Pressure ulcer management in paraplegic patients with a novel negative pressure device: a randomised controlled trial

Abstract

Our NPD is better than standard wound care procedures and cost-effective for management of PU.

Negative pressure wound therapy versus healing by secondary intention in pressure ulcers

“…29 In the first study the length and width of an ulcer decreased significantly (p<0.01) in NPWT group compared to standard care group at week 9. 24 In the other two studies the authors did not report a significant difference between the two groups, respectively in Wanner 27 days in NPWT group and 28 in the traditional treatment and 51.8% with NPWT in Ford and 42.1% with traditional treatment 28,29 (Tab. IV) .…”

“…The evaluation of this tissue was performed in different modalities: newly-formed granulation tissue and wound contracture (measured the volume instead of the area of the usually undermined wounds) as reported from Wanner [28], the absolute and relative proportion of wound surface granulation tissue as reported from Wild 27 or the conversion of slough into red granulation tissue as reported from Dwivedi. 24 Conversely the presence of exudates, fibrin or necrosis were poor prognostic signs: absolute and relative proportion of fibrin tissue at the wound base or absolute and relative proportion of necrosis. Only few significantly better results were reported in patients who underwent NPWT (lower exudates in NPWT group at weeks 4 and 9 and higher conversion of slough into red granulation tissue, increase in surface granulation), differently the other evaluation did not report report any advantage in macroscopic (newlyformed granulation tissue and wound contracture, absolute and relative proportion of fibrin tissue at the wound base and of necrosis) or biopsy evaluation (mean number of PMNs and lymphocytes per high-power field and mean number of capillaries per high-power field).…”

“…In three studies the authors described the etiology of immobilization and reported a traumatic paraplegia. The location of ulcer was reported in five studies and it was exclusively sacral in the paper of Dwivedi 24 and Wild, 27 differently Ashby 25 and Ford 29 reported a mix of locations: sacral, ischial, lateral malleolar and trochanter region. Overall, 141 patients were enrolled: 62 underwent NPWT and 79 other conventional treatments.…”

“…II). [24][25][26][27][28][29] Quality assessment of the included studies. Since all the included studies are RCTs the quality assessment was based on the risk of bias.…”

“…Three trials described the reduction in ulcer volume, but the outcome descriptions were very inconsistent [24,28,29]. Dwivedi reported the length and width of ulcer, 24 differently Wanner reported the mean (SD) time to reach 50% of the initial volume 28 and Ford reported the mean percent reduction in ulcer volume. 29 In the first study the length and width of an ulcer decreased significantly (p<0.01) in NPWT group compared to standard care group at week 9.…”