Subatmospheric pressure wound dressing in wound management:: Medical education

Subatmospheric pressure dressing (SPWD) is a new wound dressing that has been used latterly. SPWD is the controlled application of subatmospheric pressure to a wound using an electrical pump to intermittently or continuously convey subatmospheric pressure through connecting tubing to a specialized wound dressing. Recent studies with this wound dressing, the use of which was initially recomended for chronic wounds, has shown that it can effectively be used for acute wounds, skin grafted areas and donor site care, degloving injuries and bums. SPWD is a topical treatment used to promote healing in acute and chronic wounds by applying subatmospheric pressure to the wound bed. Four board mechanisms of action are proposed: increase of local blood supply, mechanical deformation, removal of harmful enzymes from the wound bed, decrease intertisiel edema. The combination of these mechanisms makes the SPWD treatment an extremely versatile tool in the armamentarium of wound healing. SPWD is generally well tolerated and, with few complications. Numerous case studies and articles have documented this treatment effectiveness. But, recent experimental studies, evaluations and personal experience raise many questions about the currently treatment protocol of SPWD: Is intermittent subatmospheric pressure therapy equivalent to continuos subatmospheric pressure wound therapy, how is optimal pressure level for wound healing? In this article, the past and present of subatmospheric pressure wound care is revised by considering articles within the accessible literature. Furthermore, insufficient and inquisitional aspects of this method is also emphasized.