As the first comparative study that looks into the performances of portable negative pressure wound therapy devices, the author has helped us to gain a more complete understanding of their advantages and limitations [Citation1].
The author described and compared the main characteristics of several broadly used portable negative pressure therapy devices. The article also completed a through analysis of the main advantages and disadvantages of all these devices, including their liabilities, flexibilities, and cost [Citation1]. Although comparative studies present limitations due to the nature of study designs, the presented data in this manuscript had allowed us to understand the efficacy of negative pressure wound therapy from a different perspective and pointed out directions for future research.
Studies involving negative pressure wound therapy are challenging to conduct given the limited number of patient population. It is also difficult to set up control groups due to the lack of homogeneity in patient recruitment [Citation2]. These limitations were already indicated by the author in the manuscript. Nevertheless, the manuscript does point out possible study directions in the future. The author has mentioned that hospitals have different protocols and devices in managing patients. Therefore, coordinated multi-center studies would be a possible solution to these limitations by allowing cross-sectional comparison of patients receiving either different types of negative pressure devices or traditional therapies. These will allow us to understand portable negative pressure devices’ strengths and weaknesses in comparison to traditional wound care protocols.
Another topic addressed by the author is the cost benefits analysis surrounding negative pressure therapy. In previous research, traditional commercial negative pressure therapy is not only expansive in acquiring and maintaining equipment, but also require strict operative settings to allow vital status monitoring and anesthetics administrations [Citation3]. The portable negative pressure devices could a possible solution and open new doors for the treatment planning.
There are also concerns with regard to the consistency of these portable negative pressure therapy devices. Of these devices studied, only “PICO” can offer a wide range of pressure settings, while the rest only function at a set of pressure points, such as –75, –100, and –125 mmHg [Citation1]. This could be a problem when managing diverse patient population with a wide degree of wound characteristics [Citation4]. The depths, areas, and locations of wounds respond differently to different pressures levels and some complicated wounds may require higher pressure to sustain hemodynamic and granulation [Citation5]. What is more concerning is the liability of these portable devices. Being the only device that offers adjustable pressure setting, PICO works similar to other one time only disposable medical devices. It no longer functions after 7 days of operations regardless of maintenance or battery change. Other portable devices may last longer but will also deemed as unusable after a set period of time. This would greatly limit the efficacy of portable negative pressure therapy [Citation1]. It would not only add unnecessary economic burdens to the patients, but also limit the cost benefits of portable negative pressure devices.
Nevertheless, it is important for the reader to understand that many complicated wounds, such as large are third degree burns and ulcers need to be managed as soon as possible to avoid complications and wound deteriorations [Citation2]. Negative pressure therapy can be an excellent alternative if the traditional treatment plans failed to address the wound healing issues [Citation2].
Overall the future for negative pressure wound therapy is bright and encouraging, and should be pursued. With extensive research studies support, the cost benefit of negative pressure therapy will gradually improve.
References
- Cuomo R., Grimaldi L., Nisi G., Zerini I., Giardino F. R., Brandi C. Ultraportable devices for Negative Pressure Wound Therapy: first comparative analysis. J Invest Surg. 2021;34(3):335–343. doi: 10.1080/08941939.2019.1616009.
- Ren Y, Chang P, Sheridan RL. Negative wound pressure therapy is safe and useful in pediatric burn patients. Int J Burns Trauma 2017;7(2):12.
- Soares MO, Dumville JC, Ashby RL, et al. Methods to assess cost-effectiveness and value of further research when data are sparse: negative-pressure wound therapy for severe pressure ulcers. Med Decis Mak. 2013;33(3):415–436. doi: 10.1177/0272989X12451058.
- Borgquist O, Ingemansson R, Malmsjö M. Wound edge microvascular blood flow during negative-pressure wound therapy: examining the effects of pressures from –10 to –175 mmHg. Plast Reconstr Surg. 2010;125(2):502–509. doi: 10.1097/PRS.0b013e3181c82e1f.
- Dumville JC, Munson C, Christie J. Negative pressure wound therapy for partial-thickness burns. Cochrane Datab Syst Rev. 2014;(12):CD006215. doi: 10.1002/14651858.CD006215.pub4.