CLINICS

Clinics (Sao Paulo). 2017 December; 72(12): 737-742.
doi:10.6061/clinics/2017(12)04

Copyright © 2017 CLINICS

A new low-cost negative-pressure wound therapy versus a commercially available therapy device widely used to treat complex traumatic injuries: a prospective, randomized, non-inferiority trial

Fabio Kamamoto I * , Ana Lucia Munhoz Lima II , Marcelo Rosa de Rezende III , Rames Mattar-Junior IV , Marcos de Camargo Leonhardt IV , Kodi Edson Kojima IV , Carla Chineze dos Santos V

Pesquisador, Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, SP, BR

Departamento de Controle de Infeccao Hospitalar, Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, SP, BR

Departamento de Microcirurgia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, SP, BR

Instituto de Ortopedia e Traumatologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, BR

Consultor Independente, Sao Paulo, SP, BR

*Corresponding author. E-mail: fabio.kamamoto@gmail.com

received June 7, 2017; revised September 6, 2017; accepted October 6, 2017.

Abstract

OBJECTIVES:

Negative-pressure wound therapy has been widely adopted to reduce the complexity of treating a broad range of acute and chronic wounds. However, its cost is high. The objective of this study was to evaluate the following two different methods of negative-pressure wound therapy in terms of healing time: a low-cost method of negative-pressure wound therapy (a pressure stabilizer device connected to a hospital wall-vacuum system with a gauze-sealed dressing, USP) and the standard of care (vacuum-assisted closure, VAC).

METHODS:

This is a randomized, controlled, non-inferiority, unblinded trial. Patients admitted with complex injuries to a trauma center in a public referral hospital who were indicated for orthopedic surgery were randomized to a USP or VAC group. The primary outcome was the time required to achieve a “ready for surgery condition”, which was defined as a wound bed with healthy granulation tissue and without necrosis or purulent secretion. Wound bed area contraction, granulation tissue growth and the direct costs of the dressings were secondary outcomes.

RESULTS:

Variation in area and granulation tissue growth were essentially the same between the systems, and healing time was equal between the groups (p=0.379). In both systems, serial debridement increased wound area (p=0.934), and granulation tissue was also increased (p=0.408). The mean treatment cost was US$ 15.15 in the USP group and US$ 872.59 in the VAC group.

CONCLUSIONS:

For treating complex traumatic injuries, USP was non-inferior to and less expensive than VAC.

Keywords: Negative-Pressure Wound Therapy, Wound Healing, Wounds and Injuries, Cost Savings


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