title: The impact of negative-pressure wound therapy with instillation compared with standard negative-pressure wound therapy: a retrospective, historical, cohort, controlled study.
abstract: BACKGROUND
  Negative-pressure wound therapy with instillation is a novel wound therapy that combines negative pressure with instillation of a topical solution.
  
  
  METHODS
  This retrospective, historical, cohort-control study examined the impact of negative-pressure wound therapy with and without instillation.
  
  
  RESULTS
  One hundred forty-two patients (negative-pressure wound therapy, n = 74; therapy with instillation, 6-minute dwell time, n = 34; and therapy with instillation, 20-minute dwell time, n = 34) were included in the analysis. Number of operative visits was significantly lower for the 6- and 20-minute dwell time groups (2.4 ± 0.9 and 2.6 ± 0.9, respectively) compared with the no-instillation group (3.0 ± 0.9) (p ≤ 0.05). Hospital stay was significantly shorter for the 20-minute dwell time group (11.4 ± 5.1 days) compared with the no-instillation group (14.92 ± 9.23 days) (p ≤ 0.05). Time to final surgical procedure was significantly shorter for the 6- and 20-minute dwell time groups (7.8 ± 5.2 and 7.5 ± 3.1 days, respectively) compared with the no-instillation group (9.23 ± 5.2 days) (p ≤ 0.05). Percentage of wounds closed before discharge and culture improvement for Gram-positive bacteria was significantly higher for the 6-minute dwell time group (94 and 90 percent, respectively) compared with the no-instillation group (62 and 63 percent, respectively) (p ≤ 0.05).
  
  
  CONCLUSIONS
  The authors' results suggest that negative-pressure wound therapy with instillation (6- or 20-minute dwell time) is more beneficial than standard negative-pressure wound therapy for the adjunctive treatment of acutely and chronically infected wounds that require hospital admission.
  
  
  METHODS
  Therapeutic, III.
authors.affiliation: Washington, D.C.; and Dallas, Texas From the Department of Plastic Surgery, Georgetown University Hospital; Georgetown University School of Medicine; Georgetown University Medical Center; and the Department of Plastic Surgery, University of Texas Southwestern Medical Center.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Kim
authors.forename: Christopher E
authors.initials: CE
authors.lastname: Attinger
authors.forename: John S
authors.initials: JS
authors.lastname: Steinberg
authors.forename: Karen K
authors.initials: KK
authors.lastname: Evans
authors.forename: Kelly A
authors.initials: KA
authors.lastname: Powers
authors.forename: Rex W
authors.initials: RW
authors.lastname: Hung
authors.forename: Jesse R
authors.initials: JR
authors.lastname: Smith
authors.forename: Zinnia M
authors.initials: ZM
authors.lastname: Rocha
authors.forename: Larry
authors.initials: L
authors.lastname: Lavery
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000008:administration & dosage; D001622:Betaine / Q000008:administration & dosage; D001645:Biguanides / Q000008:administration & dosage; D002908:Chronic Disease; D015331:Cohort Studies; D003646:Debridement; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy / Q000379:methods*; D012189:Retrospective Studies; D013501:Surface-Active Agents / Q000008:administration & dosage; D007507:Therapeutic Irrigation; D014945:Wound Healing; D014946:Wound Infection / Q000601:surgery* / Q000628:therapy; D055815:Young Adult
chemical_list: D000890:Anti-Infective Agents; D001645:Biguanides; D013501:Surface-Active Agents; C031233:polihexanide; D001622:Betaine