Negative Pressure Wound Therapy for Extremity Open Wound Management: A Review of the Literature. (September 2022)

• Record Type: Journal Article
• Authors: Van Rysselberghe, Noelle L.; Gonzalez, Christian A.; Calderon, Christian; Mansour, Adam; Oquendo, Yousi A.; Gardner, Michael J.
• Is Part Of: Journal of orthopaedic trauma. Volume 36(2022)Supplement 4
• Page Start: S6
• Page End: S11
• Publication Date: 2022-09
• Subjects: negative pressure -- wound vac -- open fractures -- soft tissue reconstruction; Orthopedics -- Periodicals; Wounds and injuries -- Periodicals; Orthopedics -- Periodicals; Wounds and Injuries -- therapy -- Periodicals; Periodicals; 617.47044
• DOI: 10.1097/BOT.0000000000002430
• Languages: English
• ISSNs: 0890-5339

Abstract

Summary: Negative pressure wound therapy (NPWT) with reticulated open cell foam is used commonly in orthopaedic trauma, particularly in the management of complex open fracture wounds. This article reviews the literature to date regarding this adjunctive treatment, particularly in regard to removal of infectious material, temporary management of wounds pending soft tissue reconstruction, combat wounds, and over split-thickness skin grafts. Mechanism of action is also reviewed, including stabilization of the wound environment, edema control, macrodeformation, and microdeformation effects. Use of NPWT as an adjunct in management of open fractures along with operative debridement, systemic antibiotics, and early soft tissue reconstruction are the highest yield interventions for managing open fracture wounds with infection. NPWT as an adjunct therapy in the protocol for open fractures seems to add additional clinical benefit for patients with severe open fracture wounds not amenable to primary, immediate closure.