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Negative pressure wound therapy

Discussion in 'Diabetic Foot & Wound Management' started by NewsBot, Jun 12, 2006.

  1. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Use of Multiple Adjunctive Negative Pressure Wound Therapy Modalities to Manage Diabetic Lower-Extremity Wounds.
    Cole WE et al
    Eplasty. 2016 Dec 20;16:e34. eCollection 2016.
     
  2. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    The Effectiveness of Negative Pressure Therapy in Diabetic Foot Ulcers with Elevated Protease Activity: A Case Series.
    Izzo V et al
    Adv Wound Care (New Rochelle). 2017 Jan 1;6(1):38-42. doi: 10.1089/wound.2016.0700.
     
  3. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    The effectiveness of negative pressure therapy on infected wounds: preliminary results
    Federico Lo Torto, et al
    International Wound Journal; 15 February 2017
     
  4. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Resource Utilization and Cost Effectiveness of Negative Pressure Wound Therapy (NPWT) Versus Moist Wound Therapy (MWT) in Management of Diabetic Foot Transmetatarsal Amputation (TMA)
    Narkhede, P.S., Vivekanand, Vishnu, M. et al.
    Indian J Surg (2017). doi:10.1007/s12262-017-1630-2
     
  5. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Effectiveness of negative pressure wound therapy in the management of
    chronic diabetic ulcers: a prospective study

    Sharma D et al.
    Int Surg J. 2017 Apr;4(4):1313-1318
     
  6. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Evaluation of negative-pressure wound therapy for patients with diabetic foot ulcers: systematic review and meta-analysis
    Liu S, He C, Cai Y, Xing Q, Guo Y, Chen Z, Su J, Yang L
    18 April 2017 Volume 2017:13 Pages 533—544
     
  7. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Effect of Negative Pressure Wound Therapy Cellular Fibronectin and Transforming Growth Factor-β1 Expression in Diabetic Foot Wounds
    Shao Ling Yang, PhD, Lv Yun Zhu, PhD, Rui Han, BSc, Lei Lei Sun, MSc, Jing Tao Dou, PhD
    Foot & Ankle International April 29, 2017
     
  8. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Histomorphological observation of surgical debridement combined with negative pressure therapy in treatment of diabetic foot.
    Dong JY et al
    Chin J Traumatol. 2017 Apr 20. pii: S1008-1275(16)30255-3. doi: 10.1016/j.cjtee.2016.08.004.
     
  9. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Effects of topical negative pressure therapy on tissue oxygenation and wound healing in vascular foot wounds.
    Chiang Net al
    J Vasc Surg. 2017 Jun 2. pii: S0741-5214(17)30934-5. doi: 10.1016/j.jvs.2017.02.050
     
  10. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Complications associated with the negative pressure therapy in the treatment of the diabetic foot ulcers: Retrospective case series
    Sara García Orejaa et al
    Revista Española de Podología; 18 July 2017
     
  11. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Dysregulation of Wound Healing Mechanisms in Diabetes and the Importance of Negative Pressure Wound Therapy (NPWT).
    Khamaisi M, Balanson S.
    Diabetes Metab Res Rev. 2017 Aug 17. doi: 10.1002/dmrr.2929.
     
  12. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Outcome of negative pressure wound therapy on diabetic foot ulcers: an observational study
    He F et al
    Zhonghua Yi Xue Za Zhi. 2017 Aug 22;97(32):2525-2527. doi: 10.3760/cma.j.issn.0376-2491.2017.32.011.
     
  13. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Press Release:
    Negative Pressure Wound Therapy Market Analysis by Product, Application, and End User 2017
    Negative Pressure Wound Therapy (Npwt) Market by Product, Application, and End User - Global Industry Analysis and Forecast To 2025

    9/27/2017 - The Latest research study titled, “Negative Pressure Wound Therapy (NPWT) Market by Product, Application, and End User - Global Industry Analysis and Forecast to 2025” published by Crystal Market Research, states that the NPWT market is projected to be around $4 billion by 2025.
    Negative pressure wound therapy refers to the intermittent application of partial vacuum to a wound by means of a motorized pump. A controlled negative pressure environment increases the oxygenation of tissues and evacuates bacteria, edema fluid and exudate. The therapy has shown promising capabilities in assisting healing of chronic and acute wounds such as diabetic and pressure ulcers, partial burns and skin grafts. Diabetes is one of the most common chronic diseases worldwide and its prevalence is increasing. As per International Diabetes Federation, as of 2015, 415 million adults suffered from diabetes and this number is expected to reach 642 million by 2040. Moreover, as per the American Podiatric Medical Association (APMA), about 15% of the total patients having diabetes experience foot ulcers.DFUs often co-exist with vascular insufficiency, which leads to gangrene and amputation in diabetic individuals. Major amputation is associated with significant morbidity and mortality (13-14% during 1st year to 39-80% at 5 years) besides social, psychological and financial consequences.

    Conventional NPWT devices segment accounted for the largest share in the global market in 2016, owing to their ability to heal a wide variety of wounds; while the single-Use NPWT devices is projected to be the fastest-growing segment over the forecast period, due to its light weight and availability of advanced dressing options. Chronic wounds segment accounted for the largest share of global NPWT market in 2016, with diabetic foot ulcers market leading the segment, due to rising prevalence of chronic wounds such as diabetic foot ulcers. In addition to this, surgical wounds market is projected to be the fastest-growing segment over the forecast period.

    Get PDF copy of an Exclusive Report @ http://www.crystalmarketresearch.com/report-sample/HC057

    North America held a major share of the overall market in 2016. This is primarily attributed to a number of factors such as the rising incidence of diabetes mellitus, rapidly aging population, increased adoption of technologically advanced NPWT products, and highly developed healthcare infrastructure. Asia Pacific is expected to witness lucrative market growth over the forecast period

    Key players in Market:
    Some of the major companies include ConvaTec Inc., Mölnlycke Health Care, Acelity L.P. Inc., Smith & Nephew plc, Coloplast A/S, Paul Hartmann AG, Cardinal Health Inc., Medela AG, Devon Medical, Inc., and Talley Group Limited.These players have adopted strategies such as new product development, collaboration, and strategic acquisitions. For instance, in 2015, Acelity acquired a line of disposable NPWT products, SNaP Therapy System, from Spiracur. This is expected to accelerate the company’s plans in the disposable NPWT space while strengthening its product portfolio.
     
  14. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Use of cryopreserved umbilical cord with negative pressure wound therapy for complex diabetic ulcers with osteomyelitis.
    Raphael A, Gonzales J.
    J Wound Care. 2017 Oct 1;26(Sup10):S38-S44. doi: 10.12968/jowc.2017.26.Sup10.S38.
     
  15. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Tissue Oxygenation and Negative-Pressure Wound Therapy When Applied to the Feet of Persons With Diabetes Mellitus: An Observational Study.
    Lee YN, Lee JS, Han SK, Jung HK.
    J Wound Ostomy Continence Nurs. 2017 Nov/Dec;44(6):517-523. doi: 10.1097/WON.0000000000000378.
     
  16. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    A randomized controlled trial comparing low cost vacuum assisted
    dressings and conventional dressing methods in the
    management of diabetic foot ulcers

    Caren Dsouza, Rouchelle, Chirag, Erel Diaz, Shubha Rao
    l. Int Surg J. 2017 Dec;4(12):xxx-xxx
     
  17. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    A randomized controlled trial comparing low cost vacuum assisted
    dressings and conventional dressing methods in the
    management of diabetic foot ulcers

    Caren Dsouza, Rouchelle, Chirag, Erel Diaz, Shubha Rao
    l. Int Surg J. 2017 Dec;4(12):xxx-xxx
     
  18. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Negative pressure wound therapy in the management of mine blast injuries of lower limbs: Lessons learnt at a tertiary care center.
    Maurya S, Srinath N, Bhandari PS
    Med J Armed Forces India. 2017 Oct;73(4):321-327. doi: 10.1016/j.mjafi.2016.06.002.
     
  19. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Effect of negative pressure wound therapy on molecular markers in diabetic foot ulcers
    Rehab A. Karam et al
    Gene; 11 May 2018
     
  20. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Negative Pressure Wound Therapy Versus Conventional Dressing in Treatment of Diabetic Foot Wound.
    Bayoumi, Atef; Al-Sayed, Abdullah; Al-Mallah, Abdullah
    Egyptian Journal of Hospital Medicine . Jul2018, Vol. 72 Issue 3, p4054-4059. 6p.
     
  21. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Negative-pressure wound therapy for management of chronic neuropathic noninfected diabetic foot ulcerations – short-term efficacy and long-term outcomes
    S Borys et al
    Endocrine 11 August 2018
     
  22. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Negative pressure wound therapy in the treatment of diabetic foot ulcers may be mediated through differential gene expression.
    Borys S et al
    Acta Diabetol. 2018 Sep 17.
     
  23. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Using single use negative pressure wound therapy for patients with complicated diabetic foot ulcers: an economic perspective.
    Wounds UK . 2018, Vol. 14 Issue 4, p89-93. 5p.
    SHARPE, ANDREW; MYERS, DAVID; SEARLE, RICHARD
     
  24. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    An inexpensive method of negative pressure wound therapy for extremities
    Sri Vengadesh Gopal Ashley Solomon
    Int W Jnl: 10 October 2018
     
  25. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Efficacy of negative pressure wound therapy using vacuum-assisted closure combined with photon therapy for management of diabetic foot ulcers.
    Hu X et al
    Ther Clin Risk Manag. 2018 Oct 25;14:2113-2118. doi: 10.2147/TCRM.S164161. eCollection 2018.
     
  26. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Negative pressure wound therapy use in diabetic foot syndrome - from mechanisms of action to clinical practice.
    Borys S et al
    Eur J Clin Invest. 2019 Jan 1:e13067
     
  27. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Negative pressure assisted dressings: a game changer in wound care?
    Srinivas N.M et al
    Asian Pac. J. Health Sci., 2018; 5(3):197-202 e-ISSN: 2349-0659, p-ISSN: 2350-0964
     
  28. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Long-term Negative Pressure Wound Therapy Decreases Diabetic Foot's Risk of Amputation Assessed in the University of Texas Wound Classification
    AdamWęgrzynowskiMikołajKamińskiPiotrLiszkowskiJacekSoskaAleksandraAraszkiewiczDorotaZozulinska-Ziolkiewicz
    Wound Medicine; 15 February 2019
     
  29. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Negative pressure wound therapy promoted wound healing by suppressing inflammation via down-regulating MAPK-JNK signaling pathway in diabetic foot patients.
    Wang T et al
    Diabetes Res Clin Pract. 2019 Feb 27
     
  30. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Impact of negative pressure wound therapy in complete healing rates following surgical debridement in heel and ankle regions in diabetic foot infections.
    Hasaballah A, Aboloyoun H, Elbadawy A, Ezeldeen M.
    Egypt J Surg 2019;38:165-9
     
  31. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Effect of negative-pressure wound therapy on the circulating number of peripheral endothelial progenitor cells in diabetic patients with mild to moderate degrees of ischaemic foot ulcer.
    Mu S et al
    Vascular. 2019 Mar 6:1708538119836360
     
  32. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Comparison of vacuum-assisted closure therapy and conventional dressing on wound healing in patients with diabetic foot ulcer: A randomized controlled trial.
    James SM, Sureshkumar S, Elamurugan TP, Debasis N, Vijayakumar C, Palanivel C.
    Niger J Surg 2019;25:14-20
     
  33. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    PUBLIC RELEASE: 8-APR-2019
    Negative pressure wound therapy: manufacturer data provided later allow benefit conclusion
    Indication of advantages for secondary wound healing; hint for primary wound healing / Stricter transparency regulations needed for medical devices /



    Negative pressure wound therapy (NPWT) has been used in hospitals for over 20 years; over 100 studies have been completed. However, conclusions on benefit and harm are in part uncertain because study initiators are withholding results. In the summer of 2018, the proportion of missing data was still so large for the area of application "secondary wound healing" that an assessment was not possible. After the manufacturer KCI (Acelity) eventually provided sufficient information, in its final report the German Institute for Quality and Efficiency in Health Care (IQWiG) now sees an indication of a greater benefit of NPWT compared with standard treatment. Regarding primary wound healing, for which the Institute now presents the preliminary assessment, the results are also in favour of NPWT; however, the differences are markedly smaller. IQWiG sees a hint of an advantage here. Comments on this preliminary report are possible until 29 April 2019.

    In general, the Institute still regards the transparency regulations for clinical studies on medical devices to be insufficient and demands that the same requirements should apply that have long been the norm for drugs. Because for NPWT too, not all study results are on the table. Gaps now primarily exist for studies conducted by research institutions themselves.

    Negative pressure is supposed to increase circulation
    In NPWT, the wound is covered with an airtight bandage to which a pump is attached via a thin tube. This tube constantly sucks out wound fluid from the wound, thus creating negative pressure in the wound area. This is supposed to increase circulation in the wound. In addition, the wound stays wet, which is also supposed to promote healing.

    NPWT is, among others, used for poorly healing or large wounds, for example, in patients with a decubitus ulcer (bed sore) or after surgery. In primary wound healing or healing by primary intention, the margins of the wound are aligned and can be sewn together, as is the case, for example, after surgery. In contrast, in secondary wound healing or healing by secondary intention, tissue has to be newly formed and the wound has to contract or skin has to be transplanted.

    Data gap reduces certainty of conclusions
    In the preliminary report on secondary wound healing published in the summer of 2018, data on more than half of the participants were still missing in the manufacturer-initiated trials. However, with a total of 40% of missing data, a large gap was also noticeable in investigator-initiated trials (IITs), i.e., studies initiated by researchers working at universities, for example. IQWiG had at that time repeatedly requested these data in vain from the responsible researchers.

    While the manufacturer KCI subsequently provided a sufficiently large proportion of these data during the commenting procedure, the increase in the data basis was less pronounced for the IITs. An assessment of benefit and harm is now possible. However, as overall 24% of the data are still missing for secondary wound healing and 17% are missing for primary wound healing, IQWiG downgraded the certainty of conclusions of its assessments ("indication" instead of "proof"; "hint" instead of "indication"). This is because missing data can strongly bias the assessment result, meaning that the benefit or harm of an intervention appears to be bigger or smaller. This is referred to as publication bias.

    Secondary wound healing: advantage for several outcomes
    The final report on secondary wound healing acknowledges advantages of NPWT versus standard treatment that are relevant for patients: the Institute sees an indication of a greater benefit for the outcome of wound closure. The data show that wounds heal more often and the healing process is faster. In addition, the length of hospital stay is shortened.

    In contrast, the data show no advantages or disadvantages for the outcomes of mortality, adverse events (side effects of treatment), frequency of amputations, pain, quality of life, and social functioning. No conclusions are possible on the outcomes "need of third-party help" or "need of long-term care", as IQWiG had no access to usable data.

    Studies on primary wound healing: focus on risk factors
    Usable data were available from a total of 39 randomized controlled trials for the area of application "primary wound healing", i.e., the use of NPWT after surgery. These studies, with a total of 5674 patients, investigated wounds after surgery, primarily after obstetrical, abdominal, vascular and heart surgery, as well as after endoprosthetic surgery (joint replacement). Poor wound healing was to be expected for the vast majority of patients, as they had at least one risk factor such as obesity or diabetes. Wound complications and treatment-related complications (adverse events) were the outcomes most commonly recorded in the studies.

    At the same time, adverse events in the form of complications were the only outcome where the data showed at least one advantage: for instance, infections occurred less frequently if NPWT was used. IQWiG sees a "hint" of a greater benefit of NPWT here; this was not the case for any other patient-relevant outcome, including the overall rate of complications (adverse events).

    The Institute requests written comments on this preliminary result of the benefit assessment, the preliminary report, by 29 April. These will be scrutinized and, if IQWiG has open questions, discussed in a public hearing with the persons submitting comments.

    Medical devices: stricter transparency rules needed
    An assessment of NPWT was only possible after the manufacturer KCI provided previously unpublished study results to IQWiG. In contrast, the increase in the data basis was less pronounced for the IITs.

    Stefan Sauerland, Head of IQWiG's Non-Drug Interventions Department notes: "The fact that about a quarter of all data are still missing for secondary wound healing can particularly be ascribed to those responsible for IITs; for primary wound healing, nearly a sixth of the data are missing. NPWT again shows that we need to regulate publication obligations for medical devices or non-drug interventions just as strictly as we have done for drugs. For the latter, the data situation has considerably improved in the past 10 years due to various measures, including legal ones. The EU Medical Device Regulation (MDR) is overall a step in the right direction, but unfortunately only a small one with regard to publication obligations. Ethics committees or public funders such as the Ministry of Science could also put pressure on study initiators by linking approvals to publications. I suggest that any study initiator who has not published properly in the past receives no funding or no approval for the next study."

    German studies also help close the evidence gap
    IQWiG had already assessed NPWT in 2006 on behalf of the Federal Joint Committee (G-BA). The conclusion was that no superiority versus standard treatment could be determined. Data from meaningful studies were lacking. Several publicly funded studies were then started in Germany, also on the initiative of the G-BA.

    Stefan Sauerland explains: "Instead of making decisions on an uncertain data basis, to generate meaningful evidence yourself seems to me like an effective and targeted approach. In particular the NPWT studies on diabetic foot wounds and superficial post-surgical wound infections, funded by statutory health insurance, were important for obtaining specific results on wound therapy in Germany."

    Process of report production
    The Institute had published the preliminary report on secondary wound healing in August 2018 and in the corresponding press release had criticized the study manufacturers and investigators who violate scientific and ethical standards if they do not publish study results. In the following commenting procedure, which also included an oral hearing in Cologne, KCI subsequently submitted study data. The written comments, as well as the verbatim minutes of the hearing, are also available on the Institute`s website.

    Together with the final report, IQWiG published the preliminary report on NPWT for primary wound healing. Interested persons and institutions can submit written comments on these still preliminary assessment results up to 29 April 2019. The Institute will scrutinize these comments and invite persons submitting comments to an oral hearing if open questions in the written comments remain. The preliminary report will then be revised, sent as the final report to the commissioning agency G-BA, and published 8 weeks later on the IQWiG website.
     
  34. NewsBot

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    Articles:
    1
    The efficacy of negative pressure wound therapy for diabetic foot ulcers: A systematised review
    MatthewWynn
    Journal of Tissue Viability; 10 April 2019
     
  35. NewsBot

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    Articles:
    1
    A Prospective, Randomized, Controlled Clinical Trial on the Efficacy of a Single-use Negative Pressure Wound Therapy System, Compared to Traditional Negative Pressure Wound Therapy in the Treatment of Chronic Ulcers of the Lower Extremities.
    Kirsner R et al
    Wound Repair Regen. 2019 May 14
     
  36. NewsBot

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    Articles:
    1
    Comparison of Vaccum Assisted Closure Therapy with
    Vaseline Gauze Dressing in Healing of Diabetic Foot Ulcers
    .
    Alam S, Iqbal N, Ahmad M, Ali N, Abbas S, Nadeem M;
    JSMC 2019;9(1):113-6.
     
  37. NewsBot

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    Articles:
    1
    Randomized clinical study to compare negative pressure wound therapy with simultaneous saline irrigation and traditional negative pressure wound therapy for complex foot infections.
    Davis KE et al
    Wound Repair Regen. 2019 Jun 27
     
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