Negative pressure wound therapy: Where are we in 2022?

Michael A Quacinella, Taylor M Yong, William T Obremskey, Daniel J Stinner
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Abstract

The use of negative pressure wound therapy (NPWT) continues to be an important tool for surgeons. As the use and general acceptance of NPWT have grown, so have the indications for its use. These indications have expanded to include soft tissue defects in trauma, infection, surgical wound management, and soft tissue grafting procedures. Many adjuvants have been engineered into newer generations of NPWT devices such as wound instillation of fluid or antibiotics allowing surgeons to further optimize the wound healing environment or aid in the eradication of infection. This review discusses the recent relevant literature on the proposed mechanisms of action, available adjuvants, and the required components needed to safely apply NPWT. The supporting evidence for the use of NPWT in traumatic extremity injuries, infection control, and wound care is also reviewed. Although NPWT has a low rate of complication, the surgeon should be aware of the potential risks associated with its use. Furthermore, the expanding indications for the use of NPWT are explored, and areas for future innovation and research are discussed.

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负压伤口治疗:2022年我们在哪里?
负压伤口治疗(NPWT)的使用仍然是外科医生的重要工具。随着NPWT的使用和普遍接受程度的增长,其使用的迹象也在增加。这些适应症已经扩展到包括创伤、感染、外科伤口处理和软组织移植手术中的软组织缺陷。许多佐剂已被设计成新一代的NPWT设备,如伤口灌注液体或抗生素,允许外科医生进一步优化伤口愈合环境或帮助根除感染。这篇综述讨论了最近有关NPWT作用机制的相关文献,可用的佐剂,以及安全应用NPWT所需的成分。在创伤性肢体损伤、感染控制和伤口护理中使用NPWT的支持证据也进行了回顾。虽然NPWT的并发症发生率低,但外科医生应该意识到使用它的潜在风险。此外,还探讨了扩大NPWT使用的适应症,并讨论了未来创新和研究的领域。
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