Negative Pressure Wound Therapy for Soft Tissue Infections

  • Elizabeth R. Benjamin
  • Demetrios DemetriadesEmail author


  • The principles in the management of severe soft tissue infections include:
    • Debridement of dead and ischemic tissues

    • Systemic antibiotics for invasive infections

    • Local wound care

  • Negative pressure wound therapy (NPWT) may benefit patients with severe soft tissue infections, such as:
    • Necrotizing soft tissue infections

    • Surgically drained septic arthritis

    • Surgically drained infected orthopedic implants

    • Infected wounds with exposed bone

    • Surgically treated osteomyelitis

    • Diabetic foot infections

  • Adequate surgical debridement is an absolute requirement before NPWT.

  • NPWT provides a closed and moist environment, increases perfusion, decreases edema, removes infected fluid, promotes granulation, and reduces wound volume.

  • NPWT can be enhanced by using a built-in automated irrigation system (V.A.C. VeraFlo System). This concept allows slow introduction of a predetermined volume of irrigation fluid, soaking of the wound for a defined period of time, removal of the irrigation fluid, and maintenance of negative pressure therapy for a defined interval before the cycle repeats.

  • NPWT with instillation is associated with:
    • Enhanced granulation tissue production

    • Decreased bacterial load

    • Fewer surgical debridements

    • Shorter time to wound closure

    • Fewer hospital days

  • Irrigation fluids that can be used with VAC irrigation system include normal saline, Dakin’s solution, polyhexanide, acetic acid solution, and antibiotic solution.

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of Trauma, Emergency Surgery and Surgical Critical CareUniversity of Southern CaliforniaLos AngelesUSA

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