Experience of using negative pressure wound therapy with instillation in complex treatment of purulent-necrotic diseases of soft tissue of the trunk and extremities

Introduction. Negative pressure wound therapy (NPWT) has been widely used for over 20 years in the treatment of purulent–necrotic soft tissue infections. However, negative pressure wound therapy with instillation (NPWT-i) is a newer method employed in complex wound management. Objective. To improve surgical treatment outcomes in patients with purulent-necrotic soft tissue infections. Materials and methods. The study included 25 patients with purulent-necrotic soft tissue infections of the trunk and extremities, divided into two groups. Group I (15 patients) received conventional NPWT as part of comprehensive treatment, while Group II (10 patients) underwent NPWT-i with normal saline instillation. The groups were comparable in age, sex, wound size, and primary pathogen. Results. The mean number of secondary surgical debridements was 5,50 ± 1,25 in Group I and 3,00 ± 0,82 in Group II (p < 0,05). The mean plasma C-reactive protein (CRP) level on day 7 after initial debridement was 99,65 ± 15,50 mg/L in Group I and 47,25 ± 32,26 mg/L in Group II (p < 0,05). The average hospitalization duration was 43,00 ± 8,08 days in Group I and 34,75 ± 4,65 days in Group II (p < 0,05). Computerized planimetric wound surface analysis on day 7 post-debridement showed that the mean granulation tissue area was 48,60 ± 4,34 % in Group I versus 71,25 ± 5,06 % in Group II (p < 0,05). Fibrin coverage was 27,00 ± 5,83 % and 15,75 ± 1,26 %, respectively (p < 0,05), while necrotic tissue area was 24,40 ± 2,70 % in Group I compared to 11,50 ± 2,08 % in Group II (p < 0.05). Conclusion. Negative pressure wound therapy with instillation (NPWT–i) is an effective approach in the comprehensive treatment of purulent–necrotic soft tissue infections of the trunk and extremities.