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MedTech Outlook | Thursday, September 22, 2022
Negative pressure wound therapy has shown remarkable results in faster wound healing rates in patients with ulcers, offering potential benefits for such patients.
FREMONT, CA: With the development of devices and dressings assisting wound healing, wound care technology continues to expand. This technology is used to heal non-healing and chronic ulcers, making it a cost-effective method by reducing the nursing burden. Often, the proposed wound care technologies do not meet the needs of major healing outcomes. Therefore, suppliers should have reasonable expectations of what each technology provides and how it helps with resident care. One example of effective care is negative pressure wound technologies offering optimal healing outcomes.
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Negative pressure wound therapy (NPWT) is usually available in the nursing home. It is a closed system utilising negative pressure to drain wound fluid away from and nutrients into a wound. It uses medical-grade placed over the wound, covering it with a thin transparent biofilm, creating an airtight seal. Providers use NPWT therapy for diabetic feet or pressure ulcers. Proponents of this therapy consider that wound healing is accelerated by drawing fluid out of the interstitial space or reducing the number of bacteria in the wounds.
A few RCTs of NPWT therapy were present until 2005, and different systematic reviews revealed only a small number of randomised prospective trials taking place before 2005. One study included six RCTs with 148 subjects, out of which 54 came from a single trial. The overall strength of the evidence is fair, with only one intention-to-treat trial. Systematic reviews judged the evidence from RCTs to be inconclusive relative to the advantage of NPWT for chronic wound healing.
After the systematic reviews, the most robust science involving an RCT was published. This initiative selected 162 patients randomly to provide standard wound care (n = 85) versus NPWT (n = 77) in 18 outpatient wound care facilities. This was a case-control study of patients undergoing partial foot amputation. It included subjects with diabetic neuropathic ulcers without peripheral arterial disease. They were a younger population and predominantly male (81 per cent). The administrators observed a higher complete healing rate in the NPWT group with 56 per cent, than in people in the standard care group with 39 per cent. They experienced rapid healing rates in the NPWT group compared to 84 days (IQR, 57-112). This indicates that NPWT offers many potential benefits for ulcers, but current proof confines it to use in diabetic foot ulcers with adequate arterial supply.
Despite lower nursing costs and faster healing times in the single study examining the question, cost-benefit analysis shows a need for cost-cutting efforts despite better evidence of healing with NPWT therapy. Proper training of nursing staff is required to leverage NPWT effectively, thereby adding to the overall cost. Furthermore, the therapy improves complete healing rates and speeds up healing in diabetic foot ulcers.
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