Clinician decision-making for transitioning to single-use negative pressure wound therapy: analysis of real-world practice in an acute setting.

Abstract

Objective: Despite the widespread adoption of traditional negative pressure wound therapy (tNPWT) to improve clinical outcomes for hard-to-heal (chronic) wounds and the increasing availability of single-use systems that improve patient acceptability, there is limited evidence published about when to use each type of system to optimise treatment pathways. The aim of this retrospective case review was to evaluate those wounds transitioned from tNPWT to single-use NPWT (sNPWT) in a real-world, acute care setting and review clinical outcomes, thereby informing future practice approaches.

Method: A retrospective chart review of the treatment pathway and clinical outcomes of all patients with wounds managed using NPWT presenting at a single, acute care hospital in the US from February 2023 to September 2024 was conducted. Initial tNPWT was administered continually at either -80mmHg or -120mmHg for all wounds. Wound characteristics and healing outcomes for patients transitioned from tNPWT to sNPWT during the course of treatment were reviewed.

Results: Electronic medical records of 27 patients (12 females, 15 males; with 70% aged 36-75 years) with wounds that were eligible for treatment with NPWT were available for review. Mean duration of tNPWT and sNPWT was 9.8±11.1 days (median: 7 days; range: 3-60 days). Estimated daily mean wound area reduction was 5.8% (median value: 3.2%) with similar improvements noted for wound volume. Of the 27 wounds treated with tNPWT, eight were successfully transitioned to sNPWT once a sustained healing trajectory had been achieved. No wounds received first-line treatment with sNPWT, despite many of the wounds potentially being suitable for this approach.

Conclusion: Approximately 30% of wounds included in this review were considered eligible for transition from tNPWT to sNPWT, facilitating earlier hospital discharge without compromising clinical outcomes. More widespread adoption of sNPWT, and even first-line use for appropriate wounds, may help to reduce hospital stay while maintaining effective wound management, thereby improving the patient experience, hospital efficiency and resource utilisation.