Negative Pressure Wound Therapy.
SummaryIn recent years Negative Pressure Wound Therapy has revolutionised the way clinicians manage and treat a wide range of wounds, Negative Pressure Wound Therapy (NPWT) is a mechanical wound care treatment that uses controlled negative pressure to assist and accelerate wound healing (Bryant, R. 2000).
This gauze based dressing technique used and first described by Chariker–Jeter et al in 1989 involves the application of a moistened anti-microbial dressing (AMD) gauze and a silicone drain to the wound, this is then covered with a transparent film, ensuring an air tight seal and a moist wound healing environment is maintained. The drainage tubing is then connected to the canister attached to a pump where the pressure is regulated. Once the prescribed pressure is set, negative pressure is delivered to the wound. Using this technique utilises lower pressure settings, usually between 60-80mmHg of negative pressure, compared to the higher pressures of 125mmHg used in the V.A.C® system.
The growing body of clinical data available for the gauze based technique and a recent study into the effects of NPWT using polyurethane foam compared to using gauze, highlighted that gauze and foam are equally effective at delivering negative pressure to the wound. NPWT, via both foam and gauze, results in mechanical deformation of the wound, which is widely believed to play a role in the mechanism through which NPWT stimulates new tissue formation. (Malmsjo et al 2008)
Polyhexamethylene biguamide (PHMB) impregnated gauze (Kerlix AMD, Covidien) has been used as a therapeutic medium in wound care for many years. The gauze in the NPWT application is used as a space filler to facilitate wound drainage, while the PHMB exerts an antimicrobial effect.
Clinicians who have used this technique have found that the application of moistened gauze enables it to be manipulated to the exact shape of the wound creating a moist wound environment. The use of the gauze in this way is simple, quick and easy to use, teach and learn as well as being cost effective in comparison to conventional NPWT dressings.
The soft flexible silicone drains can be cut to length for a custom fit and the choice of different dressings allow the clinician to select the right one for the wound type being treated. Everything needed to apply the dressing to the wound is included in these individual kits.
NPWT has been described for use in the management of many different clinical conditions. Wounds that may benefit from negative pressure wound therapy are:-
• Partial/Full thickness Pressure Ulcers • Dehisced surgical wounds • Diabetic/Neuropathic ulcers • Venous leg ulcers • Post surgical wounds • Sinus drainage and management • Traumatic wounds • Pre-op flap/graft • Post op surgical flap/grafts • Necrotising fasciitis • Burns There are many clinical benefits associated with the use of negative pressure wound therapy, which include:- • Removal of excess fluid and oedema • Assisting in wound contraction • Stimulating granulation tissue • Protecting from outside contaminants • Increasing Vascular perfusion • Decreasing wound bioburden • Remodelling of the connective matrix • Encouraging maturation of epithelial cells • Maintaining a moist healing environment The gauze based Chariker – Jeter technique was successfully launched in the U.S by BlueSky Medical using their Versatile1™ and V1sta™ pump systems and in June 2006 they appointed the Talley Group as their distribution partner in the UK.
With the international interest in this technology Smith and Nephew purchased the BlueSky Medical Company in 2007 and they launched the products internationally under the Smith and Nephew Advanced Wound Care banner
Tally Group Ltd then developed their own NPWT product range Venturi™ utilising the gauze based dressing technique and with over 2 years experience in the NPWT arena, the Talley Group design and manufacture the Venturi™ NPWT System at their Hampshire base in the UK.
The user friendly and cost effective Venturi™ pump unit is purpose built to provide NPWT and has sophisticated alarm functions, an integrated canister which is sealed and incorporates exudate solidifying granules, as well as hydrophobic and bacterial filters. This product range is just one example of the advanced manufacturing processes employed at the Talley Group’s purpose built premises, where further space has recently been made available to cater for the increased international demands.
Venturi™ has already achieved remarkable growth since its launch in the UK and Europe and Talley are delighted with the international interest shown in the product when it was showcased at the World Union of Wound Healing Societies event in Toronto Canada.
Venturi™ attracted a lot of interest at this event and has continued to prove its clinical acceptance worldwide. The growing body of internationally published evidence that along with existing clinical studies clearly demonstrates the efficacy of the gauze based dressing technique.
Talley Group Ltd now sells Venturi™ in over 9 countries and their strategy of providing clinical evidence along with an aggressive pricing policy has influenced their growth in the UK and International markets. This successful strategy is designed to encourage an increase in NPWT usage with more patients being treated and allowing access to NPWT for clinicians who are looking for a clinical and cost effective alternative to traditional solutions, one that delivers exceptional clinical outcomes.
The developing International market for NPWT has attracted other entrants utilising the same gauze based dressing technique with differing pump technology.