Clinician Panel Recommendations for Use of Negative Pressure Wound Therapy with Instillation.

ABSTRACT

Addition of an instilled topical wound solution to negative pressure wound therapy (NPWT) is designed to facilitate regular wound cleansing to help improve outcomes of some complex wounds, but the addition of instillation to NPWT adds a level of complexity to the wound care process. The paucity of knowledge and experience with instillation may affect optimal use of this treatment modality. In an effort to address this knowledge gap, a 2-day panel meeting of nurses (N = 11) with experience using negative pressure wound therapy with instillation and dwell time (NPWTi-d) was convened to discuss their usage recommendations for managing wounds with this treatment modality in the acute care setting. Panelists reviewed available evidence and presented recommendations for managing wounds treated with NPWTi-d. Panelists agreed NPWTi-d is primarily suited to prepare surgical or nonsurgical wounds for delayed primary closure and preparing/protecting periwound skin improves maintenance of a tight seal. Educating a team of nurses on basic NPWTi-d troubleshooting, providing a short checklist of tasks to perform every shift, and organizing needed supplies and resources may help continuity of care and prevent problems. Panelists also emphasized the im- portance of wound assessment and documentation and recommend educating the patient, family members, and other members of the patient-care team. Research to compare the safety, ef cacy, and effectiveness of NPWTi-d and other irrigation techniques on patient outcomes and research to validate these recommendations is needed.