Risk Factors for Unsuccessful Treatment and Complications With Negative Pressure Wound Therapy

The aim of this retrospective study was to identify risk factors related to unsuccessful treatment and complications with negative pressure wound therapy (NPWT). Methods. A consecutive series of patients treated with NPWT for wounds of various etiologies (n = 87) from 2005-2007 at a general hospital in a large city (Stockholm, Sweden) were assessed for risk for unsuccessful treatment and complications associated with NPWT. Results. Twenty-nine percent of the patients treated with NPWT had unsuccessful treatment results. The strongest risk factors associated with unsuccessful treatment were pressure ulcers (OR 4.6) or a positive culture for Staphylococci (OR 3.4). The complication rate was 21%, of which 14 patients had to terminate treatment. A positive culture for either Staphylococci or Pseudomonas was strongly associated (P = 0.001) with risk of complications during NPWT treatment. Patients with insufficient peripheral circulation in the extremities had a risk of both unsuccessful treatment and complications. Conclusion. The findings of the present study stress the importance of evaluating bacterial cultures and adequate antibiotic therapy when infection is suspected. The status of the patient's peripheral macrocirculation in the lower extremities seems to have a significant impact on the risk of unsuccessful treatment or complications. There, fore, is it of great importance to evaluate peripheral circulation status before initializing NPWT.