Positive Outcomes with
Negative Pressure
Wound Therapy
Laurie S. Stelmaski BSN,RN,CWOCN
Objectives
Understand the healing science behind
negative pressure wound therapy
(NPWT).
 Identify the indications and
contraindications for use of NPWT in
acute and chronic wounds.
 Identify treatment endpoints for NPWT.

NPWT – How Does It Work?
The use of subatmospheric pressure to
promote wound healing.
 Subatmospheric pressure causes
mechanical stress to the tissue and the
wound is drawn closed.
 Basic components of a NPWT system
include the dressing, sealing mechanism,
tubing and a suction pump.

NPWT – Mechanisms of Action
Stimulation of wound edge retraction
 Moist wound environment
 Decrease in peripheral edema
 Increase in local circulation at the site of
the wound
 Reduced bacterial load
 Stimulation of granulation tissue
formation

Indications for NPWT
Acute wounds
 Chronic wounds
 Traumatic wounds
 Partial-thickness burns
 Dehisced wounds
 Pressure ulcers
 Diabetic ulcers
 Flaps and skin grafts

Contraindications for NPWT
 Malignancy
in the wound
 Untreated osteomyelitis
 Non-enteric or unexplored fistulas
 Necrotic tissue with eschar or
slough present
 Exposed blood vessels or organs
Patient Candidates
Appropriate patient selection will prevent
complications and ensure success of
NPWT.
 Need to optimize the patient’s ability to
heal:

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◦
◦
◦
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Manage comorbidities
Hemodynamic stability
Nutritional status
Blood sugar
Infection
Safe Use of NPWT
 Patient assessment
◦ Physician orders
 Wound preparation
◦ Debridement and cleansing
 Device application
◦ Documentation
 Monitoring and assessment
◦ Procedure and protocol
Treatment Endpoints
Based on wound progress and/or
achievement of treatment goal.
 Planned surgical closure with flap or skin
graft.
 Healing by secondary intention
 Failure to progress after 2-4 weeks of
NPWT.

Case Study #1
Case Study #2
References
Gupta, S. (2004). Guidelines for managing pressure ulcers
with negative pressure wound
therapy. Advances in
Skin & Wound Care, 17(S2), 2-16.
Long, M.A. & Blevins, A. (2009). Options in negative
pressure wound therapy: Five case studies. Journal
of Wound Ostomy and Continence Nursing, 36(2), 202-211.
Martindell, D. (2012). The safe use of negativepressure wound therapy. American Journal of
Nursing, 112(6), 59-63.