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Positive Outcomes with Negative Pressure Wound Therapy Laurie S. Stelmaski BSN,RN,CWOCN
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Positive Outcomes with Negative Pressure Wound Therapy Laurie S. Stelmaski BSN,RN,CWOCN.

Dec 23, 2015

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Page 1: Positive Outcomes with Negative Pressure Wound Therapy Laurie S. Stelmaski BSN,RN,CWOCN.

Positive Outcomes withNegative Pressure Wound

Therapy

Laurie S. Stelmaski BSN,RN,CWOCN

Page 2: Positive Outcomes with Negative Pressure Wound Therapy Laurie S. Stelmaski BSN,RN,CWOCN.

Objectives

Understand the healing science behind negative pressure wound therapy (NPWT).

Identify the indications and contraindications for use of NPWT in acute and chronic wounds.

Identify treatment endpoints for NPWT.

Page 3: Positive Outcomes with Negative Pressure Wound Therapy Laurie S. Stelmaski BSN,RN,CWOCN.

NPWT – How Does It Work?

The use of subatmospheric pressure to promote wound healing.

Subatmospheric pressure causes mechanical stress to the tissue and the wound is drawn closed.

Basic components of a NPWT system include the dressing, sealing mechanism, tubing and a suction pump.

Page 4: Positive Outcomes with Negative Pressure Wound Therapy Laurie S. Stelmaski BSN,RN,CWOCN.

NPWT – Mechanisms of Action

Stimulation of wound edge retraction

Moist wound environmentDecrease in peripheral edemaIncrease in local circulation at the

site of the woundReduced bacterial loadStimulation of granulation tissue

formation

Page 5: Positive Outcomes with Negative Pressure Wound Therapy Laurie S. Stelmaski BSN,RN,CWOCN.
Page 6: Positive Outcomes with Negative Pressure Wound Therapy Laurie S. Stelmaski BSN,RN,CWOCN.

Indications for NPWTAcute woundsChronic woundsTraumatic woundsPartial-thickness burnsDehisced woundsPressure ulcersDiabetic ulcersFlaps and skin grafts

Page 7: Positive Outcomes with Negative Pressure Wound Therapy Laurie S. Stelmaski BSN,RN,CWOCN.

Contraindications for NPWT

Malignancy in the woundUntreated osteomyelitisNon-enteric or unexplored fistulas

Necrotic tissue with eschar or slough present

Exposed blood vessels or organs

Page 8: Positive Outcomes with Negative Pressure Wound Therapy Laurie S. Stelmaski BSN,RN,CWOCN.

Patient CandidatesAppropriate patient selection will

prevent complications and ensure success of NPWT.

Need to optimize the patient’s ability to heal:◦Manage comorbidities ◦Hemodynamic stability◦Nutritional status◦Blood sugar◦Infection

Page 9: Positive Outcomes with Negative Pressure Wound Therapy Laurie S. Stelmaski BSN,RN,CWOCN.

Safe Use of NPWTPatient assessment

◦Physician ordersWound preparation

◦Debridement and cleansingDevice application

◦DocumentationMonitoring and assessment

◦Procedure and protocol

Page 10: Positive Outcomes with Negative Pressure Wound Therapy Laurie S. Stelmaski BSN,RN,CWOCN.

Treatment Endpoints

Based on wound progress and/or achievement of treatment goal.

Planned surgical closure with flap or skin graft.

Healing by secondary intentionFailure to progress after 2-4

weeks of NPWT.

Page 11: Positive Outcomes with Negative Pressure Wound Therapy Laurie S. Stelmaski BSN,RN,CWOCN.

Case Study #1

Page 12: Positive Outcomes with Negative Pressure Wound Therapy Laurie S. Stelmaski BSN,RN,CWOCN.

Case Study #2

Page 13: Positive Outcomes with Negative Pressure Wound Therapy Laurie S. Stelmaski BSN,RN,CWOCN.

ReferencesGupta, S. (2004). Guidelines for managing pressure ulcers with negative pressure wound therapy. Advances in Skin & Wound Care, 17(S2), 2-16.Long, M.A. & Blevins, A. (2009). Options in negative pressure wound therapy: Five case

studies. Journal of Wound Ostomy and Continence Nursing, 36(2), 202-211.

Martindell, D. (2012). The safe use of negative-pressure wound therapy. American

Journal of Nursing, 112(6), 59-63.