Volume 55 - Issue 6 - June, 2009

Intermittent NPWT and Lower Negative Pressures — Exploring the Disparity between Science and Current Practice: A Review

Abstract: Negative pressure wound therapy (NPWT) is used to treat a wide and growing range of problematic acute and chronic wounds. Continuous therapy delivered at -125 mm Hg has been routinely recommended, despite consistent research findings suggesting potential advantages to the use of lower pressures and intermittent therapy. To enhance understanding and document the disparity between the body of NPWT science and current practice with respect to negative pressure levels and modes of therapy, a search of the English-language literature from June 1989 through May 2009 was conducted.



Using Low Pressure, NPWT for Wound Preparation & the Management of Split-Thickness Skin Grafts in 3 Patients with Complex Wound

Abstract: The use of negative pressure wound therapy (NPWT) is well established in the management of hard-to-heal wounds. One institution, familiar with NPWT’s capabilities as well as its shortcomings (eg, pain at dressing changes and pain with the maximum recommended setting of 125 mm Hg), sought a viable alternative. A low pressure, negative pressure wound therapy (LP-NPWT) system, using subatmospheric pressure levels of 75 mm Hg and a low-adherence dressing, was evaluated to prepare the wound bed for split-thickness skin graft (STSG) on three patients.



Stomal Mucocutaneous Dehiscence as a Complication of Topical Negative Pressure Used to Treat an Open Abdomen: A Case Series

Abstract: Although mucocutaneous dehiscence in cases of laparostomies is rare, this complication occurred in three patients in the Netherlands (all men, 53 to 65 years old) who received topical negative pressure (TNP) therapy in the management of open abdomens. Two patients experienced anastomotic failure following colonic resection and one had iatrogenic suturing of the small bowel to the fascia. TNP therapy was initiated and stomal dehiscence occurred after 2 to 3 days, contaminating the area. All patients developed sepsis and one died.



Implementing Wound Care Guidelines: Observations and Recommendations from the Bedside

Abstract:The successful implementation of wound care guidelines requires an appreciation for the frustrations experienced by nurses trying to incorporate these tools into clinical practice. These frustrations or barriers to best wound care practice implementation are examined from the perspective of: 1) the practice environment, which must be understood; 2) the potential adopters, predominantly nurses seeking the best fit between evidence and their clinical practice setting; and 3) the evidence-based innovation created to change wound care practice at the point of care.



It’s All about the “E”

Perfection is the child of time. — Bishop Joseph Hall (1574–1656)

     Last April, thousands of wound care professionals attended the Spring 2009 Symposium on Advanced Wound Care. While most of the country focused on the economy and swine flu epidemic, the buzzwords in Texas were efficacy, effectiveness, and evidence. Although these terms have been clearly defined, their roles in wound care seem ambiguous.

     By definition, efficacy — the degree to which an intervention produces a beneficial result — can be determined only if you measure



Optimizing Pressure Ulcer Care: A Checklist for System Change

     Our healthcare system sought to enrich and improve strategies to assess, document, and prevent pressure ulcers and to identify key personnel to implement these strategies. An evaluation of our practices yielded the following recommendations:

     1. Assess policies and procedures relevant to documentation systems, risk assessment tools, prevention techniques, and skin assessment documentation along with ease of understanding, thoroughness, accuracy of terms, and incorporation of current evidence-based information.

     2. Ensure docu



Understanding the Protein Digestibility Corrected Amino Acid Score (PDCAAS)

     Protein, defined as a complex nitrogenous compound made up of amino acids in peptide linkages, is essential for life. Proteins carry out the work of the cell by serving as enzymes, receptors, transporters, hormones, antibodies, or communicators that build, maintain, and repair body tissues.

     Wound care professionals and registered dietitians (RDs) understand that patients often require increased amounts of protein for healing. Protein is a hot topic today. This has resulted in a proliferation of new products on the market, such as whole proteins, par



A (Lone) Star Wound Care Practitioner

OWM recently spoke with Andrew J. Applewhite, MD, CWS, UHM, and Today’s Wound Clinic editorial board member, to learn about his academic and professional journey in wound care and his most recent accomplishment — ie, being named Medical Director of the Comprehensive Wound Care Center at Baylor Dallas (Dallas, Tex).

     OWM: You attended the University of Texas at Austin and the University of Texas Medical School in Houston. What are some of your most significant experiences as a student?

     Dr. A: The things I remember most about UT Austin were



Treating the Aftermath of Childbirth

     Nowhere in the world does life confront death more starkly than on the African continent. According to the World Health Organization (WHO), more than half of the 536,000 women around the world who die during pregnancy and childbirth are in Africa. Experts at the WHO consider most of these deaths to be preventable. The deaths occur for two fundamental but related reasons — lack of access to basic obstetrical care and facilities and lack of adequate training among those providing care during labor and delivery. The young ages of many of these mothers, their own lack of educ



New Products and Industry News June

Abdomen dressing receives FDA clearance

     Kinetic Concepts Inc (KCI, San Antonio, TX) recently received 510(k) clearance from the US Food and Drug Administration (FDA) to market its ABThera™ Open Abdomen Dressing. Earlier this year, the FDA cleared the ABThera™ Open Abdomen Negative Pressure Therapy Unit. Together, the ABThera™ Open Abdomen Negative Pressure Therapy System will be indicated for temporary bridging of abdominal wall openings where primary closure is not possible or where repeat abdominal entries are necessary.

     The propr