Skip to main content

Advertisement

Log in

Negative pressure wound therapy: current practice in India

  • Original Paper
  • Published:
European Journal of Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

Negative pressure wound therapy (NPWT) is a therapeutic technique using a vacuum dressing to promote healing in acute or chronic wounds. This study aims to survey current opinion regarding negative pressure wound therapy (NPWT) among plastic surgeons in India.

Methods

Registered plastic surgeons currently practicing in India were identified from the Association of Plastic Surgeons in India database. A questionnaire was designed asking a set of question which included if they used NPWT in their plastic surgical practice, whether or not they considered themselves aware of the current evidence and applications of NPWT and how successful they felt that NPWT was in different clinical situations. The questionnaire was uploaded online and a link was e-mailed to them requesting for completion. Two e-mail reminders were sent to those who failed to respond.

Results

Of 388 plastic surgeons, 240 responded (62 %). The median response time was 18.2 days. Out of 240, 182 (76 %) plastic surgeons used NPWT in their clinical practice. The main adverse events when using NPWT appeared to be pain when changing the dressing (22 %), bleeding (18 %) and infection (12 %). NPWT was most commonly used for diabetic foot wounds post-debridement, pressure sores and arterial/venous ulcers. As per the respondents, use of NPWT reduced the time interval from admission to final procedure by almost 40 %.

Conclusions

Currently in India, NPWT is most commonly used for diabetic foot wounds post-debridement, pressure sores and arterial ulcers followed by venous ulcers, with perceived success correlating with this order of popularity. There is a need for surgeons in India to understand the controversies regarding NPWT and adopt it in their clinical practice wherever feasible.

Level of Evidence: Level III, therapeutic study.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Fogg E (2009) Best treatment of nonhealing and problematic wounds. J Am Acad Physician Assistants 22(8):46–48

    Article  Google Scholar 

  2. Banwell PE, Musgrave M (2004) Topical negative pressure therapy: mechanisms and indications. Int Wound J 1:95–106

    Article  PubMed  Google Scholar 

  3. Morykwas MJ, Simpson J, Punger K, Argenta A, Kremers L, Argenta J (2006) Vacuum-assisted closure: state of basic research and physiologic foundation. Plast Reconstr Surg 117(7 Suppl):121S–126S

    PubMed  CAS  Google Scholar 

  4. Henderson V, Timmons J, Hurd T, Deroo K, Maloney S, Sabo S (2010) NPWT in everyday practice made easy. Wounds Int 1(5)

  5. Lambert KV, Hayes P, McCarthy M (2005) Vacuum assisted closure: a review of development and current applications. Eur J Vasc Endovasc Surg 29:219–226

    Article  PubMed  CAS  Google Scholar 

  6. Schintler MV, Prandl EC (2008) Vacuum-assisted closure—what is evidence based? Eur Surg 40/1:11–18

    Article  Google Scholar 

  7. Ubbink DT, Westerboss SJ, Nelson EA, Vermeulen H (2008) A systematic review of topical negative pressure therapy for acute and chronic wounds. Br J Surg 95:685–692

    Article  PubMed  CAS  Google Scholar 

  8. Van den Boogaard M, de Laat E, Spauwen P, Schoonhoven L (2008) The effectiveness of topical negative pressure in the treatment of pressure ulcers: a literature review. Eur J Plast Surg 31:1–7

    Article  Google Scholar 

  9. Armstrong DG, Lavery LA (2005) Diabetic foot study consortium. Negative pressure wound therapy after partial diabetic foot amputation: a multicentre, randomised controlled trial. Lancet 366(9498):1704–1710

    Article  PubMed  Google Scholar 

  10. Mouës CM, van den Bemd GJ, Meerding WJ, Hovius SE (2005) An economic evaluation of the use of TNP on full-thickness wounds. J Wound Care 14(5):224–227

    PubMed  Google Scholar 

  11. Leininger BE, Rasmussen TE, Smith DL, Jenkins DH, Coppola C (2006) Experience with wound VAC and delayed primary closure of contaminated soft tissue injuries in Iraq. J Trauma 61(5):1207–1211

    Article  PubMed  Google Scholar 

  12. Apelqvist J, Armstrong DG, Lavery LA, Boulton AJ (2008) Resource utilization and economic costs of care based on a randomized trial of vacuum-assisted closure therapy in the treatment of diabetic foot wounds. Am J Surg 195(6):782–788

    Article  PubMed  Google Scholar 

  13. Park, Defranzo AJ, Marks MW, Molnar JA (2009) Outpatient reconstruction using integra and subatmospheric pressure. Ann Plast Surg 62(2):164–169

    Article  PubMed  CAS  Google Scholar 

  14. Braakenburg I, Obdeijn MC, Feitz R, Van Rooij IALM, Van Griethuysen AJ, Klinkenbijl JHG (2006) The clinical efficacy and cost effectiveness of the vacuum-assisted closure technique in the management of acute and chronic wounds: a randomized controlled trial. Plast Reconstr Surg 118(2):390–397

    Article  PubMed  CAS  Google Scholar 

  15. Hurd T, Chadwick P, Cote J, Cockwill J, Mole TR, Smith JM (2010) Impact of gauze-based NPWT on the patient and nursing experience in the treatment of challenging wounds. Int Wound J 7(6):448–455

    Article  PubMed  Google Scholar 

  16. Vikatmaa P, Juutilainen V, Kuukasjarvi P, Malmivaara A (2008) Negative pressure wound therapy: a systematic review on effectiveness and safety. Eur J Vasc Endovasc Surg 36:438–448

    Article  PubMed  CAS  Google Scholar 

  17. Morykwas MJ, Argenta LC, Shelton-Brown EI, McGuirt W (1997) Vacuum-assisted closure: a new method for wound control and treatment: animal studies and basic foundation. Ann Plast Surg 38(6):553–562

    Article  PubMed  CAS  Google Scholar 

  18. Morykwas MJ (1998) External application of sub-atmospheric pressure and healing: mechanisms of action. Wound Heal Soc Newsl 8(4–5)

    Google Scholar 

  19. Philbeck TE Jr, Whittington KT, Millsap MH, Briones RB, Wight DG, Schroeder WJ (1999) The clinical and cost effectiveness of externally applied negative pressure wound therapy in the treatment of wounds in home healthcare Medicare patients. Ostomy Wound Manag 45(11):41–50

    Google Scholar 

  20. McCallon SK, Knight CA, Valiulus JP, Cunningham MW, McCulloch JM, Farinas LP (2000) Vacuum-assisted closure versus saline-moistened gauze in the healing of postoperative diabetic foot wounds. Ostomy Wound Manag 46(8):28–34

    CAS  Google Scholar 

  21. Wanner MB, Schwarzl F, Strub B, Zaech GA, Pierer G (2003) Vacuum-assisted wound closure for cheaper and more comfortable healing of pressure sores: a prospective study. Scand J Plast Reconstr Surg Hand Surg 37(1):28–33

    PubMed  Google Scholar 

  22. Mouës CM, Vos MC, Van Den Bemd GJCM, Stijnen T, Hovius SER (2004) Bacterial load in relation to vacuum-assisted closure wound therapy: a prospective randomized trial. Wound Repair Regen 12(1):11–17

    Article  PubMed  Google Scholar 

  23. Etöz A, Özgenel Y, Özcan M (2004) The use of negative pressure wound therapy on diabetic foot ulcers: a preliminary controlled trial. Wounds 16(8):264–269

    Google Scholar 

  24. Moisidis E, Heath T, Boorer C, Ho K, Deva AK (2004) A prospective, blinded, randomized, controlled clinical trial of topical negative pressure use in skin grafting. Plast Reconstr Surg 114(4):917–922

    Article  PubMed  Google Scholar 

  25. Schwien T, Gilbert J, Lang C (2005) Pressure ulcer prevalence and the role of negative pressure wound therapy in home health quality outcomes. Ostomy Wound Manag 51(9):47–60

    Google Scholar 

  26. Blume P, Walters J, Payne W et al (2008) Comparison of negative pressure wound therapy using vacuum assisted wound closure with advanced moist wound therapy in the treatment of diabetic foot ulcers. A multicentre randomized controlled trial. Diabetes Care 31(4):631–636

    Article  PubMed  Google Scholar 

  27. Peinemann F, Sauerland S (2011) Negative pressure wound therapy—systematic review of randomized controlled trials. Dtsch Arztebl Int 108(22):381–389

    PubMed  Google Scholar 

  28. Neubauer G, Ujlaky R (2003) The cost-effectiveness of topical negative pressure versus other wound-healing therapies. J Wound Care 12(10):392–393

    PubMed  CAS  Google Scholar 

  29. Searle R, Milne J (2010) Tools to compare the cost of NPWT with advanced wound care: an aid to clinical decision-making. Wounds UK 6(1):106–109

    Google Scholar 

  30. Vuerstaek JDD, Vainas T, Wuite J et al (2006) State of the art treatment of chronic leg ulcers: a randomized controlled trial comparing vacuum-assisted closure (V.A.C) with modern wound dressings. J Vasc Surg 44(5):1029–1037

    Article  PubMed  Google Scholar 

  31. Morris GS, Brueilly KE, Hanzelka H (2007) Negative pressure wound therapy achieved by vacuum-assisted closure: evaluating the assumptions. Ostomy Wound Manag 53(1):52–57

    Google Scholar 

Download references

Conflict of interest

None

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Deevish Dinakar.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Dinakar, D., Venkataram, A., Santhosh, S. et al. Negative pressure wound therapy: current practice in India. Eur J Plast Surg 36, 567–572 (2013). https://doi.org/10.1007/s00238-013-0857-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00238-013-0857-9

Keywords

Navigation