Long-Term Outcome Assessment Between Antiseptic and Normal Saline for Negative Pressure Wound Therapy with Instillation.

MedStar author(s):
Citation: Advances in Wound Care. 10(10):535-543, 2021 10.PMID: 33860686Institution: MedStar Washington Hospital CenterDepartment: Surgery/Plastic Surgery | Surgery/Podiatric SurgeryForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Anti-Infective Agents, Local/tu [Therapeutic Use] | *Negative-Pressure Wound Therapy/mt [Methods] | *Saline Solution/tu [Therapeutic Use] | *Wound Healing | Adult | Aged | Aged, 80 and over | Betaine/ad [Administration & Dosage] | Biguanides/ad [Administration & Dosage] | Female | Humans | Kaplan-Meier Estimate | Male | Middle Aged | Outcome Assessment, Health Care | Retrospective Studies | Wound Healing/ph [Physiology]Year: 2021ISSN:
  • 2162-1918
Name of journal: Advances in wound careAbstract: APPROACH: This was a single-center retrospective study analyzing the course of patients receiving 0.9% normal saline or 0.1% polyhexanide plus 0.1% betaine as instillation for wounds requiring surgery. Measured outcomes included rates of dehiscence, new wounds, re-operations, amputations, and mortality over 5 years. The manuscript adheres to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement.CONCLUSION: This is the first evaluation of non-surrogate outcomes of different instillations for negative pressure wound therapy in infected wounds. The results indicate that normal saline instillation outcomes are comparable to those of 0.1% polyhexanide 0.1% betaine. The clinical success, cost benefit and accessibility of normal saline can expand the utilization of this therapeutic approach for larger patient populations.INNOVATION: To compare clinical outcomes associated with two fundamentally different instillation solutions over the full wound-care episode and elucidate the potential impact of these results for future applications.OBJECTIVE: To analyze long-term outcomes following inpatient treatment of infected wounds with antimicrobial or normal saline instillation during negative-pressure wound therapy.RESULTS: 42 patients received normal saline instillation and 41 the anti-septic solution. Rates of dehiscence, wound recurrence, and re-operations in the saline and anti-septic cohorts were 6.3% and 5.6%, 9.4% and 5.6%, and 14.3% and 9.8%, respectively (p > 0.05). In patients requiring further surgery, time to wound closure averaged 104 and 130 days in the saline and anti-septic cohorts, respectively (p=0.81). 5-year amputation and mortality rates were 14.3% and 22% (p=0.36), and 24% and 17% (p=0.45) in the saline and anti-septic cohorts, respectively.All authors: Attinger C, Charipova K, Evans KK, Fan KL, Hill C, Kim PA, Meshkin D, Steinberg JSOriginally published: Advances in Wound Care. 2021 Apr 16Fiscal year: FY2022Fiscal year of original publication: FY2021Digital Object Identifier: Date added to catalog: 2021-06-07
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Journal Article MedStar Authors Catalog Article 33860686 Available 33860686

APPROACH: This was a single-center retrospective study analyzing the course of patients receiving 0.9% normal saline or 0.1% polyhexanide plus 0.1% betaine as instillation for wounds requiring surgery. Measured outcomes included rates of dehiscence, new wounds, re-operations, amputations, and mortality over 5 years. The manuscript adheres to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement.

CONCLUSION: This is the first evaluation of non-surrogate outcomes of different instillations for negative pressure wound therapy in infected wounds. The results indicate that normal saline instillation outcomes are comparable to those of 0.1% polyhexanide 0.1% betaine. The clinical success, cost benefit and accessibility of normal saline can expand the utilization of this therapeutic approach for larger patient populations.

INNOVATION: To compare clinical outcomes associated with two fundamentally different instillation solutions over the full wound-care episode and elucidate the potential impact of these results for future applications.

OBJECTIVE: To analyze long-term outcomes following inpatient treatment of infected wounds with antimicrobial or normal saline instillation during negative-pressure wound therapy.

RESULTS: 42 patients received normal saline instillation and 41 the anti-septic solution. Rates of dehiscence, wound recurrence, and re-operations in the saline and anti-septic cohorts were 6.3% and 5.6%, 9.4% and 5.6%, and 14.3% and 9.8%, respectively (p > 0.05). In patients requiring further surgery, time to wound closure averaged 104 and 130 days in the saline and anti-septic cohorts, respectively (p=0.81). 5-year amputation and mortality rates were 14.3% and 22% (p=0.36), and 24% and 17% (p=0.45) in the saline and anti-septic cohorts, respectively.

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