically calculates the volume needed) is a valuable addition to the user’s wound care toolbox.

When using this upgraded computer software for NPWTi fluid instillation, Dr. Kim found, “It under-instills the amount of volume that I am typically used to using. But however, for the novice/intermittent user, it's a great innovation.”

The most important aspect that should drive the adoption of a new biologic device or drug should be the clinical outcome, but clinical outcomes can be measured in multiple ways. From the administrative side, Dr. Kim thinks the efficiency of the delivery of care is vital, which is ultimately reflected in cost savings (eg, decreased hospital length of stay lowers the health care expenditure) for patients and the health care system. But a primary concern the clinician faces is the quality of care provided. As Dr. Kim emphasizes— “The issue is a clinician can't sacrifice the quality of care for cost savings.” Clinicians must balance the 2 sides of the concern—delivering high-quality care and providing continuity of care after being discharged from a hospital setting vs total cost of care and length of treatment.

“The clinical outcomes are obviously the most important pieces to focus on,” said Dr. Kim. He notes that external drivers are the guiding force the everyday clinician can appreciate. Some clinicians may not realize that some of these health care decisions are outside of their control, but the clinician is responsible for the collective responsibility of investigating tools critically, evaluating the evidence available, and determining if that evidence supports the use of the device or drug. In closing, Dr. Kim finishes the interview by saying, “I think it's on us to make those decisions.”

 –Cat Urbanski, Associate Digital Editor

To learn more on this topic, check out the video releasing on May 11th, 2022.