The Role of Negative Pressure Wound Therapy with Instillation and Dwell Time in the Preparation of Wound Bed

Abstract

Introduction
Although the negative pressure wound therapy (NPWT) is a time tested method of wound preparation, the role of NPWT with
instillation and dwell time (NPWTi-d) in decreasing the downtime of wound preparation needs to be evaluated.
Objective
The objective of this study is assess the role of NPWTi-d in wound bed preparation.
Materials and Methods
This study was conducted in a tertiary care center, after getting informed consent and ethical clearance. NPWTi-d was done
on a 36-years-old female with no known co-morbidities admitted with infected raw area over the right below knee amputation
stump and exposed bone who was not responding well to conventional wound dressing. NPWT was applied with the help of
sterile polyurethane sponge and two tubes. The antimicrobial solution used was ionic silver solution, just enough to wet the
sponge completely and up to the point when the transparent occlusive covering begins to lift. Negative pressure was applied at
125 mmHg. The wound was bathed with ionic silver solution and it was allowed to stay in the wound for 10-minutes, after every
2-hours of negative pressure application. This was continued for 1-week. The dressing was opened at the end of 1-week, wound
irrigated with normal saline, exudate swabs for culture taken and debrided, following which fresh NPWTi-d was applied. This
was repeated for the next 3-weeks.
Result
By the end of third week, the wound became clean, fully covered with healthy granulation and the wound bed was ready to undergo
the definitive wound cover procedure.