Use of negative pressure wound therapy in burn patients

Abstract

According to previous research, adjunctive negative pressure wound therapy (NPWT) can help manage infected wounds when applied along with appropriate debridement and antibiotic therapy as deemed clinically relevant. NPWT not only removes fluid, and reduces oedema, but also promotes perfusion around the wounds. In addition, NPWT may lead to improved graft fixation when used as a bolster, especially in patients who are less compliant or have poor graft fixation that result from using traditional methods. NPWT is a good choice to bolster skin grafts in young, active and less-compliant patients. We propose an enhanced segmental compartment-covered technique, which uses NPWT adjunctively as first-line wound treatment to help manage postoperative infection. Moreover, NPWT promotes granulation tissue formation to prepare the wound bed for subsequent skin graft and may be used as a bolster over the graft, which helps to attain skin graft viability.

Keywords: Burns; Negative pressure wound therapy; Skin grafts; Wound healing.

Figure 1

Patient with 90% total burn surface area on the trunk. (A) Trunk burns at presentation; (B) trunk following the first round of surgical debridement; (C) application of Meek technique skin grafts with an expansion ratio of 1:4; (D) application of negative pressure wound therapy (NPWT); (E) trunk after 12 weeks of NPWT.

Figure 2

Patient presenting with lower extremity burns. (A) Burns at presentation; (B) right leg following two rounds of surgical debridement; (C) left leg following three rounds of surgical debridement; (D) back of legs following 12 weeks of negative pressure wound therapy (NPWT); (E) front of legs following 12 weeks of NPWT.