Recommendations on negative pressure wound therapy with instillation and antimicrobial solutions'-'when, where and how to use: "What does the evidence show?

International Wound Journal

Volumn 10, Issue S1, 2013, Pages 32-42

  Back, David A ^a   Scheuermann Poley, Catharina ^a   Willy, Christian ^a  

^a Plastic Surgery   (Germany)

Author keywords

Antiseptics; Contamination; Instillation; Negative pressure wound therapy; Vacuum assisted closure

Indexed keywords

ANTIBIOTIC AGENT; ANTIINFECTIVE AGENT; CEPHALOSPORIN DERIVATIVE; DOXYCYCLINE; GENTAMICIN; HYPOCHLORITE SODIUM; POVIDONE IODINE; SILVER NITRATE; SOAP; SODIUM CHLORIDE; TOBRAMYCIN; VANCOMYCIN;

ANTIBIOTIC THERAPY; ANTIMICROBIAL THERAPY; CHRONIC WOUND; COST OF ILLNESS; DRUG INSTILLATION; EVIDENCE BASED MEDICINE; GAUZE DRESSING; HEALTH CARE COST; HUMAN; INFECTION PREVENTION; OPEN FRACTURE; OSTEOMYELITIS; PRIORITY JOURNAL; REVIEW; SOFT TISSUE INJURY; SYSTEMATIC REVIEW; TREATMENT DURATION; TREATMENT OUTCOME; VACUUM ASSISTED CLOSURE; WOUND CARE; WOUND HEALING; WOUND INFECTION; WOUND IRRIGATION;

ANTISEPTICS; CONTAMINATION; INSTILLATION; NEGATIVE PRESSURE WOUND THERAPY; VACUUM-ASSISTED CLOSURE;

ACETIC ACID; ANTI-INFECTIVE AGENTS, LOCAL; BIGUANIDES; CROSS INFECTION; EVIDENCE-BASED MEDICINE; HUMANS; NEGATIVE-PRESSURE WOUND THERAPY; POVIDONE-IODINE; SURGICAL WOUND INFECTION; THERAPEUTIC IRRIGATION; WOUND INFECTION; WOUNDS AND INJURIES;

EID: 84888058277     PISSN: 17424801     EISSN: 1742481X     Source Type: Journal    
DOI: 10.1111/iwj.12183     Document Type: Review

References (83)

1. OMeara S, Al-Kurdi D, Ologun Y, Ovington LG. Antibiotics and antiseptics for venous leg ulcers. Cochrane Database Syst Rev 2008;20(Suppl 1):CD003557.
2. Knops AM, Storm-Versloot MN, Mank AP, Ubbink DT, Vermeulen H, Bossuyt PM, Goossens A. Factors influencing long-term adherence to two previously implemented hospital guidelines. International J Qual Health Care 2010;22:421-9.
3. Ovington L. Bacterial toxins and wound healing. Ostomy Wound Manage 2003;49(7A Suppl):8-12.
4. Singhal H, Kaur K, Zammit C. Wound Infection. URL http://emedicinecom/med/topic2422htm%3E. [accessed on 15 September 2009]
5. Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol 1999;20:250-78, quiz 79-80.
6. Wilson AP, Gibbons C, Reeves BC, Hodgson B, Liu M, Plummer D, et al. Surgical wound infection as a performance indicator: agreement of common definitions of wound infection in 4773 patients. BMJ 2004;329:720.
7. Hacker SM. Common infections of the skin. Characteristics, causes, and cures. Postgrad Med 1994;96:43-6, 49-52.
8. Janda JM, Abbott SL, Brenden RA. Overview of the etiology of wound infections with particular emphasis on community-acquired illnesses. Eur J Clin Microbiol Infect Dis 1997;16:189-201.
9. Nichols RL. Surgical wound infection. Am J Med 1991;91(3B):54S-64S.
10. McDonnell G, Russell AD. Antiseptics and disinfectants: activity, action, and resistance. Clin Microbiol Rev 1999;12:147-79.
11. Devi PS, Rao PS, Shivananda PG. Characterization, antibiotic susceptibility pattern and detection of beta-lactamases in Enterococci. Indian J Pathol Microbiol 2002;45:79-82.
12. Joint Formulary Committee. British National Formulary: London, UK. v. 43. 2002.
13. Argenta LC, Morykwas MJ. Vacuum-assisted closure: a new method for wound control and treatment: clinical experience. Ann Plast Surg 1997;38:563-76, discussion 77.
14. Fleischmann W, Strecker W, Bombelli M, Kinzl L. [Vacuum sealing as treatment of soft tissue damage in open fractures]. Unfallchirurg 1993;96:488-92.
15. Morykwas MJ, Argenta LC, Shelton-Brown EI, McGuirt W. Vacuum-assisted closure: a new method for wound control and treatment: animal studies and basic foundation. Ann Plast Surg 1997;38:553-62.
16. Orgill DP, Manders EK, Sumpio BE, Lee RC, Attinger CE, Gurtner GC, Ehrlich HP. The mechanisms of action of vacuum assisted closure: more to learn. Surgery 2009;146:40-51.
17. Orgill DP, Bayer LR. Update on negative-pressure wound therapy. Plast Reconstr Surg 2011;127(Suppl 1):105S-15S.
18. Willy C, editor. Experimental basis I'-'review of the literature. The theory and practice of vacuum therapy. Scientific basis, indications for use, case reports, practical advice. Ulm: Lindqvist Publishing, 2006.
19. Gabriel A, Shores J, Heinrich C, Baqai W, Kalina S, Sogioka N, Gupta S. Negative pressure wound therapy with instillation: a pilot study describing a new method for treating infected wounds. Int Wound J 2008;5:399-413.
20. Lehner B, Fleischmann W, Becker R, Jukema GN. First experiences with negative pressure wound therapy and instillation in the treatment of infected orthopaedic implants: a clinical observational study. Int Orthop 2011;35:1415-20.
21. Timmers MS, Graafland N, Bernards AT, Nelissen RG, van Dissel JT, Jukema GN. Negative pressure wound treatment with polyvinyl alcohol foam and polyhexanide antiseptic solution instillation in posttraumatic osteomyelitis. Wound Repair Regen 2009;17:278-86.
22. Zelen CM, Stover B, Nielson D, Cunningham M. A prospective study of negative pressure wound therapy with integrated irrigation for the treatment of diabetic foot ulcers. Eplasty 2011;11:e5.
23. Allen D, Labarbera LA, Bondre IL, Lessing MC, Rycerz AM Jr, Kilpadi DV, Collins BA, Perkins J, McNulty AK. Comparison of tissue damage, cleansing and cross-contamination potential during wound cleansing via two methods: lavage and negative pressure wound therapy with instillation. Int Wound J 2012 Aug 21. doi: 10.1111/j.1742-481X.2012.01073.x. [Epub ahead of print].
24. Brem MH, Blanke M, Olk A, Schmidt J, Mueller O, Hennig FF, Gusinde J. [The vacuum-assisted closure (V.A.C.) and instillation dressing: limb salvage after 3 degrees open fracture with massive bone and soft tissue defect and superinfection]. Unfallchirurg 2008;111:122-5.
25. Chien SH, Tan WH, Hsu H. New continuous negative-pressure and irrigation treatment for infected wounds and intractable ulcers. Plast Reconstr Surg 2008;122:318, author reply 9.
26. D'Hondt M, D'Haeninck A, Dedrye L, Penninckx F, Aerts R. Can vacuum-assisted closure and instillation therapy (VAC-Instill therapy) play a role in the treatment of the infected open abdomen? Tech Coloproctol 2011;15:75-7.
27. Fleischmann W, Russ M, Westhauser A, Stampehl M. [Vacuum sealing as carrier system for controlled local drug administration in wound infection]. Unfallchirurg 1998;101:649-54.
28. Fujiwara M, Matsushita Y, Fukamizu H. Negative pressure therapy with irrigation for an infected digit: a preliminary report. Hand Surg 2011;16:99-103.
29. Gabriel A. Integrated negative pressure wound therapy system with volumetric automated fluid instillation in wounds at risk for compromised healing. Int Wound J 2012;9(Suppl 1):25-31.
30. Gupta S. Sterilizing chronic wounds with negative pressure therapy: the role of antibiotic irrigation. Wound Repair Regen 2000;9:171.
31. Harada A, Nakamura Y, Fukumori K, Nagata T, Iguro Y. Negative pressure wound therapy was useful in treating empyema with bronchopleural fistula. Kyobu Geka 2010;63:1039-43.
32. Jerome D. Advances in negative pressure wound therapy: the VAC instill. J Wound Ostomy Continence Nurs 2007;34:191-4.
33. Kirr R, Wiberg J, Hertlein H. [Clinical experience and results of using the V.A.C. instill therapy in infected hip- and knee prosthetics]. Zentralbl Chir 2006;131(Suppl 1):S79-82.
34. Kiyokawa K, Takahashi N, Rikimaru H, Yamauchi T, Inoue Y. New continuous negative-pressure and irrigation treatment for infected wounds and intractable ulcers. Plast Reconstr Surg 2007;120:1257-65.
35. Kurihara C, Nishimura T, Kinoshita O, Kawata M, Hisagi M, Kyo S, Ono M. Successful treatment of mediastinitis after ventricular assist device implantation with rerouting of the outflow vascular prosthesis. J Artif Organs 2011;14:155-8.
36. Labler L, Trentz O. V.A.C. instillation: in vitro model. Part 1. Biomed Tech (Berl) 2005;50:413-8.
37. Labler L, Trentz O. V.A.C. instillation: in vitro model. Part 2. Biomed Tech (Berl) 2006;51:30-7.
38. Lee SS, Chang KP, Lai CS, Lin SD. Does continuous negative-pressure and irrigation treatment really rinse the whole closed wound? Plast Reconstr Surg 2008;122:319-20, author reply 20-1.
39. Lehner B, Bernd L. [V.A.C.-instill therapy in periprosthetic infection of hip and knee arthroplasty]. Zentralbl Chir 2006;131(Suppl 1):S160-4.
40. Matsushita Y, Fujiwara M, Nagata T, Noda T, Fukamizu H. Negative pressure therapy with irrigation for digits and hands: pressure measurement and clinical application. Hand Surg 2012;17:71-5.
41. McNulty AK, Nguyen K. What is the benefit of instillation therapy? Int J Low Extrem Wounds 2010;9:68-9.
42. Moch D, Fleischmann W, Russ M. [The BMW (biosurgical mechanical wound treatment) in diabetic foot]. Zentralbl Chir 1999;124(Suppl 1):69-72.
43. Moch D, Fleischmann W, Westhauser A. [Instillation vacuum sealing--report of initial experiences]. Langenbecks Arch Chir Suppl Kongressbd 1998;115:1197-9.
44. Participants. V.A.C. instill therapy'-'indications and technical applications. Abstracts of the First V.A.C. Instill Symposium. Heidelberg, Germany. November 21, 2008. Infection 2008;37(Suppl 1):3-45.
45. Plikaitis CM, Molnar JA. Subatmospheric pressure wound therapy and the vacuum-assisted closure device: basic science and current clinical successes. Expert Rev Med Devices 2006;3:175-84.
46. Raad W, Lantis JC 2nd, Tyrie L, Gendics C, Todd G. Vacuum-assisted closure instill as a method of sterilizing massive venous stasis wounds prior to split thickness skin graft placement. Int Wound J 2010;7:81-5.
47. Riepe G, Schneider M. [V.A.C. instill'-'first experiences on an inflammatory process of the proximal femur 3 years after hip-joint operation]. Zentralbl Chir 2006;131(Suppl 1):S157-9.
48. Rycerz AM, Slack P, McNulty AK. Distribution assessment comparing continuous and periodic wound instillation in conjunction with negative pressure wound therapy using an agar-based model. Int Wound J 2013;10:214-20.
49. Schintler MV, Grohmann M, Donia C, Aberer E, Scharnagl E. Management of an unfortunate triad after breast reconstruction: pyoderma gangrenosum, full-thickness chest wall defect and Acinetobacter baumannii infection. J Plast Reconstr Aesthet Surg 2010;63:e564-7.
50. Scimeca CL, Bharara M, Fisher TK, Giovinco N, Armstrong DG. Novel use of doxycycline in continuous-instillation negative pressure wound therapy as "wound chemotherapy". Foot Ankle Spec 2010;3:190-3.
51. Scimeca CL, Bharara M, Fisher TK, Kimbriel H, Mills JL, Armstrong DG. Novel use of insulin in continuous-instillation negative pressure wound therapy as "wound chemotherapy". J Diabetes Sci Technol 2010;4:820-4.
52. Streubel PN, Stinner DJ, Obremskey WT. Use of negative-pressure wound therapy in orthopaedic trauma. J Am Acad Orthop Surg 2012;20:564-74.
53. Wolvos T. Wound instillation-the next step in negative pressure wound therapy. Lessons learned from initial experiences. Ostomy Wound Manage 2004;50:56-66.
54. Wolvos T. Wound instillation with negative pressure wound therapy. Ostomy Wound Manage 2005;51(2A Suppl):21S-6S.
55. Chang FY, Chang MC, Wang ST, Yu WK, Liu CL, Chen TH. Can povidone-iodine solution be used safely in a spinal surgery? Eur Spine J 2006;15:1005-14.
56. Daeschlein G, Assadian O, Bruck JC, Meinl C, Kramer A, Koch S. Feasibility and clinical applicability of polihexanide for treatment of second-degree burn wounds. Skin Pharmacol Physiol 2007;20:292-6.
57. Moscati RM, Mayrose J, Reardon RF, Janicke DM, Jehle DV. A multicenter comparison of tap water versus sterile saline for wound irrigation. Acad Emerg Med 2007;14:404-9.
58. Fernandez R, Griffiths R. Water for wound cleansing. Cochrane Database Syst Rev 2008;1:CD003861.
59. Fernandez R, Griffiths R. Water for wound cleansing. Cochrane Database Syst Rev 2012;2:CD003861.
60. Hall S. A review of the effect of tap water versus normal saline on infection rates in acute traumatic wounds. J Wound Care 2007;16:38-41.
61. Chisholm CD, Cordell WH, Rogers K, Woods JR. Comparison of a new pressurized saline canister versus syringe irrigation for laceration cleansing in the emergency department. Ann Emerg Med 1992;21:1364-7.
62. Khan MN, Naqvi AH. Antiseptics, iodine, povidone iodine and traumatic wound cleansing. J Tissue Viability 2006;16:6-10.
63. Watt BE, Proudfoot AT, Vale JA. Hydrogen peroxide poisoning. Toxicol Rev 2004;23:51-7.
64. Cartotto RC, Peters WJ, Neligan PC, Douglas LG, Beeston J. Chemical burns. Can J Surg 1996;39:205-11.
65. Nicks BA, Ayello EA, Woo K, Nitzki-George D, Sibbald RG. Acute wound management: revisiting the approach to assessment, irrigation, and closure considerations. Int J Emerg Med 2010;3:399-407.
66. Conroy BP, Anglen JO, Simpson WA, Christensen G, Phaup G, Yeager R, Gainor BJ. Comparison of castile soap, benzalkonium chloride, and bacitracin as irrigation solutions for complex contaminated orthopaedic wounds. J Orthop Trauma 1999;13:332-7.
67. Culver DH, Horan TC, Gaynes RP, Martone WJ, Jarvis WR, Emori TG, Banerjee SN, Edwards JR, Tolson JS, Henderson TS, Hughes JM. Surgical wound infection rates by wound class, operative procedure, and patient risk index. National Nosocomial Infections Surveillance System. Am J Med 1991;91(3B):152S-7S.
68. Costagliola M, Agrosi M. Second-degree burns: a comparative, multicenter, randomized trial of hyaluronic acid plus silver sulfadiazine vs. silver sulfadiazine alone. Curr Med Res Opin 2005;21:1235-40.
69. Creanor S, Barton A, Marchbank A. Effectiveness of a gentamicin impregnated collagen sponge on reducing sternal wound infections following cardiac surgery: a meta-analysis of randomised controlled trials. Ann R Coll Surg Engl 2012;94:227-31.
70. Murray CK, Obremskey WT, Hsu JR, Andersen RC, Calhoun JH, Clasper JC, Whitman TJ, Curry TK, Fleming ME, Wenke JC, Ficke JR. Prevention of infections associated with combat-related extremity injuries. J Trauma 2011;71(2 Suppl 2):S235-57.
71. Hospenthal DR, Murray CK, Andersen RC, Bell RB, Calhoun JH, Cancio LC, Cho JM, Chung KK, Clasper JC, Colyer MH, Conger NG, Costanzo GP, Crouch HK, Curry TK, D'Avignon LC, Dorlac WC, Dunne JR, Eastridge BJ, Ficke JR, Fleming ME, Forgione MA, Green AD, Hale RG, Hayes DK, Holcomb JB, Hsu JR, Kester KE, Martin GJ, Moores LE, Obremskey WT, Petersen K, Renz EM, Saffle JR, Solomkin JS, Sutter DE, Tribble DR, Wenke JC, Whitman TJ, Wiesen AR, Wortmann GW. Guidelines for the prevention of infections associated with combat-related injuries: 2011 update: endorsed by the Infectious Diseases Society of America and the Surgical Infection Society. J Trauma 2011;71(2 Suppl 2):S210-34.
72. Hospenthal DR, Murray CK, Andersen RC, Bell RB, Calhoun JH, Cancio LC, Cho JM, Chung KK, Clasper JC, Colyer MH, Conger NG, Costanzo GP, Crouch HK, Curry TK, D'Avignon LC, Dorlac WC, Dunne JR, Eastridge BJ, Ficke JR, Fleming ME, Forgione MA, Green AD, Hale RG, Hayes DK, Holcomb JB, Hsu JR, Kester KE, Martin GJ, Moores LE, Obremskey WT, Petersen K, Renz EM, Saffle JR, Solomkin JS, Sutter DE, Tribble DR, Wenke JC, Whitman TJ, Wiesen AR, Wortmann GW. Executive summary: guidelines for the prevention of infections associated with combat-related injuries: 2011 update: endorsed by the Infectious Diseases Society of America and the Surgical Infection Society. J Trauma 2011;71(2 Suppl 2):S202-9.
73. Petrisor B, Jeray K, Schemitsch E, Hanson B, Sprague S, Sanders D, Bhandari M. Fluid lavage in patients with open fracture wounds (FLOW): an international survey of 984 surgeons. BMC Musculoskelet Disord 2008;9:7.
74. Stevenson J, McNaughton G, Riley J. The use of prophylactic flucloxacillin in treatment of open fractures of the distal phalanx within an accident and emergency department: a double-blind randomized placebo-controlled trial. J Hand Surg Br 2003;28:388-94.
75. Anglen JO. Comparison of soap and antibiotic solutions for irrigation of lower-limb open fracture wounds. A prospective, randomized study. J Bone Joint Surg Am 2005;87:1415-22.
76. Petrisor B, Sun X, Bhandari M, Guyatt G, Jeray KJ, Sprague S, Tanner S, Schemitsch E, Sancheti P, Anglen J, Tornetta P, Bosse M, Liew S, Walter S. Fluid lavage of open wounds (FLOW): a multicenter, blinded, factorial pilot trial comparing alternative irrigating solutions and pressures in patients with open fractures. J Trauma 2011;71:596-606.
77. Investigators F. Fluid lavage of open wounds (FLOW): design and rationale for a large, multicenter collaborative 2 x 3 factorial trial of irrigating pressures and solutions in patients with open fractures. BMC Musculoskelet Disord 2010;11:85.
78. Becerro de Bengoa Vallejo R, Losa Iglesias ME, Cervera LA, Fernandez DS, Prieto JP. Efficacy of intraoperative surgical irrigation with polihexanide and nitrofurazone in reducing bacterial load after nail removal surgery. J Am Acad Dermatol 2011;64:328-35.
79. Fournel I, Tiv M, Soulias M, Hua C, Astruc K, Aho Glele LS. Meta-analysis of intraoperative povidone-iodine application to prevent surgical-site infection. Br J Surg 2010;97:1603-13.
80. Kokavec M, Fristakova M[. Efficacy of antiseptics in the prevention of post-operative infections of the proximal femur, hip and pelvis regions in orthopedic pediatric patients. Analysis of the first results]. Acta Chir Orthop Traumatol Cech 2008;75:106-9.
81. Mohd AR, Ghani MK, Awang RR, Su Min JO, Dimon MZ. Dermacyn irrigation in reducing infection of a median sternotomy wound. Heart Surg Forum 2010;13:E228-32.
82. Dissemond J, Assadian O, Gerber V, Kingsley A, Kramer A, Leaper DJ, Mosti G, Piatkowski de Grzymala A, Riepe G, Risse A, Romanelli M, Strohal R, Traber J, Vasel-Biergans A, Wild T, Eberlein T. Classification of wounds at risk and their antimicrobial treatment with polihexanide: a practice-oriented expert recommendation. Skin Pharmacol Physiol 2011;24:245-55.
83. Willy C, Scheuermann-Poley C, Krapohl BD, Back DA. A small view back, some reflections and final recommendation. In: Willy C, editor. Antiseptics in surgery'-'update 2013, 1st edn. Berlin: Lindqvist Books Publishing, 2013:203-19.