Department of General
Surgery and Semiology no.3, Municipal Clinical Hospital no.1,
Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of MoldovaIntroduction. Negative pressure wound treatment (NPWT) consists of applying a special
dressing to the internal wound’s environment, controlled by subatmospheric pressure. Sterile
sponges with an impermeable membrane connected to a pump delivering subatmospheric
pressure are applied to wound’s edges. The sponges don’t allow bacteria to multiply, and lead to
reducing wound’s size until healing occurs.
Aim of the study. To evaluate the NPWT benefits in purulent wounds treatment.
Materials and methods. The study was based on 19 cases presented with various purulent
wounds of soft tissues treated at the Department of General Surgery, Municipal Clinical Hospital
No.1 (Chisinau). There were 12 (63.15%) male and 7 (36.85%) female patients. Age of subjects
varied between 32 and 76 years. The NPWT system was used if local signs of wound
suppuration during its surgical secondary processing were noticed. Patients were treated under
local or general intravenous anesthesia, in aseptic conditions. After the removing of sutures,
hydrogen peroxide was used, necrotic masses – removed, and hemostasis – applied. Then a piece
of sterile sponge was adjusted and installed into the wound channel. External tip of a tube,
placed inside the sponge, exiting through a separate incision. The wound was partially sutured. Wound’s edges were treated with alcohol solution, and then dried. Hermetic film was then
applied to cover the wound. The drain was connected to the NPWT system set at the pressure of
-125 to -75 mm Hg. The dressings were changed once every 72 hours. During the application of
another dressing, the sponge and the previously installed system was removed from the wound,
examining the persistence of the necrotic masses. The state of the granulation tissue was also
checked. The number of sessions depended on the above listed findings. In the absence of
necrotic masses and pathological discharge secondary sutures were applied.
Results. In 3 (15.8%) cases dressings were changed only 2 times – enough for granulation tissue
appearance. Twelve (63.15%) patients required 4 and another four (21%) – 6 sessions
(exchanges of NPWT system) until sufficient proliferation of the granulation tissue.
Conclusions. We proved the usefulness of NPWT system that has been able to prepare the
wounds to secondary sutures applying. Vacuum therapy in the treatment of purulent wounds is
associated with shorter period of hospitalization and more effective pain management
