Topical negative-pressure wound therapy: emerging devices and techniques

ABSTRACT

Introduction: The treatment of chronic wounds constitutes a massive financial burden to society and our health-care system. Therefore, efficient wound care is of great importance to all kinds of medical fields. The implementation and modification of negative-pressure wound therapy can be seen as a major improvement in wound healing. Many different NPWT applications evolved trying to address various wound etiologies.

Areas covered: This review aims to give an overview of various NPWT applications, show its effects on wound healing, and discuss future modifications.

Expert opinion: NPWT as a delivery device for cold plasma, growth factors, or targeted stem cells to the wound bed and the ability to monitor the inflammatory activity, bacterial load and wound healing factors can be seen as possible future steps to individualized wound care. In addition, it requires high-quality experimental studies to develop the ideal foam in terms of microstructure, pore size, and material properties.

KEYWORDS:

• Medical device
• negative pressure wound therapy
• wounds
• wound coverage
• wound management
• future applications

Article Highlights

• Negative-pressure wound therapy has shown to be an effective treatment modality for various types of wounds.

• Closed incision negative-pressure wound therapy shows improved tissue perfusion close to the wound edges and reduced infection and wound dehiscence rates.

• Negative-pressure wound therapy with instillation and dwell time possesses huge potential especially for infected wounds.

• The enhancement of various foam properties (such as biological degradability) can broaden the clinical use of NPWT in the future.

• The delivery of various wound-specific substances such as stem cells and growth factors at a desired rate and dose using NPWT with instillation can play an important role in future wound management.

Author Contribution

All authors meet the International Committee of Medical Journal Editors (ICJME) requirements for authorship:

Prof Dr med Dr h.c. Raymund E. Horch, MD

Dr med Ingo Ludolph, MD

Dr med Wibke Müller-Seubert, MD

Katharina Zetzmann, MD

Dr med sci Theresa Hauck, MD

Prof Dr med Andreas Arkudas, MD

Dr med univ Alexander Geierlehner, MSc, MD

Declaration of interest

RE Horch has received third party funding for scientific research on NPWT from KCI- an Acelity company in the past and has served as a speaker on scientific symposia and as a member of a scientific advisory board of KCI-Acelity in the past. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

One peer reviewer is a KOL expert for Acelity and has acted as a speaker for oral presentations. Peer reviewers on this manuscript have no other relevant financial relationships or otherwise to disclose.

Additional information

Funding

This paper was not funded.