McKanna M, Geraci J, Hall K, Hauan B, Howell M, Huey T, Lucius A, Mendez-Eastman S, Purcell K, Raizman R, Shepherd D, Gabriel A, et al.
Ostomy/wound management. Date of publication 2016 Apr 1;volume 62(4):S1-S14.
1. Ostomy Wound Manage. 2016 Apr;62(4):S1-S14.
Clinician Panel Recommendations for Use of Negative Pressure Wound Therapy with
Instillation.
McKanna M(1), Geraci J(2), Hall K(3), Hauan B(4), Howell M(5), Huey T(6), Lucius
A(7), Mendez-Eastman S(8), Purcell K(9), Raizman R(10), Shepherd D(11), Gabriel
A(12).
Author information:
(1)Union Hospital, Terre Haute, IN.
(2)Bethesda North Hospital, Amelia, OH.
(3)Carilion Clinic, Roanoke, VA.
(4)UW Northwest Hospital, Seattle, WA.
(5)Emanuel Medical Center, Turlock, CA.
(6)Catawba Valley Medical Center, Hickory, NC.
(7)UT Southwestern Medical Center, Dallas, TX.
(8)Nebraska Medicine, Bellevue, NE.
(9)Select Specialty Hospital, Newberry, FL.
(10)Shoshray Consulting, Toronto, ON.
(11)Parkland Health and Hospital System, Dallas, TX.
(12)PeaceHealth Medical Group, Vancouver, WA.
Addition of an instilled topical wound solution to negative pressure wound
therapy (NPWT) is designed to facilitate regular wound cleansing to help improve
outcomes of some complex wounds, but the addition of instillation to NPWT adds a
level of complexity to the wound care process. The paucity of knowledge and
experience with instillation may affect optimal use of this treatment modality.
In an effort to address this knowledge gap, a 2-day panel meeting of nurses (N =
11) with experience using negative pressure wound therapy with instillation and
dwell time (NPWTi-d) was convened to discuss their usage recommendations for
managing wounds with this treatment modality in the acute care setting. Panelists
reviewed available evidence and presented recommendations for managing wounds
treated with NPWTi-d. Panelists agreed NPWTi-d is primarily suited to prepare
surgical or nonsurgical wounds for delayed primary closure and
preparing/protecting periwound skin improves maintenance of a tight seal.
Educating a team of nurses on basic NPWTi-d troubleshooting, providing a short
checklist of tasks to perform every shift, and organizing needed supplies and
resources may help continuity of care and prevent problems. Panelists also
emphasized the im- portance of wound assessment and documentation and recommend
educating the patient, family members, and other members of the patient-care
team. Research to compare the safety, ef cacy, and effectiveness of NPWTi-d and
other irrigation techniques on patient outcomes and research to validate these
recommendations is needed.
PMID: 28657895 [Indexed for MEDLINE]
