Kennedy A, Van Zant R; Physical Therapy Program, The University of Findlay, Findlay, OH. vanzant@findlay.edu.

PURPOSE: The purpose of this retrospective multiple case report was to describe the results of negative pressure wound therapy in the treatment of wounds of various size, shape, location and etiology in four patients. SUBJECTS: The efficacy of negative pressure wound therapy was assessed in the following four patients: (1) 68 year old male diagnosed with cellulitis presenting with two open wounds on the left foot; (2) 60 year old male diagnosed with Type II diabetes mellitus presenting with a stage IV full thickness wound on the plantar surface of the right foot; (3) 64 year old male diagnosed with necrotizing fasciitis, diabetes mellitus, and Crohn’s disease presenting with a left gluteal wound; (4) 47 year old obese female diagnosed with necrotizing fasciitis presenting with a wound of the right groin and buttock. METHODS: All wounds underwent debriding of devitalized material and were comprised of nearly 100% granulation tissue prior to application of negative pressure therapy. In all cases application of the negative pressure therapy occurred three times per week, with each application period lasting 48 hours, followed by dressing change, cleaning of the wound bed and continued debridement as required. Treatment duration, which varied from six to nine weeks, corresponded to the length of the patient’s stay at the sub-acute rehabilitation facility. Negative pressure settings during treatment ranged from 100 to 200 mmHg. Measurements of wound length, width, depth and appearance were recorded once a week. Post-treatment follow-up phone calls were conducted 6-18 months following treatment to assess the self-reported status of the wound. ANALYSIS: Descriptive statistics documenting both absolute and percent change in the length, width, and depth of wound were reported. RESULTS: Negative pressure wound therapy resulted in reductions of wound length, width, and depth, with the greatest reduction in each case seen with the depth of the wound. Reduction in wound depth ranged from 75-100% (100% indicating complete wound closure), with four of the five wounds demonstrating reductions in excess of 90%. Reduction in wound length ranged from 32-100%, with three of the five wounds showing reductions exceeding 80%, and reduction in wound width ranged from, 35-100%, again with three of five wounds exceeding 80% reduction. Follow-up phone calls indicated that three of the five wounds closed completely either during therapy or soon (2-4 weeks) thereafter. Two of the five wounds were reduced in size sufficiently for treatment via skin grafts, one of which was successful for wound closure, and one which required additional surgery. CONCLUSIONS: The efficacy of negative pressure wound therapy was demonstrated in the treatment of five wounds in four patients. The treatment resulted in reductions in wound length, width, and depth in all cases, with the greatest impact being on reducing wound depth. FUNDING SOURCE: None.

Copyright 2004 by the American Physical Therapy Association

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