(CS-039) Using Mechanically Powered Disposable Negative Pressure Therapy Over Closed Incisions in the Outpatient Setting

Krista Bauer, RN, WCC, OMS; Kari Day, RN, BSN, WCC; Ashley Wardman, CPPM, Surgical LPN-C

Introduction: Closed incision negative pressure therapy (ciNPT*) helps hold incision edges together, removes fluid and infectious materials, and creates a barrier against external contamination.¹ Typically, this dressing is placed in the operating room and remains in place for 7 days. However, some patients may benefit from additional negative pressure therapy over the closed incisions. Mechanically powered, disposable negative pressure wound therapy (dNPWT^†) may provide an additional option for NPWT over incisions in the outpatient population. The use of ciNPT and dNPWT over closed incisions in 5 patients in the outpatient setting is presented.

Methods: All wounds received debridement, and closure with flap advancement or primary closure. A placental allograft^‡ was placed to optimize cellular proliferation and healing. ciNPT was placed over closed incisions in the operating room and continuous negative pressure at -125 mmHg was initiated. The dressing was left in place for 7 days. After which, ciNPT was discontinued and patients received dNPWT in the outpatient setting. A non-adherent protective layer was placed over the closed incision follow by application of dNPWT. Continuous negative pressure at -125 mmHg was utilized. dNPWT dressings were changed at 4-7 days for a total of 2 dressing changes.

Results: Five patients underwent surgical closure. Wound etiologies included pilonidal disease, pressure injury and trauma. Surgical closure included flap reconstruction (n=3) and primary closure of wounds (n=2). One patient was not compliant with smoking cessation and splint usage and required a secondary procedure that resulted in wound healing. The remaining 4 patients healed without complications of dehiscence or infection.

Discussion: In these patients, placement of dNPWT placed in the outpatient setting following ciNPT help facilitate positive incision healing outcomes and success following surgical management.