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Plast Reconstr Surg. 2014 Mar;133(3):709-16. doi: 10.1097/01.prs.0000438060.46290.7a.

The impact of negative-pressure wound therapy with instillation compared with standard negative-pressure wound therapy: a retrospective, historical, cohort, controlled study.

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  • 1Washington, D.C.; and Dallas, Texas From the Department of Plastic Surgery, Georgetown University Hospital; Georgetown University School of Medicine; Georgetown University Medical Center; and the Department of Plastic Surgery, University of Texas Southwestern Medical Center.

Abstract

BACKGROUND:

Negative-pressure wound therapy with instillation is a novel wound therapy that combines negative pressure with instillation of a topical solution.

METHODS:

This retrospective, historical, cohort-control study examined the impact of negative-pressure wound therapy with and without instillation.

RESULTS:

One hundred forty-two patients (negative-pressure wound therapy, n = 74; therapy with instillation, 6-minute dwell time, n = 34; and therapy with instillation, 20-minute dwell time, n = 34) were included in the analysis. Number of operative visits was significantly lower for the 6- and 20-minute dwell time groups (2.4 ± 0.9 and 2.6 ± 0.9, respectively) compared with the no-instillation group (3.0 ± 0.9) (p ≤ 0.05). Hospital stay was significantly shorter for the 20-minute dwell time group (11.4 ± 5.1 days) compared with the no-instillation group (14.92 ± 9.23 days) (p ≤ 0.05). Time to final surgical procedure was significantly shorter for the 6- and 20-minute dwell time groups (7.8 ± 5.2 and 7.5 ± 3.1 days, respectively) compared with the no-instillation group (9.23 ± 5.2 days) (p ≤ 0.05). Percentage of wounds closed before discharge and culture improvement for Gram-positive bacteria was significantly higher for the 6-minute dwell time group (94 and 90 percent, respectively) compared with the no-instillation group (62 and 63 percent, respectively) (p ≤ 0.05).

CONCLUSION:

The authors' results suggest that negative-pressure wound therapy with instillation (6- or 20-minute dwell time) is more beneficial than standard negative-pressure wound therapy for the adjunctive treatment of acutely and chronically infected wounds that require hospital admission.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, III.

PMID:
24572860
[PubMed - indexed for MEDLINE]
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