The Role of Negative Pressure Wound Therapy in the Spectrum of Wound Healing

Wound care clinicians have a wide array of available treatment options to manage and help heal acute and chronic complex wounds that require a systematized and comprehensive approach to address the complexity of wound care and to optimize patient outcomes. The treatment of wounds represents a major cost to society. Public policies increasingly focus on quality of care, patient outcomes, and lowering costs. Wound care clinicians are not immune to these pressures. Wound care clinicians must ensure that their assessments, treatment pathways, and product selections are both clinically and economically sound. Negative pressure wound therapy (NPWT) has been demonstrated to be an efficacious option to promote healing in a variety of acute and chronic complex wounds. Previous guidelines on the use of NPWT have focused on application but have not provided recommendations on when it is most appropriate to use NPWT; there are few criteria for 1) when to initiate NPWT based on various wound types, 2) pre-application management to optimize treatment outcomes, 3) identification of appropriate candidates for NPWT, 4) benchmark indicators for treatment response, and 5) recommendations on when to transition between NPWT and moist wound healing (MWH) or another treatment modality. In September 2009, an international panel of wound care experts from multiple disciplines convened to develop a document to guide clinicians in making decisions about the appropriate use of NPWT within the spectrum of wound healing. Where empirical research was lacking, clinical experiences and patient factors were considered to ensure the clinical utility of the document. The goal of these guidelines is to encourage responsible wound management across the healthcare continuum and spectrum of wound pathologies to achieve positive, cost-effective patient outcomes.