Sound Evidence - May 2008 - (Page 1) Sound Evidence Combination of Negative Pressure Wound Therapy and Acoustic Pressure Wound Therapy for Treatment of Infected Surgical Wounds: A Case Series Paul A. Liguori, MD; Kim L. Peters, RN, CWS; and Jolene M. Bowers, RN Whittier Rehabilitation Hospital, Haverhill, Massachusetts The optimal wound therapy for healing infected wounds post surgery or surgical debridement has not been established. Negative pressure wound therapy and acoustic pressure wound therapy are advanced wound-healing modalities that apply forms of mechanical pressure to wound tissue in an effort to promote healing by stimulating cellular proliferation. Using a combination of negative pressure wound therapy and acoustic pressure wound therapy was evaluated in a series of six patients with large, infected surgical wounds presenting with moderate to large amounts of serosanguineous drainage. After concurrent treatment with both modalities (range: 4 to 12 weeks), wound volume was reduced by 99% to 100% in all wounds except one wound for which depth at end of treatment was not measurable due to hypergranulation. Similarly, wound surface area was reduced by 82% to 100%, with the exception of the hypergranular wound, which decreased in size by 60%. Serosanguineous wound drainage was reduced in four wounds and remained unchanged in two wounds. KEYWORDS: acoustic pressure wound therapy, negative pressure wound therapy, surgical wounds, wound infection, debridement Ostomy Wound Management 2008;54(5):50-53 nfected wounds are difficult to treat and often require “advanced” wound healing modalities to supplement conventional wound care using moist dressings and topical agents.1 In these wounds, the presence of devitalized tissue and bacterial infection slows both the granulation process and the progression of wound closure.2 Two advanced wound-healing modalities apply forms of mechanical pressure to the wound tissue that is intended to promote healing by stimulating cellular proliferation. Negative pressure wound therapy (NPWT) employs an open-cell, foam dressing with adhesive drape connected to a vacuum pump that applies either inter- I mittent or continuous subatmospheric pressure to the wound tissues. Acoustic pressure wound therapy (APWT) delivers ultrasound-generated acoustic pressure to wound tissues via a fine mist of sterile saline. Whether these two therapies stimulate the cellular activity necessary for wound healing is not definitively known. Regardless, published studies1,3 of NPWT and APWT have reported noteworthy improvements compared to conventional wound care in outcomes such as time to wound closure, proportion of wounds closed, and volume or area reduction. It should be noted that the preponderance of evidence supporting NPWT and Support for Sound Evidence is provided by an educational grant from Celleration, Inc. to HMP Communications/Ostomy Wound Management. The opinions and statements herein, as well as the selection of metrics to measure wound healing, are specific to the authors and are not necessarily those of Celleration, Inc., OWM, or HMP Communications, LLC. Please note: these articles are subject to peer review. The opinions herein may not be consistent with the labeling for MIST Therapy System. Patients are selected for your educational benefit. View celleration.com for the full package insert. Results may vary. 50 OstomyWound Management http://celleration.com
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