Conference Coverage

Workshop Summary: Understanding the Basics of Negative Pressure Wound Therapy

10/02/2024

More than 2000 leaders in the areas of wound care industry, research, and clinical practice attended the Symposium on Advanced Wound Care (SAWC) Fall taking place at Caesars Palace in Las Vegas, Nevada (October 2-5, 2024), to learn about the advances and evidence behind the latest wound care education via lectures, hands-on workshops, and clinical research presentations. In one hands-on workshop on October 2, An Algorithmic Approach to Negative Pressure Wound Therapy: A Hands-On Skills Lab, supported by an educational grant from Solventum, Medical Surgical Business, the speakers walked the attendees through using negative pressure wound therapy (NPWT) in clinical practice. The workshop included the speakers providing an evidence-based understanding of the therapy, clinical recommendations and updates, and key tips and tricks in using NPWT. The SAWC Preconference Workshop was led by the following experts: Michael Desvigne, MD, FACS; Devinder Singh, MD; Kara Couch, MS, CRNP, CWCN-AP; and Robert Klein, DPM, CWS. This lecture summary provides an overview of a few key pieces of information to better understand NPWT.

NPWT is a type of medical device that delivers subatmospheric pressure to the wound bed, usually in the pressure range of -80 mm Hg to -120 mm Hg.^1,2 This pressure can be intermittent or continuous. According to Dr. Klein, a speaker from the preconference workshop, “NPWT works by drawing the wound edges together, removing exudate [and] infectious materials, reducing edema, and promoting perfusion to the wound (macrostrain).” Additionally, he notes, “NPWT also causes tissue to be pulled up into the foam dressing, resulting in microdeformation causing cells to stretch. This cell stretch leads to cellular migration and proliferation, which promotes granulation tissue formation along with increased vascularity of the wound bed (microstrain).” Another benefit of NPWT is the reduction of edema in the periwound area via the removal of exudate from the wound site. This not only reduces tissue compression on the wound bed, but also normalizes microvascular circulation.³

An important point to keep in mind is that not all NPWT devices are the same, and there are multiple devices with differing indications available on the market. For instance, there is traditional NPWT, which is indicated for acute wounds. When acute wounds cannot be closed by primary intention because of infection, skin tension, or swelling,⁴ traditional NPWT may be an advanced wound care treatment to consider. Alternatively, a different NPWT device, NPWT with instillation and dwell time, may be used when wound infection is present.⁵ Dr. Klein recommends that health care practitioners consult the device’s instructions for use and even speak with their NPWT representative to determine what is best for the patient. “There are many considerations, including which drape might be best for a particular wound, [or] perhaps using ORC/collagen/Ag under NPWT,” noted Dr. Klein. It would be beneficial for health care practitioners to familiarize themselves with the indications and their local industry representative if interested.

According to Dr. Klein, “There are many ways to learn about NPWT. Your NPWT rep is a great resource to reach out to learn about NPWT. They offer many educational opportunities included Live Medical Education programs, regional workshops, and pre-conference workshops at SAWC.” Webinars and online programs led by experts in NPWT are also available via the Wound Care Learning Network.

To learn more about SAWC Fall lectures and abstract presentations, visit the SAWC Newsroom.

—Wounds Editorial Staff

References

1. Argenta LC, Morykwas MJ. Vacuum-assisted closure: a new method for wound control and treatment: clinical experience. Ann Plast Surg. 1997;38(6):563-576.

2. Scalise A, Calamita R, Tartaglione C, et al. Improving wound healing and preventing surgical site complications of closed surgical incisions: a possible role of incisional negative pressure wound therapy. A systematic review of the literature. Int Wound J. 2016;13(6):1260-1281. doi:10.1111/iwj.12492

3. Huang C, Leavitt T, Bayer LR, Orgill DP. Effect of negative pressure wound therapy on wound healing. Curr Probl Surg. 2014;51(7):301-303. doi:10.1067/j.cpsurg.2014.04.001

4. Thompson JT, Marks MW. Negative pressure wound therapy. Clin Plast Surg. 2007;34(4):673-684. doi:10.1016/j.cps.2007.07.005

5. Kim PJ, Attinger CE, Constantine T, et al. Negative pressure wound therapy with instillation: International consensus guidelines update. Int Wound J. 2020;17(1):174-186. doi:10.1111/iwj.13254