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Negative-Pressure Wound Therapy with Instillation: International Consensus Guidelines

Kim, Paul J. D.P.M., M.S.; Attinger, Christopher E. M.D.; Steinberg, John S. D.P.M.; Evans, Karen K. M.D.; Lehner, Burkhard M.D.; Willy, Christian M.D., Ph.D.; Lavery, Larry D.P.M., M.P.H.; Wolvos, Tom M.D., M.S.; Orgill, Dennis M.D., Ph.D.; Ennis, William D.O., M.B.A.; Lantis, John M.D.; Gabriel, Allen M.D.; Schultz, Gregory Ph.D.

Plastic and Reconstructive Surgery: December 2013 - Volume 132 - Issue 6 - p 1569–1579
doi: 10.1097/PRS.0b013e3182a80586
Reconstructive: Trunk: Original Article
Video Discussion

Background: Negative-pressure wound therapy with instillation is increasingly utilized as an adjunct therapy for a wide variety of wounds. Despite its growing popularity, there is a paucity of evidence and lack of guidance to provide effective use of this therapy.

Methods: A panel of experts was convened to provide guidance regarding the appropriate use of negative-pressure wound therapy with instillation. A face-to-face meeting was held where the available evidence was discussed and individual clinical experience with this therapy was shared. Follow-up communication among the panelists continued until consensus was achieved. The final consensus recommendations were derived through more than 80 percent agreement among the panelists.

Results: Nine consensus statements were generated that address the appropriate use of negative-pressure wound therapy with instillation. The question of clinical effectiveness of this therapy was not directly addressed by the consensus panel.

Conclusion: This document serves as preliminary guidelines until more robust evidence emerges that will support or modify these consensus recommendations.

Video discussion by Mark W. Clemens, M.D., is available online for this article

Washington, D.C.; Heidelberg and Berlin, Germany; Dallas, Texas; Scottsdale, Ariz.; Boston, Mass.; Chicago, Ill.; New York, N.Y.; Vancouver, Wash.; Gainesville, Fla.

From the Department of Plastic Surgery, Georgetown University Hospital; the Orthopedic and Trauma Clinic, Heidelberg University; Department of Trauma Senior Surgery and Orthopedics, Reconstructive, Septic, and Hand Surgery, Military Hospital Berlin; the Department of Plastic Surgery, University of Texas Southwestern; the Division of General Surgery, Scottsdale Healthcare Osborn Medical Center; the Department of Surgery, Harvard Medical School; the Department of Clinical Surgery, University of Illinois at Chicago; the Department of Surgery, Columbia University; the Department of Plastic and Maxillofacial Surgery, Southwest Washington Medical Center; and the Department of Wound Research, University of Florida.

Received for publication March 8, 2013; accepted May 13, 2013.

Disclosure: Drs. Kim and Gabriel are consultants for Kinetic Concepts, Inc., and are on the scientific advisory board of Innovative Therapies, Inc. Dr. Attinger is an unpaid consultant for Kinetic Concepts. Dr. Lavery is on the scientific advisory board of Innovative Therapies. Drs. Wolvos and Orgill are consultants for Kinetic Concepts. Dr. Ennis is on the global scientific advisory board of Kinetic Concepts. Dr. Lantis is a consultant for Kinetic Concepts and Smith & Nephew, Inc. Dr. Schultz has received a research grant from Kinetic Concepts. Drs. Steinberg, Evans, Lehner, and Willy have no financial interests to declare.

A Video Discussion by Mark W. Clemens, M.D., accompanies this article. Go to and click on “Video Discussions” in the “Videos” tab to watch.

Christopher E. Attinger, M.D., Department of Plastic Surgery, Georgetown University Hospital, 3800 Reservoir Road, NW, Washington, D.C. 20007,

©2013American Society of Plastic Surgeons