Objective: Negative pressure wound therapy (NPWT) has been integrated in acute and reconstructive burn care and is now available with the option to instill topical solutions, which can potentially decrease patient discomfort and nursing time when using “irrigation-soak” dressings. We present our experience using NPWT with instillation and dwell time (NPWTi-d*) in managing burn wounds.

Methods: Patients were managed in inpatient burn center with NPWTi-d using hypochlorite- or sulfur-based topical solutions (dwell time of 10 or 30 minutes, followed by NPWT every 6 hours. Wounds were initially debrided in operating room. Patient 1 was a 42-year-old male with bilateral electrical hand burns, patient 2 was a 22-year-old male with severe elbow friction burn, and patient 3 was a 31-year-old female with large subcutaneous degloving-friction injury. Prior to debridement and NPWTi-d, cream dressings were used.

Results: After 1-2 weeks of NPWTi-d, wounds were stabilized for closure: patient 1 closed with local flaps and split-thickness skin grafts (STSG), patient 2 closed with STSG, and patient 3 closed with local advancement and STSG. Patients 1 and 3 were followed in outpatient burn center for 12 months; wounds remained closed. Patient 2 moved out of the area after grafting.

Discussion/Conclusions: In these patients, adjunctive NPWTi-d allowed for optimal wound management in the burn center. We noted reduced dressing changes and improved patient/nurse perception of wound management burden. Prospective evaluation with standardized patient and nurse feedback should be pursued in larger populations of burn wounds.

*V.A.C. VERAFLO™ Therapy; KCI, an ACELITY company, San Antonio, TX)

Negative Pressure Wound Therapy with Instillation Use in Burn Wounds - First Experiences