npwt india presentation

www.npwtindia.com [email protected]

AN ISO 13485:2003 CERTIFIED COMPANY

INTRODUCTION OF

CLOSED CYCLIC NEGATIVE PRESSURE WOUND THERAPY

in management of wounds

By SIDDHARTH MANDAL CEO

TRIAGE HEALTHCARE TECHNOLOGIES +91 9971722111



What is Closed Cyclic Negative Pressure Wound Therapy(CCNPWT)?

Negative Pressure Wound Therapy also widely known as NPWT, WOUND VAC or TNP(Tropical Negative Pressure) is a widely accepted wound

management modality today, i.e.,

A specially designed foam dressing applied on a wound bed, sealed with a PU/PE drape further

connected with a drainage tubing to regulated / controlled negative pressure source.



How does CCNPWT promote wound healing? •Removing excess fluid (infections and non-infectious), allowing tissue decompression •Stimulates granulation tissue formation by increasing vascular perfusion, •Encourages mechanical stretching, approximates wound edges, enhances overall wound contraction •Protects wound from microbe imbalance •Maintains a moist wound healing environment



CONSUMABLES

PORTFOLIO

ALL PRODUCTS ARE CERTIFIED

ALL PRODUCTS ARE MANUFACTURED UNDER STRICT PARAMETERS OF ISO 13485:2003

SINGLE USE ONLY



1. Rinse the wound thoroughly & Debride majority of necrotic tissues

2. Cut the foam dressing in the shape of the wound

3. Place it on the wound bed & seal with PU drape

4. Make a small hole in the centre

5. Stick the drainage tubing aligning the hole made

6. INITIATE the Therapy & observe



CCNPWT creates an Environment of Wound Healing at the Cellular Level

CCNPWT THERAPY DRESSING BENEFITS

Flexible foam dressing adapts to the contours of deep & irregular surface of the wound bed Specially designed hydrophobic, non-linear networked foam dressing removes bacteria colonised wound exudate The CCNPWT foam dressing aggressively promotes uniform healthy granulation tissue throughout the wound bed



CCNPWT THERAPY DRESSING BENEFITS

Flexible foam dressing adapts to the contours of deep & irregular surface of the wound bed

Specially designed hydrophobic, non-linear networked foam dressing removes bacteria

colonised wound exudate

The CCNPWT foam dressing aggressively promotes uniform healthy granulation tissue

throughout the wound bed



CCNPWT provides a closed sterile & moist wound

healing environment

Promotes granulation tissue formation, recent

studies suggest mechanical stretching may result in

increased mitosis (Cell Replication)

Controlled Negative Pressure Therapy decreases

wound volume approximating wound edges, helps

uniformly draw wounds closed

Promotes continuous wound debridement by

removing wound debris & bacteria colonized wound

output/interstitial fluid allowing tissue decompression



Contd.. Reduces oedema

Reduces bacterial load

Stimulates cell proliferation

Enchances dermal perfusion

Promotes micro angiogenesis

Protects wound from re-infection, cross infection or spreading further infection

Promotes Skin Graft/Flap uptake (The flexible foam dressing gently presses the skin graft or flap ensuring full contact with the wound bed



Increased Perfusion Morykwas Michael J, Argenta Louis C, Shelton-Brown Erica I, McGuirt Wyman: NPWT: A New Method for Wound

Control and Treatment: Animal Studies and Basic Foundation. Annals of Plastic Surgery, 1997

Peak blood flow recorded at 125 mmHg

Study helped establish original pressure

protocol with Foam Dressing (400-600

micron pore-size)

Hypothesized that reduction in oedema

decompresses small blood vessels and

increases flow

Frank Ischaemia and Wound Hypoxia

Positive effect on perfusion with 100-125 mmHg



Reduction of Inhibitory Factors Morykwas Michael J, Argenta Louis C, Shelton-Brown Erica I, McGuirt Wyman: NPWT: A New Method for Wound

Control and Treatment: Animal Studies and Basic Foundation. Annals of Plastic Surgery, 1997

Reduction of oedema has positive effect in wound

healing

Reduction of inhibitory factors contained in

interstitial fluid (chemical)

Decompression of small blood vessels, which

restores flow (mechanical)

Negative Pressure Wound Therapy increases perfusion and oxygenation, therapy likely enhances resistance to infection



WHAT TYPE OF WOUNDS BENEFIT FROM CCNPWT?

Pressure ulcers Full thickness and partial thickness burns Diabetic / Neuropathic ulcers Venous Insufficiency ulcers Post-operative and dehisced surgical Traumatic Wounds Skin Flaps and Grafts Explored fistulas



WHEN IS CCNPWT CONTRAINDICATED? • Wounds containing malignant tissue • Untreated osteomyelitis • Necrotic tissue such as slough or eschar • Unexplored or non-enteric fistulas • Exposed or unprotected organs, blood vessels



WHAT CONDITIONS INDICATE CAUTION?

• Active bleeding or patient on anticoagulant therapy • Proximity of blood vessels, organs, muscle, and fascia requiring protection • Irradiated vessels and tissue • Bony fragments • Untreated malnutrition • Non-compliant or combative behaviour



Fixation of skin graft (mesh-grafts) or flap until the graft has taken (4-6 days). In these special cases,

Topical Negative Presure Therapy is used for the secure fixation

of a split skin graft to the wound

The soft foam helps gently press the graft/flap onto the wound bed and thus ensures full contact between the graft and the

underlying wound bed, irrespective of the wound contours and the formation of pockets, also continuously drains out the

wound output, ensures infection free graft uptake

CCNPWT helps in Flaps & Graft uptake



DRESSING APPLICATION TECHNIQUE

STEP 1 : DEBRIDE & CLEAN THE WOUND WITH ISOTONIC SOLUTION

STEP 2 : CUT THE FOAM DRESSING IN THE SHAPE OF WOUND AND PLACE IT ON WOUND BED

STEP 4 : STICK THE MAPC TUBING DISTAL END KEEPING SYMMETRY WITH HOLE IN CENTRE & CONNECT WITH THE NEGATIVE PRESSURE SOURCE

STEP 3: SEAL THE WOUND WITH SEMI-PERMEABLE DRAPE & MAKE A SMALL HOLE IN THE CENTRE



INDICATED for TRAUMA WOUNDS



DIABETIC FOOT

ULCERS

INDICATED for

Granulation after 3 days of application



Indicated for all Grade II, III & IV Pressure Ulcers



INDICATED FOR VENUS/ARTERIAL

LEG ULCERS



INDICATED FOR ABDOMINAL

COMPARTMENT SYNDROME

Infected Laprotomy

**Please seek advice for special Dressing selection



Venus Leg ulcer with complications of sickle cell anaemia



CCNPWT

application

for 10 days

20 days

post follow-up



ROAD ACCIDENT LACERATION



Road Accident case : with no vessels for primary closure

(results of 13days NPWT Dressing Application)



INFECTED COMPOUND FRACTURE



AFTER Ist DRESSING CHANGE



AFTER 2nd DRESSING CHANGE



FOLLOW-UP POST FLAP



Crushed Injury

Amputation

CCNPWT

applied for

4 days



ROAD ACCIDENT LACERATION Patient : HBsAg Positive



CCNPWT

Applied for 7 days



PRESSURE ULCER (GRADE IV)



Result of 8 days / 2 dressing change



WHAT INTERVENTIONS WILL MAXIMIZE

HEALING?

Debride wound prior to Negative Pressure

Therapy

Off load pressure ulcers consistently

Minimize time off NPWT to < 4 hours in a day

Manage co-morbid condition

Increased blood flow

Reduce oedema

Minimize infection

Control blood glucose level



WHAT ARE THE EXPECTED OUTCOMES?

• May observe increased exudate and wound size during

the first 48-72 hours due to the decompression of interstitial

space and removal of extra-cellular fluid and debris.

• Gradual reduction of fluid and surface area should be

observed with each assessment.

• Colour of wound bed should become a deeper red as

perfusion to the site increases.

• Measurements should decrease weekly.

• If healing is not observed in a week, treatment should be

re-evaluated.

• The average treatment with NPWT is 1-4 weeks. Length of

treatment is determined by goals of therapy.



HOW DO YOU MANAGE WOUND WITH CCNPWT?

Change dressing two/three times per week.

Monitor frequently

Observe wound and peri-wound area for signs and

symptoms of infection

Remove dressings carefully to protect new tissue

growth.

Bright gush flow red blood in canister requires

immediate evaluation.

Measure and document per facility protocol

Note : To initiate it is recommended to follow CCNPWT protocol, to ensure optimal results, as

ithese are tried and tested protocol designed by various CCNPWT expert wound managers



WOUND ASSESMENT

CHART



WOUND TREATMENT PLAN CHART



Thank you for your patience For any queries feel free to contact our local

representative

or visit www.npwtindia.com email: [email protected]

or [email protected]

Care : +91 9971722111/9650440444

http://www.npwtindia.com/

mailto:[email protected]

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