The combined use of NPWT and instillation using an octenidine based wound rinsing solution: a case study.
Effective wound bed preparation is an essential element in the healing of chronic wounds, including pressure ulcers (PUs). Negative pressure wound therapy (NPWT) reduces oedema, stimulates the formation of granulation tissue and helps remove wound exudate. This helps prepare the wound bed for secondary healing, skin grafting or coverage with flaps. Combining NPWT with an instillation phase using an antiseptic (octenidine based) irrigation solution is a novel approach to PU management. Three patients with Category 4 gluteal PUs were treated with NPWT and instillation fluid, following surgical debridement of necrotic tissue. The aim was to achieve optimal wound bed preparation prior to wound closure by local fasciocutaneous flap. The antiseptic efficacy of octenilin wound irrigation solution in microorganism eradication was quantified by in vitro tests simulating real conditions using leg ulcer vacuum exudates. All wounds completely healed after four weeks, and no adverse incidents occurred due to instillation of octenidine. No recurrence of the PU occurred during a one year follow-up.
Department of Plastic, Aesthetic and Reconstructive Surgery, Wilhelminenspital, Vienna, Austria.
J
J
Matiasek
G
G
Djedovic
M
M
Mattesich
E
E
Morandi
R
R
Pauzenberger
R
R
Pikula
R
R
Verstappen
G
G
Pierer
R
R
Koller
U M
UM
Rieger
D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D002081:Buttocks / Q000293:injuries*; D006801:Humans; D007097:Imines; D008297:Male; D054843:Negative-Pressure Wound Therapy; D003668:Pressure Ulcer / Q000628:therapy*; D011725:Pyridines / Q000627:therapeutic use*; D007507:Therapeutic Irrigation; D016896:Treatment Outcome; D014945:Wound Healing; D014946:Wound Infection / Q000188:drug therapy*
D000891:Anti-Infective Agents, Local; D007097:Imines; D011725:Pyridines; C034213:octenidine
negative pressure wound therapy; negative pressure wound therapy with instillation; octenilin wound irrigation solution; pressure ulcer; wound bed preparation, flap closure