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Case Series/Study
For many reasons, NPWT is the best option for the management of complex wounds with high exudation and a large coverage defect. However, in countries with low access to resources, it is underestimated due to its high cost of application. The objective of this presentation is to show the effectiveness of NPWT, in reducing the use of disposable materials, and share the strategies to achieve it.
Methods:
NPWT was applied to 28 patients, 32 complicated wounds in total. It was applied as the first therapeutic step leading to wound closure by means of a skin graft or to simplify the approach, using AWC or TC. A protocol of 1 weekly dressing change was performed at hospitals and home NPWT using commercial devices.
Wound Origin: Secondary to an infection: 13, to a surgical procedure: 10, to trauma: 4, to pressure Injuries: 3, use of cytostatic: 2.
Wound localization: Head, face, arms, chest, abdomen, back, perineum, arm, leg, foot.
Patient ages: from 3 months to 85 years.
Results:
Closure of the wounds was achieved in all the cases. In 15 wounds NPWT allowed for simplifying the approach into Traditional Care (13) or AWC (2). In 17 wounds NPWT was used to prepare the wound bed for a skin graft (14), surgical stitch (2), and muscular flap (1). NPWT was used successfully over 13 skin grafts.
No wounds presented signs of infection. 14 patients were discharged from the hospital to receive home care.
Discussion:
NPWT reduces the time and overall cost of treatments. Through the series of cases presented, it is evident that application costs can be reduced without a decrease in clinical results. Clear therapeutic goals, expertise, training the staff in charge of the patient, and maintaining permanent communication are key tools to maximize the benefits of using NPWT.
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