Page 180 - Psychology of Wounds and Wound Care in Clinical Practice ( PDFDrive )

Negative Pressure Wound Therapy 155

Negative Pressure Wound Therapy

Negative Pressure Wound Therapy (NPWT) also known
as VAC (Vacuum Assisted Closure) or Topical Negative
Pressure (TNP) is a therapeutic technique, which facilitates
the healing of acute and chronic wounds whilst preventing
the occurrence of infection (Ubbink et al. 2008 ). This treat-
ment was first established in the 1980s and developed further
in the 1990s to deal with large and complex wounds which
posed difficulties when attempting to achieve definitive
wound closure (Panicker 2009 ).
Research has highlighted some benefits associated with
NPWT, including; its ease of use for both carers and patients
(Stansby et al. 2010 ), minimal reports of pain (Stansby et al.
2010 ; Panicker 2009 ) and significant reduction in wound
size. Additionally, Augustin et al. ( 2006 ) found that patients
using NPWT reported high satisfaction with the treatment.
Furthermore, significant improvements were found across
multiple areas, including physical symptoms, psychological
and social wellbeing, and daily life.
A common complaint of NPWT is pain during dressing
change. For example, one study reported that 67 % of patients
experienced pain during dressing change when undergoing
NPWT for gynaecologic malignancies, despite experiencing
no other complications other than bleeding in one patient
out of a total of 27 (Schimp et al. 2003 ). Stansby et al. ( 2010 )
who considered pain levels associated with NPWT and its
ease of use from the perspective of both patients and carers.
Patients reported low levels of pain, with 22 % of patients
experiencing pain during treatment activation, 31 % at dress-
ing changes and 17 % at treatment deactivation. The authors
concluded that NPWT minimises pain. Furthermore, both
patients and carers deemed the NPWT system to be easy to
use. However, this study was a non- controlled, clinical inves-
tigation; it thus lacked the rigour associated with randomised
controlled trials (RCTs).
Despite these findings, high levels of pain were reported
in another study (Apostoli and Caula 2008 ) investigated the