Sacral and Ischial Pressure Ulcer Management With Negative-Pressure Wound Therapy With Instillation and Dwell
Sacral and Ischial Pressure Ulcer Management With Negative-Pressure Wound Therapy With Instillation and Dwell
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DOI：
10.1097/prs.0000000000007613
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发表时间：
2021-01-01
影响因子：
3.6
通讯作者：
Wirth, Garrett A.
中科院分区：
文献类型：
--
作者：
Arowojolu, Omotayo A.;Wirth, Garrett A.
背景：在负压创伤治疗(NPWT)已确立的伤口愈合益处的基础上，增加局部液体滴注、可编程的“停留”时间和新的泡沫伤口界面，协同作用使复杂伤口的患者受益。这项伤口护理的工程突破被称为NPWT与滴注和停留(NPWTi-d)，新的泡沫敷料是专门为NPWTi-d设计的网状开放式泡沫敷料。这项联合技术在慢性复杂创面中显示出良好的前景，并有可能用于治疗骶骨和坐骨压力伤。方法：对PubMed和Medline上报道的NPWTi-d在骶骨或坐骨压力溃疡中的应用进行定性的全面综述。结果：与传统的NPWT相比，NPWTI-d可以帮助冲洗创面，清除纤维碎屑，促进肉芽组织的形成。这与手术清创次数的减少和住院时间的减少有关。结论：这项技术在慢性骶骨和坐骨压疮住院患者中的应用正在迅速扩大。如果使用得当，NPWTI-d可以作为有效的“通往明确终点的桥梁”：无论是皮瓣重建、皮肤移植，还是带着稳定的慢性伤口和简化的伤口护理出院回家。
Background: The addition of topical fluid instillation, a programmable "dwell" time and a novel foam-wound interface to the established wound healing benefits of negative-pressure wound therapy (NPWT) works synergistically to benefit patients with complex wounds. This engineering breakthrough for wound care has been termed NPWT with instillation and dwell (NPWTi-d), and the new foam dressings are reticulated open cell foam dressings specifically designed for use with NPWTi-d. This combined technology has shown promise in chronic, complex wounds and has potential for the management of sacral and ischial pressure wounds.Methods: A qualitative comprehensive review was performed analyzing articles from PubMed and Medline that reported on the use of NPWTi-d in sacral or ischial pressure ulcers. Case series and case reports were predominant, and results of cases specific to sacral and ischial pressure wounds were extracted from larger studies and summarized for presentation.Results: Compared with conventional NPWT alone, NPWTi-d has been shown to help irrigate the wound, remove fibrinous debris, and promote granulation tissue formation. This is associated with a decreased number of operative debridements and decreased hospital length of stay.Conclusions: This technology is rapidly demonstrating expanded utilization in hospitalized patients with chronic sacral and ischial pressure ulcers. When used correctly, NPWTi-d serves as an effective "bridge to defined endpoint": whether that is a flap reconstruction, skin grafting, or discharge home with a stable chronic wound and simplified wound care.