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Three Cases Describing Outcomes of Negative-Pressure Wound Therapy With Instillation for Complex Wound Healing

Hall, Kimberly Dawn; Patterson, Jessica S.

Journal of Wound Ostomy & Continence Nursing: May/June 2019 - Volume 46 - Issue 3 - p 251–255
doi: 10.1097/WON.0000000000000516
Challenges in Practice
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BACKGROUND: We describe 3 cases where negative-pressure wound therapy with instillation and dwell time (NPWTi-d) was used as an adjunctive therapy for 3 chronic wounds.

CASES: Three patients (2 males and 1 female), ranging in age from 28 to 53 years, presented with complex, infected wounds: (1) a diabetic foot ulcer with underlying infection, (2) a dehisced abdominal wound with enterocutaneous fistula, and (3) a large wound of the upper torso and axillary region resulting from soft tissue necrosis. Negative-pressure wound therapy with instillation and dwell time was initiated by instilling normal saline or an antiseptic solution; the solution was left in place for 3 to 10 minutes. Continuous negative pressure was then applied at −125 or −150 mm Hg; cycles were repeated every 1 or 3 hours. Treatment was applied for 5 to 44 days, and dressings were changed every 2 to 3 days. Granulation tissue developed in all 3 wounds; all closed after subsequent skin grafting.

CONCLUSIONS: Outcomes of these cases suggest that NPWTi-d may be used as an adjunctive treatment modality for a variety of chronic wounds.

Kimberly Dawn Hall, DNP, RN, GCNS-BC, CWCN-AP, COCN, Carilion Clinic, Roanoke, Virginia.

Jessica S. Patterson, BSN, RN, Carilion Clinic, Roanoke, Virginia.

Correspondence: Kimberly Dawn Hall, DNP, RN, GCNS-BC, CWCN-AP, COCN, Carilion Clinic, Roanoke, VA 24014 (kdhall@carilionclinic.org).

Kimberly Dawn Hall is a consultant for KCI USA, Inc, an Acelity company. Jessica S. Patterson has no conflicts of interest to disclose.

© 2019 by the Wound, Ostomy and Continence Nurses Society.