Proposed Topic (Most preferred): :
Research and Innovations (new projects / technology / innovations / service models)
Proposed Topic (Second preferred): :
Clinical Safety and Quality Service III (Projects aiming at quality service to patients and their carers)
Authors (including presenting author) :
Li YS (1), Annie Yeung (1), Tong Y T (2)
Affiliation :
(1) Wound Team NTWC, (2) Department of surgery
Introduction :
Recent literature has shown that negative pressure wound therapy with instillation (NPWT-i) is a valid method of managing complex wounds and gained increasingly wider interest due in part to the increasing complexity of wounds.
Objectives :
The purpose of this case study was to obtain information on the profile of NPWT-i in carbuncle patients, investigate the role it plays in wound bed preparation, length of hospital stays and number of debridement operations.
Methodology :
NPWT-i has been used in patients with carbuncle with Granudacyn® solution and complete the treatment were involved in the present study. Following aggressive surgical debridement in operation theater, NPWT-i was initiated by instilling solution with a set dwell time of 10-15 minute, followed by continuous NPWT of -125 mm Hg for 3-5 hour. The system was changed on a 3 days’ schedule until sufficient granulation tissue was evident. Patients received systemic antibiotics and underwent wound debridement as indicated. Data of wound bed preparation, length of hospital stay, duration of NPWT-i therapy, number of surgical interventions were collected retrospectively from patient medical records.
Result & Outcome :
A total of 8 patients with diagnosis of carbuncle received NPWT-i were included. Granulation tissue was found to be sufficient in 9-16 days. The mean duration of NPWT-i therapy was 12.5 days prior to wound closure by suture (n = 2), or flap reconstruction (n = 6). Patients received NPWT-i treatment over a period of 4-26 days. The mean length of hospitalization was 11.3 days. All wounds were successfully closed and no recurrence of infection or adverse event was observed during NPWT-i treatment.
In these patients, NPWT-i facilitates wound cleansing and wound bed preparation and offers the clinician an additional tool for the management of carbuncle. The mechanisms of action for NPWT-i helps provide wound management through wound cleansing, removal of exudate and infectious materials, and promoting the development of granulation tissue. Additional studies are warranted to fully assess the potential clinical and health economic benefits of NPWT-i use.
