Topical negative pressure wound therapy: a review of its role and guidelines for its use in the management of acute wounds

Abstract

Over the past two decades, topical negative pressure (TNP) wound therapy has gained wide acceptance as a genuine strategy in the treatment algorithm for a wide variety of acute and chronic wounds. Although extensive experimental and clinical evidence exists to support its use and despite the recent emergence of randomised control trials, its role and indications have yet to be fully determined. This article provides a qualitative overview of the published literature appertaining to the use of TNP therapy in the management of acute wounds by an international panel of experts using standard methods of appraisal. Particular focus is applied to the use of TNP for the open abdomen, sternal wounds, lower limb trauma, burns and tissue coverage with grafts and dermal substitutes. We provide evidence-based recommendations for indications and techniques in TNP wound therapy and, where studies are insufficient, consensus on best practice.

Figure 1

Algorithm for the management of the open abdomen. RTE, reverse tissue expansion; VAC, vacuum‐assisted closure.

Figure 2

Stepwise role progression of topical negative pressure in the management of sternal wound infections.