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Negative pressure therapy for the pressure ulcers

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Pressure ulcers (PU) are caused by the pressure maintained between a bone prominence and the patient’s bed, leading to ischemia and necrosis of the involved tissues. They are common in patients with some mobility restriction, such as spinal cord injuries (paraplegic and quadriplegic) and patients under prolonged sedation. The most frequent sites of their development are the sacral, sciatic, trochanteric, calcaneal and occipital regions, among others.

The application of wound vacuum therapy in these wounds has the main objective of improving the local conditions for a later repairing surgery to obtain definitive cutaneous cover. This sequence is valid mainly in the cases of Pressure ulcers stages III and IV of the National Pressure Ulcer Advisory Panel (NPUAP), represented by deeper wounds, with muscular or bone exposure. Clinical reports such as that performed by Batra and Asseja19, however, show that even more complex wounds, when acute, could be treated only with NPT.

In 2002, Ford et al conducted a randomized, controlled study with 41 patients with deep Pressure ulcers, comparing NPT with topical healing promoter gels. The mean percentage reduction in ulcer volume was higher in the NPT group (51.8% vs. 42.1%, p=0.46). The mean number of capillaries per wound bed field was also higher in the NPT group (p=0.75). The authors stated that NPT promotes healing and neovascularization when compared to topical gel treatment20.

Ashby et al., in 2012, conducted a randomized controlled trial in patients with pressure ulcers grades III and IV, showing superior benefits of NTP in comparison with moist dressing.


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