The Use of Negative Pressure Wound Therapy with an Automated, Volumetric Fluid Administration: An Advancement in Wound Care

Introduction. This small pilot study introduces initial clinical experience with a system combining negative pressure wound therapy and negative pressure wound therapy with instillation (NPWT/NPWTi, V.A.C. ULTA (TM) Negative Pressure Wound Therapy, KCI USA, Inc, San Antonio, TX). Materials and Methods. The NPWT system with instillation delivers controlled volumetric fluid instillation, and uses instillation-specific reticulated open-cell foam (ROCF) dressings: Dressing A (ROCF-V, V.A.C. VeraFlo (TM) Dressing, KCI USA, Inc, San Antonio, TX) or Dressing B (ROCF-VC, V.A.C. VeraFlo Cleanse (TM) Dressing, KCI USA, Inc, San Antonio, TX). Six patients ranging in age from 26-83 years were treated with either NPWT with instillation and Dressing A or Dressing B, and Microcyn (R) antiseptic solution (Oculus Innovative Sciences, Petaluma, CA) (n = 5) or quarter- strength Dakin's Solution (R) (Century Pharmaceuticals, Indianapolis, IN) (n = 1), as the instillate. Negative pressure wound therapy was applied in 1 patient to a single wound using Dressing C (ROCF; V.A.C.(R) GranuFoam (TM) Dressing, KCI USA, Inc, San Antonio, TX) in one half of the wound, and Dressing B in the other half. In this patient series, instillation was repeated every 2-4 hours with a 5-10 minute soak time followed by negative pressure at -100 mm Hg to -125 mm Hg. All wounds were closed by skin graft or primary, secondary, or delayed primary intention. Results. For the wound treated with NPWT only, no difference in degree or quality of granulation tissue formation was observed by either dressing. Conclusion. The system worked well across multiple wound types in either NPWT mode or NPWT with instillation mode, and no complications were observed. Larger patient studies with controls are needed to validate the clinical observations in this patient series.