Skip to main content

Advertisement

Log in

Sacral Pressure Ulcer Management by Negative Pressure Dressing: a Randomized Open Label Study

  • Original Article
  • Published:
Indian Journal of Surgery Aims and scope Submit manuscript

Abstract

The treatment of sacral pressure sores is associated with a high rate of failure and recurrence. If inadequately treated, they severely compromise the quality of life and may herald a terminal event. The present study was undertaken to compare the efficacy of negative pressure wound therapy (NPWT) with conventional dressing treatment for sacral pressure sores. Over a 4-year period, 38 patients of grade III and IV sacral pressure sores were treated by either NPWT (22 patients) or conventional dressing (16 patients) method. Prior to application of NPWT, the wound was debrided and complete hemostasis achieved. The NPWT device was set to deliver a negative pressure of 125 mmHg with 7-min cycle (5 min on pump followed by 2 min off). The dressing was changed after 5 to 7 days. At the end of 3 months of treatment, 4 patients had died in each group. Of the 18 patients alive in NPWT group, 6 patients (33%) achieved complete healing and 9 (50%) had wound size reduction by more than 50%. The corresponding figures in the conventional dressing group were 1 (8%) and 4 patients (33%), respectively. NPWT was found to achieve superior clearance of slough, better generation of granulation tissue, and obliteration of ulcer crater compared to conventional dressing. The negative pressure led to faster reduction of bacterial load promoted angiogenesis and obtained a better rate of wound healing. Moreover, it resulted in a much cleaner and hygienic wound environment, reduced the nursing time in change of dressing, and significantly decreased patient discomfort.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Photo 1
Photo 2
Photo 3
Photo 4

Similar content being viewed by others

References

  1. Gargano F, Edstrom L, Szymanski K, Schmidt S, Bevivino J, Zienowicz R, Stark J, Taylor HO, Podda S, Liu P (2017) Improving pressure ulcer reconstruction: our protocol and the COP (cone of pressure) flap. Plast Reconstr Surg Glob Open. 5:e1234

    Article  PubMed  PubMed Central  Google Scholar 

  2. Gabriel A, Shores J, Bernstein B, de Leon J, Kamepalli R, Wolvos T, Baharestani MM, Gupta S (2009) A clinical review of infected wound treatment with vacuum assisted closure (VAC) therapy: experience and case series. Int Wound J 6(Suppl 2):1–25

    Article  PubMed  PubMed Central  Google Scholar 

  3. National pressure Ulcer Advisory Panel and European Pressure Ulcer Advisory Panel. Prevention and treatment of pressure ulcers: Clinical practice guidelines. Washington DC: National Pressure Ulcer Advisory Panel 2009

  4. Bhattacharya S, Mishra RK (2015) Pressure ulcers: current understanding and newer modalities of treatment. Indian J Plast Surg 48:4–16

    Article  PubMed  PubMed Central  Google Scholar 

  5. Desneves KJ, Todorovic BE, Carsar A, Crowe TC (2005) Treatment with supplementary arginine, vitamin C and zinc in patients with pressure ulcers: a randomized controlled trial. Clin Nutr 24:979–987

    Article  CAS  PubMed  Google Scholar 

  6. Toy LW, Macera L (2011) Evidence based review of silver dressing use on chronic wounds. J Am Acad Nurse Pract 23:183–192

    Article  PubMed  Google Scholar 

  7. Webb L, Pope H (2008) Current thought regarding the mechanism of action of negative pressure wound therapy with reticulated open cell foam. J Orthop Trauma 22(suppl 10):S135-137

    Article  PubMed  Google Scholar 

  8. Borgquist O, Gustafsson L, Ingemansson R, Malmsjő M (2010) Micro and macro mechanical effect on the wound bed of negative pressure wound therapy using gauze and foam. Ann Plastic Surg 64(6):789–93

    Article  CAS  Google Scholar 

  9. Manpinath BD, Arafut AGM, Razack A, Harendra Nath HR, Pravesh Kumar KH (2019) Comparison of negative pressure wound therapy using vacuum assisted closure with conventional wound dressing in the treatment of diabetic foot ulcer. New India J Surg 10(1):77–81

    Article  Google Scholar 

  10. Bao P, Kodra A, Tanu-Coric M, Golunko M, Ehrlich H, Bram H (2009) The role of vascular endothelial growth factor in wound healing. J Surg Res 153(2):347–358

    Article  CAS  PubMed  Google Scholar 

  11. Novak K, Khan W, Palmer J (2014) The evidence based principle of negative pressure wound in orthopaedic. Open Orthop J 8:168–177

    Article  Google Scholar 

  12. Shiokawa I, Oshima N, Mizumura N, Momosawa A. (2021) Negative pressure wound therapy for sacral pressure ulcer in Graham Stout Disease. Plast Reconstr Surg Glob Open 9:e3303

  13. Angelis B de, Lucarini L, Agovino A, Migner A, Orlandi F, Flores M, Cervelli V, Curcio C (2013)Combined use of super-oxidised solution with negative pressure for the treatment of pressure ulcers: case report. Int Wound J 10(3):336–339

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Rahul Khanna.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ahmad, I., Khanna, R., Prakash, P. et al. Sacral Pressure Ulcer Management by Negative Pressure Dressing: a Randomized Open Label Study. Indian J Surg 85, 65–70 (2023). https://doi.org/10.1007/s12262-022-03347-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12262-022-03347-x

Keywords

Navigation