Negative pressure wound therapy for patients with hard-to-heal wounds: a systematic review
Despite the lack of evidence, negative pressure wound therapy (NPWT) is commonly used in patients with hard-to-heal wounds. In our medical centre, one third of patients with abdominal wounds infected postoperatively end this therapy prematurely due to negative experiences and prefer standard wound care. This study was designed to explore the effects of NPWT on quality of life (QoL).
A search from 2000 to 2019 in eight databases was performed to identify qualitative studies of patients treated with NPWT. Studies were selected by two independent reviewers, who appraised the methodological quality, extracted and structured the data and performed content analysis.
A total of five qualitative studies with good methodological quality, incorporating 51 individual patients, were included. After content analysis, four major themes emerged: reduced freedom of movement caused by an electric device; decreased self-esteem; increased social and professional dependency; and gaining self-control.
NPWT has major effects on the physical, psychological and social domains of QoL. Knowledge of these effects may lead to improved treatment decisions for patients with hard-to-heal wounds regarding use of NPWT or standard wound care.
Negative pressure wound therapy (NPWT) is a widely used treatment modality.1 It is mainly used in the treatment of hard-to-heal wounds, such as pressure ulcers (PUs) and diabetic foot ulcers (DFUs), but also in wounds with other aetiologies, such as postoperatively infected abdominal wounds.2,3,4 Negative pressure is created by a foam dressing that is placed in the wound, fixed under a film and connected to an electric pump that creates a vacuum.5 It increases the local blood flow by traction through the vacuum in the contracted wound edges under the film. This hyperaemia leads to cell proliferation and granulation tissue formation. Also, the constant removal of debris by suction decreases bacterial overgrowth and oedema, thereby promoting the healing process.6,7,8,9,10,11,12,13,14 The popularity of NPWT over standard wound care, as claimed by the manufacturer, is due to a faster recovery, better patient comfort, and reduced workload for caregivers.15,16
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