Assessment of the effect of low-cost negative pressure dressing on wound healing

Authors

  • Maruti B. Lingayat Department of Orthopaedics, Government Medical College, Aurangabad, Maharashtra, India
  • Abhay M. Kawedia Department of Orthopaedics, Government Medical College, Aurangabad, Maharashtra, India
  • Hitarth J. Gathani Department of Orthopaedics, Government Medical College, Aurangabad, Maharashtra, India
  • Karan Baria Department of Orthopaedics, Government Medical College, Aurangabad, Maharashtra, India
  • Swapnilkumar Patil Department of Orthopaedics, Government Medical College, Aurangabad, Maharashtra, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20232503

Keywords:

Open fractures, Wound healing, Negative suction therapy, Normal dressing

Abstract

Background: Wound care is a priority element in the management of grade 3 compound fractures and has traditionally relied on the use of dressing products (gauze, foam dressings, alginates, and hydrocolloids) and manual debridement. Paving the way to the future, there are now several alternative therapies, of which negative pressure wound therapy (NPWT) is an emerging treatment. Negative suction dressing has been proven to be superior in wound healing and is faster compared with regular dressing using gauze, hydrocolloids, and local debridement. It leads to faster rates of skin cover spontaneously or with surgical procedures like skin graft and flaps, eventually resulting in early internal fixation of fractured bones, if any.  The present study was designed to assess the effect of the negative pressure dressing technique on wound healing and to compare its effect with that of the conventional dressing technique.

Methods: The study was a double-blind randomized control trial conducted after ethics approval. A case record form was used for data collection after obtaining the participants’ informed consent, and a total of 120 patients participated in the study.

Results: Low-cost negative pressure dressing has an effect on general conditions, fever, hyperemia, and irregular margins. It was observed to increase granulation tissue formation and decrease pus/serous discharge and was associated with a decreased number of hospital visits due to early healing compared with normal dressing.

Conclusions: The low-cost negative dressing technique was effective in healing wounds in type III open fractures and was associated with early recovery compared with the normal dressing technique.

References

Armstrong DG, Lavery LA, Diabetic Foot Study Consortium. Negative pressure wound therapy after partial diabetic foot amputation: a multicentre, randomised controlled trial. Lancet. 2005;366(9498):1704-10.

Noble‐Bell G, Forbes A. A systematic review of the effectiveness of negative pressure wound therapy in the management of diabetes foot ulcers. Int Wound J. 2008;5(2):233-42.

Han G, Ceilley R. Chronic wound healing: a review of current management and treatments. Adv Ther. 2017;34(3):599-610.

Kundu ZS, Kamboj P, Sangwan SS, Siwach RC, Singh R, Walecha P. Management of open olecranon fractures using clamp-cum-compressor device. Indian J Orthop. 2009;43(1):50.

Chaput B, Garrido I, Eburdery H, Grolleau JL, Chavoin JP. Low-cost negative-pressure wound therapy using wall vacuum: a 15 dollars by day alternative. Plast Reconstr Surg - Glob Open. 2015;3(6).

Kim PH, Leopold SS. In brief: Gustilo–Anderson classification. Clin Orthop Relat Res. 2012;470(11):3270-4.

Zhong B. How to calculate sample size in randomized controlled trial? J Thorac Dis. 2009;1(1):51-4.

Sop JL, Sop A. Open Fracture Management. In: StatPearls. Treasure Island (FL): StatPearls Publishing. 2022.

Yusuf E, Jordan X, Clauss M, Borens O, Mäder M, Trampuz A. High bacterial load in negative pressure wound therapy (NPWT) foams used in the treatment of chronic wounds. Wound Repair Regen. 2013;21(5):677-81.

Achten J, Parsons NR, Bruce J, Petrou S, Tutton E, Willett K, et al. Protocol for a randomised controlled trial of standard wound management versus negative pressure wound therapy in the treatment of adult patients with an open fracture of the lower limb: UK Wound management of Lower Limb Fractures (UK WOLLF). BMJ Open. 2015;5(9):e009087.

Kumaar A, Shanthappa AH, Ethiraj P. A comparative study on efficacy of negative pressure wound therapy versus standard wound therapy for patients with compound fractures in a tertiary care hospital. Cureus. 2022;14(4):e23727.

Kaushik D, Joshi N, Kumar R, Gaba S, Sapra R, Kumar K. Negative pressure wound therapy versus gauze dressings for the treatment of contaminated traumatic wounds. J Wound Care. 2017;26(10):600-6.

Virani SR, Dahapute AA, Bava SS, Muni SR. Impact of negative pressure wound therapy on open diaphyseal tibial fractures: A prospective randomized trial. J Clin Orthop Trauma. 2016;7(4):256-9.

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Published

2023-08-17

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Section

Original Research Articles