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Informational/Educational Report
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Catheter-based negative pressure wound therapy*: a new paradigm of care Lester Kiemele, PA-C, Paul Y. Takahashi, MD, Mayo Clinic College of Medicine, Rochester, MN Nonhealing ulcers present an ongoing challenge to medical providers, especially in long-term care. These wounds are often the result of trauma, vascular disease, diabetes mellitus or other circulatory conditions. Treatment can be costly and may involve lengthy hospitalizations and expensive supplies. Conventional treatments require frequent dressing changes, which can be time-consuming and uncomfortable. Negative pressure wound therapy (NPWT) has been shown to heal chronic wounds more quickly than conventional therapies. NPWT uses negative pressure to gently suction debris and fluid from a wound and draw in nutrients to augment healing. Typically, most NPWT systems use medical grade foam which is placed in a wound then covered with an occlusive, transparent film to create an airtight seal. Narrow or tunneling wounds, however, are not able to accommodate this type of packing. This case summarizes the use of a channel drain catheter to deliver negative pressure to heal a chronic Achilles ulcer. On initial examination, this ulcer measured 6 mm by 6 mm and tunneled 120 mm. Initially, the wound was packed three times daily with gauze ribbon moistened with a triple antibiotic solution. Despite 6 weeks of therapy, the tracking progressed to 140 mm. Negative pressure therapy, using a channel drain catheter, was then initiated. The tracking decreased from 140 mm to 22 mm in eight weeks, showing an 85% increase in healing of this recalcitrant wound. This suggests that this new method of care can improve healing of chronic ulcers by being more cost-effective and improve quality of life *Versatile 1¨ Wound Vacuum Systemª is a registered trade mark of Blue Sky Medical, La Costa, CA. . |
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