Comparison of Outcomes for Normal Saline and an Antiseptic Solution for Negative-Pressure Wound Therapy with Instillation.
BACKGROUND
Negative-pressure wound therapy with instillation is an adjunctive treatment that uses periodic instillation of a solution and negative pressure for a wide diversity of wounds. A variety of solutions have been reported, with topical antiseptics as the most frequently chosen option. The objective of this study was to compare the outcomes of normal saline versus an antiseptic solution for negative-pressure wound therapy with instillation for the adjunctive treatment of infected wounds.


METHODS
This was a prospective, randomized, effectiveness study comparing 0.9% normal saline versus 0.1% polyhexanide plus 0.1% betaine for the adjunctive treatment of infected wounds that required hospital admission and operative débridement. One hundred twenty-three patients were eligible, with 100 patients randomized for the intention-to-treat analysis and 83 patients for the per-protocol analysis. The surrogate outcomes measured were number of operative visits, length of hospital stay, time to final surgical procedure, proportion of closed or covered wounds, and proportion of wounds that remained closed or covered at the 30-day follow-up.


RESULTS
There were no statistically significant differences in the demographic profiles in the two cohorts except for a larger proportion of male patients (p = 0.004). There was no statistically significant difference in the surrogate outcomes with the exception of the time to final surgical procedure favoring normal saline (p = 0.038).


CONCLUSIONS
The authors' results suggest that 0.9% normal saline may be as effective as an antiseptic (0.1% polyhexanide plus 0.1% betaine) for negative-pressure wound therapy with instillation for the adjunctive inpatient management of infected wounds.


METHODS
Therapeutic, II.
Washington, D.C.; and Dallas, Texas From the Center for Wound Healing & Hyperbaric Medicine, Department of Plastic Surgery, Medstar Georgetown University Hospital; and the Department of Plastic Surgery, University of Texas Southwestern.
Paul J
PJ
Kim
Christopher E
CE
Attinger
Noah
N
Oliver
Caitlin
C
Garwood
Karen K
KK
Evans
John S
JS
Steinberg
Larry A
LA
Lavery
D000328:Adult; D000704:Analysis of Variance; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D003646:Debridement / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007322:Instillation, Drug; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy / Q000009:adverse effects / Q000379:methods*; D011446:Prospective Studies; D018570:Risk Assessment; D012965:Sodium Chloride / Q000627:therapeutic use*; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects* / Q000502:physiology; D014946:Wound Infection / Q000175:diagnosis / Q000628:therapy*; D055815:Young Adult
D000891:Anti-Infective Agents, Local; D012965:Sodium Chloride