- Neuropathic (diabetic) ulcers
- Venous or arterial insufficiency ulcer unresponsive to standard therapy
- Traumatic wounds (i.e., flap or meshed graft)
- Pressure ulcers (stage 3 or stage 4)
At the present date, the question is not whether negative pressure wound therapy is beneficial in wound healing, because numerous case studies and articles clearly document its efficacy. The questions that remain involve determining the optimum mechanism and protocols for deploying this therapy. In a recent review article,17 we have called for further research to better define the parameters for pressure intensity, duration of treatment, interval between treatments, mode of application, and timing of application to provide the most efficient and cost-effective therapy. Although there is still much to learn to optimize NPWT, this therapy is currently improving outcomes for patients suffering with pressure ulcers and other difficult-to-heal wounds.
Michael S. Miller, DO, FACOS, CWS, is the Medical Director, Marta Ortegon is a Physician Assistant, and Cheryl McDaniel is a Staff Nurse at The Wound Healing Center, Terre Haute, Indiana. Thomas Serena, MD, FACS, CWS, is the Medical Director at Penn North Centers for Advanced Wound Care, Warren, Pennsylvania. For more information, phone Dr. Miller at (812) 234-4321 or fax (812) 478-9552. To send your comments to the authors and editors, please e-mail firstname.lastname@example.org. To order reprints in quantities of 100 or more, call (866) 377-6454.
1.Fleck CA, Frizzell LD. When negative is positive: A review of negative pressure wound therapy. Extended Care Product News 2004:92;20-5.
2.Zarogen A. Nutritional assessment and intervention in the person with a chronic wound. In: Krasner DL, Rodeheaver GT, Sibbald RG. Chronic Wound Care: A Clinical Source Book for Healthcare Professionals, Third Edition. Wayne, Pa.: Health Management Publications, Inc., 2001:117-26.
3. Barker DE, Kaufman HJ, Smith LA, et al. Vacuum pack technique of temporary abdominal closure: A 7-year experience with 112 patients. The Journal of Trauma-Injury, Infection and Critical Care 2000;48:201-7.
4. Kostiuchenok II, Kolker VA, Karlov VA, et al. [Vacuum treatment in the surgical management of suppurative wounds.] Vestn Khir 1986;137:18-21.
5.Gray M, Peirce B. Is negative pressure wound therapy effective for the management of chronic wounds?
J Wound Ostomy Continence Nurs 2004;31:101-5.
6. Morykwas MJ, Argenta LC, Shelton-Brown EI, McGuirt W. Vacuum-assisted closure: A new method for wound control and treatment: Animal studies and basic foundation. Ann Plast Surg 1997;
7. Argenta LC, Morykwas MJ. Vacuum-assisted closure: A new method for wound control and treatment: Clinical experience. Ann Plast Surg 1997;
8.Davydov IuA, Larichev AB, Abramov AIu, Men'kov KG. [Concept of clinico-biological control of the wound process in the treatment of suppurative wounds using vacuum therapy.] Vestn Khir 1991;146:132-6.
9.Davydov IuA, Malafeeva E, Smirnov AP, Flegontov VB. [Vacuum therapy in the treatment of purulent lactation mastitis.] Vestn Khir 1986;137:66-70.
10. Philbeck TE Jr., Whittington KT, Millsap MH, et al. The clinical and cost effectiveness of externally applied negative pressure wound therapy in the treatment of wounds in home healthcare Medicare patients. Ostomy Wound Manage 1999;45:41-50.
11. Davydov IuA, Larichev AB, Smirnov AP, Flegontov VB. [Vacuum therapy of soft tissues and suppurative wounds.] Vestn Khir 1988;141:43-6.
12.Davydov IuA, Larichev AB, Men'kov KG. [Bacteriologic and cytologic evaluation of vacuum therapy of suppurative wounds.] Vestn Khir 1988;141:48-52.
13. Davydov IuA, Larichev AB, Abramov AIu. [Substantiation of using forced early secondary suture in the treatment of suppurative wounds by the method of vacuum therapy.] Vestn Khir 1990;144:126-28.
14.Chariker ME, Jeter KF, Tintle TE, Bottsford JE. Effective management of incisional and cutaneous fistulae with closed suction wound drainage. Contemp Surg 1989;34:59-63.
15.Morykwas MJ, Argenta LC. Nonsurgical modalities to enhance healing and care of soft tissue wounds. J South Orthop Assoc 1997 Winter;6:279-88.
16. Sibbald RG, Mahoney J; V.A.C. Therapy Canadian Consensus Group. A consensus report on the use of vacuum-assisted closure in chronic, difficult-to-heal wounds. Ostomy Wound Manage 2003;49:52-66.
17.Miller MS, Lowery CA. Negative pressure wound therapy: "A rose by any other name." Ostomy Wound Manage 2005;51:44-9. Safety Lancet
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