Week 1 Negative Pressure Wound Therapy (NPWT) Flashcards
what is NPWT
a closed wound dressing with suction, that gives sub- atmospheric pressure across the entire wound.
what is the pressure of NPWT
0-125 mmHg
what are some of the mechanisms of action and the benefits of NPWT
- removes exudate
- moist environment
- decreased bacterial burden
- reduce edema and excess ISF and increase blood flow
- increased microvascular blood flow
- stimulate granulation tissue
- promotes contracture
- reduces the amounts of time you need to –change the dressing
what is the general equipment needed
- pump to give suction (electric or battery)
- wound filler or cover to transfer pressure across the wound, and allow fluid to move into the canister
- tubing to deliver suction and allow fluids to move
- canister to hold fluid
- occlusive sheeting to give that air tight seal
what are some indications for using NPWT
VI, pressure injuries, traumatic, surgical, burns, mass casualty, high energy injuries, bone or tendon exposure, over grafts, over sutures (the last 3 with protection)
with sutures, what mode of NPWT is contraindicated
intermittent mode
can we do NPWT with pediatrics
yes, but at lower pressures (50-125), based on age and weight and location
what do we need to be concerned about in pediatric and elderly patients
dehydration
can we use NPWT for tissue protection
yes, with protection, because we don’t want to dry them out.
what is less aggressive, white, black or green
white is less aggressive
what are some precautions of using NPWT
- anticoagulants
- unexplored fistulas
- over named structures (without a barrier)
- must monitor for bleeding
- avoid circumferential occlusive sheathing to avoid ischemia
- monitor skin conditions over bony prominences, or hardwares
- debride sharp edges of a wound first.
- notify the doctor if the canister fills within 1 hour, or is more than 2 fill in 24 hours.
can we do NPWT for AI (arterial insufficiency)
no, because compression at wound edges causes 1-2.5 cm of hypo-perfusion
what mode and pressures can we maybe use for AI
low pressures, and intermittent mode.
what are some contraindications for NPWT
- more than 30% slough
- untreated osteomyelitis
- gross infection
- malignancy (unless palliative care)
- blood dyscrasia with leukemia
- directly over exposed vessels bypass grafts, organs, named structures
- ischemic wounds with proximal occlusion
- NO INTERMIT over grafts
- no suction in MRI, hyperbaric O2 chamber,
what are some prerequisites to use with infection
must be free of most systemic s/s of gross infection, necrotic tissue debrided, abscesses drained, combine with silver dressing and wound wash without the removal of the dressing
