Clinical evaluation of gauze-based negative pressure wound therapy in challenging wounds

Abstract

The aim of this randomised clinical study was to evaluate the effectiveness and safety of gauze-based negative pressure wound therapy (NPWT) in patients with challenging wounds. A total of 50 consecutive patients who had wound drainage for more than 5 days, required open wound management and had existence of culture positive infection were included the study. In this study, gauze-based NPWT was compared with conventional dressing therapy in the treatment of patients with difficult-to-heal wounds. The patients were randomly divided into two groups. Group I (n = 25) was followed by conventional antiseptic (polyhexanide solution) dressings, and group II (n = 25) was treated with saline-soaked antibacterial gauze-based NPWT. The wounds' sizes, number of debridement, bacteriology and recurrence were compared between group I and group II. The mean age of the patients was 59 center dot 50 years (range 2397). In group I, average wound sizes of pre- and post-treatment periods were 50 center dot 60 +/- 55 center dot 35 and 42 center dot 50 +/- 47 center dot 92 cm2, respectively (P < 0 center dot 001). Average duration of treatment was 25 center dot 52 +/- 16 center dot 99 days, and average wound size reduction following the treatment was 19 center dot 99% in this group. In group II, the wounds displayed considerable shrinkage, accelerated granulation tissue formation, decreased and cleared away exudate. The average wound sizes in the pre- and post-treatment periods were 98 center dot 44 +/- 100 center dot 88 and 72 center dot 08 +/- 75 center dot 78 cm2, respectively (P < 0 center dot 001). Average duration of treatment was 11 center dot 96 +/- 2 center dot 48 days, and average wound size reduction following the treatment was 32 center dot 34%. The patients treated with antibacterial gauze-based NPWT had a significantly reduced recurrence (2 wounds versus 14 wounds, P = 0 center dot 001), and increased number of the culture-negative cases (22 wounds versus 16 wounds, P < 0 center dot 047) in a follow-up period of 12 months. There was a statistically significant difference between two groups in all measurements. As a result, we can say that the gauze-based NPWT is a safe and effective method in the treatment of challenging infective wounds when compared with conventional wound management.