title: Faster wound healing with topical negative pressure therapy in difficult-to-heal wounds: a prospective randomized controlled trial.
abstract: OBJECTIVE
  A randomized clinical trial was conducted to determine the effectiveness and safety of topical negative pressure therapy in patients with difficult-to-heal wounds.
  
  
  METHODS
  A total of 24 patients were randomly assigned to either treatment with topical negative pressure therapy or treatment with conventional dressing therapy with sodium hypochlorite. The study end point was 50% reduction in wound volume. The maximum follow-up time was 6 weeks.
  
  
  RESULTS
  The median treatment time to 50% reduction of wound volume in the topical negative pressure group was 2.0 weeks (interquartile range = 1) versus 3.5 weeks (interquartile range = 1.5) in the sodium hypochlorite group (P < 0.001). The unadjusted hazard rate ratio for the time until 50% wound volume reduction was 0.123 (P < 0.001). After adjustment for relevant baseline characteristics in a Cox proportional hazards model treatment group, membership was found as the only and statistically significant indicator for the time to 50% wound volume reduction (hazard rate ratio of 0.117 [P < 0.001]). Subgroup analysis of spinal cord injured patients with severe pressure ulcers showed similar statistically significant results as in the total wound group.
  
  
  CONCLUSIONS
  Topical negative pressure resulted in almost 2 times faster wound healing than treatment with sodium hypochlorite, and is safe to use in patients with difficult-to-heal wounds.
authors.affiliation: Department of Plastic Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. e.delaat@plchir.umcn.nl
authors.forename: Erik H E W
authors.initials: EH
authors.lastname: de Laat
authors.forename: Mark H W A
authors.initials: MH
authors.lastname: van den Boogaard
authors.forename: Paul H M
authors.initials: PH
authors.lastname: Spauwen
authors.forename: Dirk H J M
authors.initials: DH
authors.lastname: van Kuppevelt
authors.forename: Harry
authors.initials: H
authors.lastname: van Goor
authors.forename: Lisette
authors.initials: L
authors.lastname: Schoonhoven
mesh_terms: D001458:Bandages; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy / Q000379:methods*; D003668:Pressure Ulcer / Q000209:etiology / Q000628:therapy*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D013119:Spinal Cord Injuries / Q000150:complications; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology*