Tips, Quips, and Pearls| Volume 49, ISSUE 3, P299-300, May 2010

Negative-pressure Wound Therapy Applied to High-risk Surgical Incisions


      Negative-pressure wound therapy (NPWT) is commonly used for chronic wounds, open fractures with soft tissue defects, and coverage over split-thickness skin grafts. NPWT uniformly draws wounds closed by helping to remove interstitial fluid, which contains inflammatory and potentially infectious exudate that could impair healing. Recently in our practice, we have used NPWT in cases involving tenuous incisions, such as those used to access target structures during total ankle replacement or open repair of joint depression calcaneal fractures, in an effort to prevent hematoma or wound dehiscence. Although it is generally understood that NPWT can be efficacious and cost-effective for management of a wide range of lower extremity wounds, we also believe it to be beneficial in the management of low-energy trauma and elective hindfoot and ankle reconstructions, and feel that it has led to decreased pain, swelling, and time to healing in our patients. Based on our experience with ankle arthroplasty and the surgical management of hindfoot and ankle trauma, we believe that the use of NWPT in the immediate postoperative period is both safe and efficacious.


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        • Flack S.
        • Apelquist J.
        • Keith M.
        • Trueman P.
        • Williams D.
        An economic evaluation of NPWT therapy compared with wound dressing in the treatment of diabetic foot ulcers.
        J Wound Care. 2008; 17: 71-78
      1. Weinberg Group, Inc. Technology Assessment of the V.A.C. for In-home Treatment of Chronic Wounds, p 61, The Weinberg Group, Inc., Washington, DC, 1999.

        • Stannard J.P.
        • Robinson J.T.
        • Anderson E.R.
        • McGwin Jr., G.
        • Volgas D.A.
        • Alonso J.E.
        Negative pressure wound therapy to treat hematomas and surgical incisions following high-energy trauma.
        J Trauma. 2006; 60: 1301-1306
        • Hunter J.E.
        • Teot L.
        • Horch R.
        • Banwell P.E.
        Evidence-based medicine: vacuum assisted closure in wound care management.
        Int Wound J. 2007; 4: 256-269
        • Argenta L.C.
        • Morykwas M.J.
        Vacuum-assisted closure: a new method for wound control and treatment: clinical experience.
        Ann Plast Surg. 1997; 38: 563-576
        • DeFranzo A.J.
        • Argenta L.C.
        • Marks M.W.
        • Molnar J.A.
        • David L.R.
        • Webb L.X.
        • Ward W.G.
        • Teasdall R.G.
        The use of vacuum-assisted closure therapy for the treatment of lower-extremity wounds with exposed bone.
        Plast Reconstr Surg. 2001; 108: 1184-1191
        • Herscovici Jr., D.
        • Sanders R.W.
        • Scaduto J.M.
        • Infante A.
        • DiPasquale T.
        Vacuum-assisted wound closure (VAC therapy) for the management of patients with high-energy soft tissue injuries.
        J Orthop Trauma. 2003; 17: 683-688
        • Parrett B.M.
        • Batros E.
        • Pribaz J.J.
        • Orgill D.P.
        Lower extremity trauma: trends in the management of soft tissue reconstruction of open tibia-fibula fractures.
        Plast Reconstr Surg. 2006; 117: 1315-1322