2020 Volume 1 Issue 2 Pages 53-61
Introduction: Negative-pressure wound therapy (NPWT) with instillation and dwelling (NPWTi-d) system can be used to treat infected wounds. In 2017, a new reticulated open cell foam dressing (ROCF-CC) for NPWTi-d was launched. The feature of ROCF-CC is that the contact layer contains holes. It allows viscous exudate and infected materials to be removed. We report for the first time the application of NPWT-i-d with ROCF-CC in Japan.
Methods: Four patients who were admitted to our hospital between August and December 2019 were indicated for NPWTi-d with ROCF-CC. The causes of the patients' wounds, dosage of saline, saline dwell time, degree and cycle frequency of negative pressure, frequency of foam dressing changes, and duration of NPWTi-d were examined.
Results: The treated wounds consisted of necrotizing fasciitis, diabetic skin ulcer, postoperative wound, and ulcer caused by hematoma. A total of 10–100mL of normal saline was instilled. The dwell time ranged from 5 to 10min. The cycle frequency of negative pressure ranged from 2 to 3.5 h, and the level was set at −125mmHg. Dressing changes were conducted every 2–4 days. Granulation tissue formed without infections developing. Since the necrotic tissue was removable due to ROCF-CC, debridement was easy. The problems were pain and maceration.
Conclusion: We found that using NPWTi-d with ROCF-CC enabled the removal of necrotic tissue and viscous wound exudate. It allows debridement to be performed easily and safely without affecting the normal tissue and hastens granulation tissue formation.