Use of Negative Pressure Wound Therapy With Instillation and a Novel Reticulated Open-cell Foam Dressing With Through Holes at a Level 2 Trauma Center.

Current wound treatment options for complex wounds include advanced wound therapies. One such treatment, negative pressure wound therapy (NPWT), has evolved to include automated instillation of topical wound solutions with a user-specified dwell time (NPWTi-d). A novel reticulated open-cell foam dressing with through holes (ROCF-CC) was developed to assist wound cleansing by removing thick wound exudate and infectious material. The author's experience using NPWTi-d with ROCF-CC on complex wounds is presented. Patients (N = 19) received antibiotics, pain medication (oral or intravenous), and debridement when applicable. The ROCF-CC contact layer with through holes was cut to fit the wound dimensions and placed in the wound bed. The cover layer (without holes) was placed over the contact layer to fill the remainder of the wound bed, including undermined areas. The foam layers were covered with a semi-occlusive drape, and NPWTi-d was initiated by instilling saline or a hypochlorous solution with a 1-minute to 10-minute dwell time followed by 2 to 3.5 hours of negative pressure (-125 mm Hg or -150 mm Hg). Dressing changes were performed every 2 to 3 days. Mean patient age was 57.1 ± 18.1 years. Common comorbidities included diabetes, obesity, and tobacco use. After an average of 9.0 ± 6.9 days of therapy, all wounds displayed less malodor, less devitalized tissue, and improved granulation tissue formation. In all 19 cases, adjunctive use of NPWTi-d with ROCF-CC contributed to hospital discharge, wound closure, and successful limb salvage in this patient population.