Slovenská chirurgia 3/2023

Negative pressure wound therapy – current trends

Negative pressure wound therapy (NPWT) has expanded the possibilities and reach of wound care and is continually finding additional clinical applications (1) in the outpatient clinic and in the hospital (2). Currently, NPWT is applied to virtually all types of wound healing (by primary, secondary or tertiary intention) and holds promise for improving healing over standard wound care in many indications. In addition to wound healing, NPWT is currently used in the treatment of open abdomen (3). It is expected that the scope of application of NPWT will be further expanded in the future, e.g., to include indications in the treatment of complicated internal organ healing (4). However, both the evidence and the quality of evidence regarding the efficacy of NPWT in the numerous randomized controlled trials (RCTs) conducted to date vary. A meta-analysis by Peineman and Labeit (1) included 93 studies from 30 countries from 1999-2017 discussing the treatment of both open and closed wounds using NPWT. Up to 50% of the studies were unclear or at high risk of research bias. A meta-analysis by Zens et al. (2) of 48 RCTs investigating the use of NPWT in the treatment of secondary healing wounds showed a statistically significant effect of NPWT on wound healing at 6 weeks versus standard wound care and also on reduction in hospital stay. No evidence of greater patient harm (increase in mortality or incidence of other adverse events) was found for NPWT versus standard treatment of secondary healing wounds, suggesting that it is a safe treatment modality.

Keywords: negative pressure wound therapy, healing per secondary intention, infected wounds, instillation, surgical wounds