A Guide To Current And Emerging NPWT Modalities
Despite advances in research and ongoing clinical trials, the worldwide diabetes epidemic shows little sign of slowing down. Through a combination of increased tissue perfusion, removal of exudate and infectious materials, and physical stimulation of cells, NPWT reportedly increases granulation tissue formation and accelerates healing in patients with diabetic foot wounds.8,9 Negative pressure wound therapy may also improve the quality of life of patients with diabetic foot ulcers and may reduce the overall cost of treating these patients.10
Researchers have demonstrated that the instillation of fluids such as Dakin’s solution, insulin and doxycycline, which reportedly promote wound healing, may provide an added benefit of NPWT by reducing maceration via infusion of these solutions directly into the wound bed.14-16 Through the application of NPWT to post-traumatic wounds, skin grafts and, more recently, over closed incision sites, the current indications for the modality are greater than ever, and the results are promising. While the electrically powered NPWT systems most commonly used today can be difficult to procure in the outpatient setting and provide limited mobility due to their size and power source, a novel, portable system such as the SNaP system may help to remedy these issues.
Over the past 20 years, NPWT has emerged as a critical tool for foot and wound care specialists throughout the world. Over the next 20 years, the impact it will have for patients is immeasurable.
Dr. Armstrong is a Professor of Surgery at the University of Arizona College of Medicine in Tucson, Az. He is the Director of the Southern Arizona Limb Salvage Alliance (SALSA).
Dr. Isaac is the Chief Resident in the Podiatric Medicine and Surgery Residency (PM&S-36) at St. Barnabas Medical Center in Livingston, N.J. He is also an incoming Clinical Instructor in the Department of Surgery at the University of Arizona College of Medicine and Fellow at SALSA.