Efficacy of negative pressure wound therapy in the management of acute burns

Abstract

BACKGROUND: The aim of the present study was to evaluate the outcomes and efficacy of negative pressure wound therapy in the management of acute burns.

METHODS: Patients with acute burns who have received negative pressure wound therapy at the Dr. Lutfi Kirdar Kartal Research and Training Hospital Tertiary Burn Care Center between January 2014 and December 2015 were included in the study. Patient data were retrospectively reviewed by analyzing data from our prospective patient database.

RESULTS: A total of 38 patients were evaluated for the study. Three patients were excluded due to mortality prior to the completion of the treatment course. There were 32 (91.6%) male and 3 (8.4%) female patients. The mean age of the patients was 49.5 +/- 16 years. The etiological factors included electrical burn injury in 19 (54.3%), chemical burn injury in 7 (20%), flame burn injury in 6 (17.2%), and hot water burns in 3 (8.4%) patients. The severity of the burns was grade 3 or 4 in all of the patients included in the study. The mean duration of negative pressure wound therapy was 10.1 +/- 3.9 days. There were no procedure-related complications throughout the duration of the study. During the standard application of the device, one patient experienced local pain; therefore, low pressure (75 mmHg) was applied during therapy, and pressure was steadily increased. As a result of the application of this therapy, a decrease in the surface area, edema, and secretion of the wound and an increase in the granulation tissue and perfusion of the wound were observed in all treated patients. Wound cultures revealed no bacterial growth in any of the patients. The mean duration of surgical wound closure was 11.2 +/- 3.7 days. No complication was observed related to wound closure. The mean duration of hospital discharge in the postoperative period was 6.7 +/- 2.1 days.

CONCLUSION: Well-designed, randomized control studies showing the efficacy of negative pressure wound therapy in patients with burns are lacking. The results of the present study showed that negative pressure wound therapy may reduce the number of wound debridement sessions, time of wound closure, and hospitalization in major burn injuries exposing the underlying tendons and bones.