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Practice Innovations
Negative pressure wound therapy (NPWT) is one of the most effective and widely used interventions for challenging wounds and indicated for multiple wound indications1-3. The application of traditional negative pressure wound therapy (tNPWT) may require a technique termed bridging, dependent on the wound location on the body and optimal tubing placemnent4. This is commonly done to prevent ulcerations caused by hard ports and tubing and to position the device4. Bridging may require extra time and resources, and misapplication can lead to skin ulcerations4, 5. This real-world quantitative and qualitative research sought to explore tNPWT bridging technique application and the impact of using either a soft or hard port options from the two leading NPWT* manufacturers in the United States.
Methods:
Two hundred healthcare professionals (100 surgeons, 100 nurses) from the United States, experienced in utilising both tNPWT systems and bridging technique were recruited to complete an online quantitative survey, consisting of a 10-minute interview during September 5th until October 10th, 2022. Primary objectives were to explore if the soft port, when compared to hard port, eases application when administering tNPWT, alleviates concerns when applied to awkward anatomical areas and eliminates the need for bridging.
Results:
The majority agreed that bridging adds complexity, extra time, more supplies and extra hands. Half of the participants (53%) agreed that the soft port can eliminate the need for bridging. Nurses and specialists were significantly less likely to favour a hard port. Further benefits of soft port reported included: a preference for soft port where the delivery port itself reduces pressure, wound bed is small and port may cause pain, on anatomical areas at risk of pressure and when there is a concerns that tubing may kink.
Discussion:
A soft port can eliminate the need for bridging when using tNPWT, particularly when the wound is anatomically located where the patient may lie, sit or stand on the tubing or hard port. Additionally, the soft port remains effective regardless of kinks, saving time and decreasing the risk of skin breakdown from misapplications.
Trademarked Items: *(Soft Port, Smith and Nephew and SENSAT.R.A.C., 3M/KCI)
References: References
1. Borys S, Hohendorff J, Frankfurter C, Kiec-Wilk B, Malecki MT. Negative pressure wound therapy use in diabetic foot syndrome-from mechanisms of action to clinical practice. Eur J Clin Invest. 2019;49(4):e13067.
2. Apelqvist J, Willy C, Fagerdahl AM, et al. EWMA Document: Negative Pressure Wound Therapy. J Wound Care. 2017;26(suppl 3):S1–S154. doi:10.12968/jowc.2017.26.Sup3.S1
3. Brownhill VR, Huddleston E, Bell A, Hart J, Webster I, Hardman MJ, et al. Pre-Clinical Assessment of Single-Use Negative Pressure Wound Therapy During In Vivo Porcine Wound Healing. Adv Wound Care (New Rochelle). 2021;10(7):345-56.
4. Fife, C. W., D. (2010). The Challenges of Negative Pressure Wound Therapy in Clinical Practice. Today's Wound Clinic. Retrieved from https://www.hmpgloballearningnetwork.com/site/twc/npwt
5. Sandoz, H. (2015). Negative pressure wound therapy: clinical utility. Chronic Wound Care Management Research, 2, 71-79.