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Best Practices demonstrated in a case series to allow the use of pure pH controlled hypochlorous acid solution* for instillation without interfering with the efficient application of the NPWT.
Introduction: Negative Pressure Wound Therapy with instillation (NPWTi-d)** has been used to further increase the clinical efficacy of the principles of Negative Pressure Wound Therapy (NPWT). The use of hypochlorous acid based solutions has been reported to produce benefits in terms of the enhanced mechanical removal of bioburden and necrotic tissue. However, clogging or blockage of the tubes involved in the NPWT process with instillation sometimes causes undesirable disruption of the NPWT. In our acute care, trauma, and burn practice, we have used some specific techniques to encounter this problem and have successfully continued to use hypochlorous acid with instillation. We present here a case series disclosing how we achieve our goals without clogging the tubes.
Methods: We describe a series of 3 patients with wounds where NPWTi-d was used using a pH controlled hypochlorous acid solution for instillation. To avoid clogging of the tubes we took specific steps that we describe in this study.
Results and Discussion: The wounds progressed over time in our acute care unit without blockage of the tubes and needless setting of alarms. The mechanism of necrotic tissue removal by instillation with hypochlorous acid solution is not completely understood, we describe it as mechanical, and we also note that it has documented ability to mechanically remove microbes.  While it is true we have encountered blockage issues with the hypochlorous acid in NPWT instillation use in the past, we believe we have overcome the problem using the methods described here.
We have found the method to harness the power of hypochlorous acid preserved wound solutions without the annoying stoppages in the NPWT process which is extremely disruptive on the healing process.
Trademarked Items (if applicable): Vashe (Urgo)
VAC (3M-KCI)
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