Negative Pressure Wound Therapy with Instillation in the Management of Infected and/or Chronic Wounds in Indian Patients

Background: Management of wounds is one of the most crucial aspects of surgical care. Wound management has come a long way in last 2-3 decades. During this period, Negative Pressure Wound Therapy (NPWT) has emerged as a boon for the surgeons. However, the management of infected and chronic wounds stills remains a challenge to the surgeons throughout the globe. To tackle these wounds, modifications were made in regular NPWT by adding intermittent automated instillation of topical wound irrigation solutions. This therapy is known as Negative Pressure Wound Therapy with Instillation (NPWTi). This method provided an additional dimension by reducing bioburden and biofilms present in these wounds, that may impair the processes of proper wound healing. Methods: A prospective analysis of 45 patients with infected and/or chronic wounds between December 2018 to June 2020 were included in this study. After surgical debridement, all patient were managed with NPWTi. Normal saline was used as instillation fluid in all cases with dwell time of 10mins, followed by 3 hours of NPWT at -125mmhg pressure. Data collection includes patient demographics, wound characteristic, number of debridements, number of dressing change, wound area reduction, time to wound closure, method of wound closure, complications and hospital stay.Mean time for wound closure was 11.05 day. Average hospital stay for patients with infected/chronic wounds managed with NPWTi was 11.5 days Only 1 patient had wound related complication in post op period and none of them had dehiscence or wound recurrence in 3 month post op period. Conclusion: NPWTi with normal saline instillation has improved the management of infected and/or chronic wounds and has become the standard of care at our facility