In 1997, Morykwas and Agenta6,7,15 of Wake Forest University published three articles regarding their experience with a "new method for wound control and treatment...."6 A system was described in which subatmospheric pressure was applied through a closed system to an open wound for periods of 48 hours.6,7 The subatmospheric pressure was directed at the surface of the wound through an interface between the wound surface and a polyurethane sponge, allowing distribution of the negative pressure and use of either a constant or intermittent mode. The authors determined that "the application of controlled subatmospheric pressure creates an environment that promotes wound healing.6
By 2003, NPWT was commonly accepted therapy despite the few randomized, controlled studies of its efficacy. An NPWT consensus group was formed that year in Canada. Their consensus paper contains a literature review, recommendations for specific chronic wounds, and survey results from the group based solely on the V.A.C. product.16 Table. Appropriate applications for negative pressure wound therapy (NPWT)1
- Acute wounds
- Partial and full-thickness burns
- Surgically created wounds and surgical dehiscence
Patients with other medical problems, i.e., diabetes, coronary artery disease, or renal disease, may be more susceptible to wound dehiscence and delayed wound healing. NPWT may provide increased wound stability.