Combined use of adjunctive
negative pressure wound therapy (NPWT) and instillation of topical
wound solutions and
suspensions (NPWTi) has proven to be an effective next-generation NPWT technique for
wounds at risk for compromised healing. Fluid instillation has been shown to enhance exudate and debris removal, provide regular cleansing of the
wound bed, and add moisture to the
wound. Positive results have been demonstrated with NPWTi in assisting healing of stalled
wounds and treating painful
wounds as well as
wounds at high risk for
amputation. NPWTi has been used instead of conventional NPWT in
wounds with thick exudate and slough content, acute traumatic
wounds,
wounds acutely debrided due to infected soft tissue, large areas of post-debrided exposed bone, and cases of critical bacterial colonization. Instilled solutions have included topical solutions such as saline, topical
wound cleansers, and
antiseptics. While various systems that combine instillation or irrigation with NPWT have been commercialized during the past decade, until very recently these have been relatively cumbersome to use and limited in their ability to regulate
solution volume delivery. Recent advances in NPWTi technology (V.A.C. VeraFlo™
Therapy, KCI, San Antonio, TX) include automated volumetrically controlled delivery of fluids and upgraded foam dressing technology to provide better control and delivery of solutions to the
wound bed. This article describes the latest NPWTi technology and provides recommendations for successful application of NPWTi in an effort to inform clinicians about product decision-making and practice.