临床病例报告杂志

Comparison of Negative Pressure Wound Therapy (NPWT) Using Polyvinyl Alcohol (PVA) Sponge with Advanced Wound Dressings

Abstract

Ramesh Muthu, Suresh Arunasalam, Adnesh Kenneth Andrew, Suriya Tamil, Shoba Anandan, Noramirah Deraman and Nurfadhilah Marzuki

Objective: The primary purpose of this study is to compare appearance of granulation tissue, rate of wound infection, period of hospital stay and duration for complete wound healing using two different methods of wound dressing at secondary healthcare centres. Material and Methods: 127 patients between the age group 14-68 years with an average age of 42 years were included in this study. Out of these 127 cases, 1 died due to urosepsis with severe lung infection and 6 cases did not turn up for follow up treatment. The remaining 120 cases were divided into two groups i.e. A and B. Group A was subjected to modified negative pressure wound therapy (NPWT) using sterilized polyvinyl alcohol sponge as an alternative to standard Granu Foam. A Ryle’s tube with additional pores were created and interposed between the PVA sponges. The Ryle’s tube was attached to the suction drain and another end of the suction drain connected directly to wall suction which is programmed to produce a pressure of 125 mmHg. At the end of 72 hours, a new cycle was repeated. Group B was subjected to daily dressing with advanced wound dressings (dermacyn and solcoseryl gel). Results: Statistically better result was obtained in favour of NPWT for wound dressing. The appearance of granulation tissue was more rapid in group A patients. The infection rate of group A patients was very low when compared to group B patients. The mean time (duration) to complete healing was faster in Group A, however the mean length of hospital stay was longer as compared to group B patients. Conclusion: Healing is more rapid with less infection rate in NPWT group compared to advanced wound dressing group. NPWT using wall suction and PVA sponge can be performed in secondary healthcare centres with low resources as well as for patients who could not have afforded charges of commercially available standard VAC device or advance wound dressings.