NPWT Presentation by Siddharth Mandal
- 1. info@npwtindia.com Contact: +91 9971722111 www.npwtindia.com INTRODUCTION OF CLOSED CYCLIC NEGATIVE PRESSURE WOUND THERAPY in management of wounds By SIDDHARTH MANDAL CEO TRIAGE MEDITECH PVT. LTD. +91 9971722111 AN ISO 13485:2003 CERTIFIED COMPANY
- 2. info@npwtindia.com Contact: +91 9971722111 www.npwtindia.com What is Closed Cyclic Negative Pressure Wound Therapy(CCNPWT)? Negative Pressure Wound Therapy also widely known as NPWT, WOUND VAC or TNP(Tropical Negative Pressure) is a widely accepted wound management modality today, i.e., A specially designed foam dressing applied on a wound bed, sealed with a PU/PE drape further connected with a drainage tubing to regulated / controlled negative pressure source. AN ISO 13485:2003 CERTIFIED COMPANY
- 3. info@npwtindia.com Contact: +91 9971722111 www.npwtindia.com How does CCNPWT promote wound healing? •Removing excess fluid (infections and non-infectious), allowing tissue decompression •Stimulates granulation tissue formation by increasing vascular perfusion, •Encourages mechanical stretching, approximates wound edges, enhances overall wound contraction •Protects wound from microbe imbalance •Maintains a moist wound healing environment AN ISO 13485:2003 CERTIFIED COMPANY
- 4. info@npwtindia.com CONSUMABL ES PORTFOLIO Contact: +91 9971722111 www.npwtindia.com ALL PRODUCTS ARE CERTIFIED SINGLE USE ONLY ALL PRODUCTS ARE MANUFACTURED UNDER STRICT PARAMETERS OF ISO 13485:2003 AN ISO 13485:2003 CERTIFIED COMPANY
- 5. info@npwtindia.com Contact: +91 9971722111 www.npwtindia.com 5. Stick the drainage tubing aligning the hole made 1. Rinse the wound thoroughly & Debride majority of necrotic tissues 4. Make a small hole in the centre 2. Cut the foam dressing in the shape of the wound 3. Place it on the wound bed & seal with PU drape 6. INITIATE the Therapy & observe AN ISO 13485:2003 CERTIFIED COMPANY
- 6. info@npwtindia.com Contact: +91 9971722111 www.npwtindia.com AN ISO 13485:2003 CERTIFIED COMPANY
- 7. info@npwtindia.com Contact: +91 9971722111 www.npwtindia.com CCNPWT creates an Environment of Wound Healing at the Cellular Level AN ISO 13485:2003 CERTIFIED COMPANY
- 8. info@npwtindia.com Contact: +91 9971722111 www.npwtindia.com AN ISO 13485:2003 CERTIFIED COMPANY
- 9. info@npwtindia.com Contact: +91 9971722111 www.npwtindia.com AN ISO 13485:2003 CERTIFIED COMPANY
- 10. CCNPWT THERAPY DRESSING BENEFITS Flexible foam dressing adapts to the contours of deep & irregular surface of the wound bed Specially designed hydrophobic, non-linear networked foam dressing removes bacteria colonised wound exudate The CCNPWT foam dressing aggressively promotes uniform healthy granulation tissue throughout the wound bed
- 11. info@npwtindia.com Contact: +91 9971722111 www.npwtindia.com CCNPWT THERAPY DRESSING BENEFITS Flexible foam dressing adapts to the contours of deep & irregular surface of the wound bed Specially designed hydrophobic, non-linear networked foam dressing removes bacteria colonised wound exudate The CCNPWT foam dressing aggressively promotes uniform healthy granulation tissue throughout the wound bed AN ISO 13485:2003 CERTIFIED COMPANY
- 12. info@npwtindia.com Contact: +91 9971722111 www.npwtindia.com CCNPWT provides a closed sterile & moist wound healing environment Promotes granulation tissue formation, recent studies suggest mechanical stretching may result in increased mitosis (Cell Replication) Controlled Negative Pressure Therapy decreases wound volume approximating wound edges, helps uniformly draw wounds closed Promotes continuous wound debridement by removing wound debris & bacteria colonized wound output/interstitial fluid allowing tissue decompression AN ISO 13485:2003 CERTIFIED COMPANY
- 13. info@npwtindia.com Contact: +91 9971722111 www.npwtindia.com Contd.. Reduces oedema Reduces bacterial load Stimulates cell proliferation Enchances dermal perfusion Promotes micro angiogenesis Protects wound from re-infection, cross infection or spreading further infection Promotes Skin Graft/Flap uptake (The flexible foam dressing gently presses the skin graft or flap ensuring full contact with the wound bed AN ISO 13485:2003 CERTIFIED COMPANY
- 14. info@npwtindia.com Contact: +91 9971722111 www.npwtindia.com Increased Perfusion Morykwas Michael J, Argenta Louis C, Shelton-Brown Erica I, McGuirt Wyman: NPWT: A New Method for Wound Control and Treatment: Animal Studies and Basic Foundation. Annals of Plastic Surgery, 1997 Peak blood flow recorded at 125 mmHg Study helped establish original pressure protocol with Foam Dressing (400-600 micron pore-size) Positive effect on perfusion with 100-125 mmHg Hypothesized that reduction in oedema decompresses small blood vessels and increases flow Frank Ischaemia and Wound Hypoxia AN ISO 13485:2003 CERTIFIED COMPANY
- 15. info@npwtindia.com Contact: +91 9971722111 www.npwtindia.com Reduction of Inhibitory Factors Morykwas Michael J, Argenta Louis C, Shelton-Brown Erica I, McGuirt Wyman: NPWT: A New Method for Wound Control and Treatment: Animal Studies and Basic Foundation. Annals of Plastic Surgery, 1997 Reduction of oedema has positive effect in wound healing Reduction of inhibitory factors contained in interstitial fluid (chemical) Decompression of small blood vessels, which restores flow (mechanical) Negative Pressure Wound Therapy increases perfusion and oxygenation, therapy likely enhances resistance to infection AN ISO 13485:2003 CERTIFIED COMPANY
- 18. info@npwtindia.com Contact: +91 9971722111 www.npwtindia.com WHAT TYPE OF WOUNDS BENEFIT FROM CCNPWT? Pressure ulcers Full thickness and partial thickness burns Diabetic / Neuropathic ulcers Venous Insufficiency ulcers Post-operative and dehisced surgical Traumatic Wounds Skin Flaps and Grafts Explored fistulas AN ISO 13485:2003 CERTIFIED COMPANY
- 20. info@npwtindia.com Contact: +91 9971722111 www.npwtindia.com AN ISO 13485:2003 CERTIFIED COMPANY
- 21. info@npwtindia.com Contact: +91 9971722111 www.npwtindia.com AN ISO 13485:2003 CERTIFIED COMPANY
- 22. info@npwtindia.com Contact: +91 9971722111 www.npwtindia.com WHEN IS CCNPWT CONTRAINDICATED? • Wounds containing malignant tissue • Untreated osteomyelitis • Necrotic tissue such as slough or eschar • Unexplored or non-enteric fistulas • Exposed or unprotected organs, blood vessels AN ISO 13485:2003 CERTIFIED COMPANY
- 23. info@npwtindia.com Contact: +91 9971722111 www.npwtindia.com WHAT CONDITIONS INDICATE CAUTION? • Active bleeding or patient on anticoagulant therapy • Proximity of blood vessels, organs, muscle, and fascia requiring protection • Irradiated vessels and tissue • Bony fragments • Untreated malnutrition • Non-compliant or combative behaviour AN ISO 13485:2003 CERTIFIED COMPANY
- 24. info@npwtindia.com Contact: +91 9971722111 www.npwtindia.com CCNPWT helps in Flaps & Graft uptake Fixation of skin graft (mesh-grafts) or flap until the graft has taken (4-6 days). In these special cases, Topical Negative Presure Therapy is used for the secure fixation of a split skin graft to the wound The soft foam helps gently press the graft/flap onto the wound bed and thus ensures full contact between the graft and the underlying wound bed, irrespective of the wound contours and the formation of pockets, also continuously drains out the wound output, ensures infection free graft uptake AN ISO 13485:2003 CERTIFIED COMPANY
- 25. info@npwtindia.com Contact: +91 9971722111 www.npwtindia.com DRESSING APPLICATION TECHNIQUE STEP 1 : DEBRIDE & CLEAN THE WOUND WITH ISOTONIC SOLUTION STEP 3: SEAL THE WOUND WITH SEMI-PERMEABLE DRAPE & MAKE A SMALL HOLE IN THE CENTRE STEP 2 : CUT THE FOAM DRESSING IN THE SHAPE OF WOUND AND PLACE IT ON WOUND BED STEP 4 : STICK THE MAPC TUBING DISTAL END KEEPING SYMMETRY WITH HOLE IN CENTRE & CONNECT WITH THE NEGATIVE PRESSURE SOURCE AN ISO 13485:2003 CERTIFIED COMPANY
- 26. info@npwtindia.com Contact: +91 9971722111 www.npwtindia.com INDICATED for TRAUMA WOUNDS AN ISO 13485:2003 CERTIFIED COMPANY
- 27. info@npwtindia.com Contact: +91 9971722111 www.npwtindia.com INDICATED for DIABETIC FOOT ULCERS Granulation after 3 days of application AN ISO 13485:2003 CERTIFIED COMPANY
- 28. info@npwtindia.com Contact: +91 9971722111 www.npwtindia.com Indicated for all Grade II, III & IV Pressure Ulcers AN ISO 13485:2003 CERTIFIED COMPANY
- 29. info@npwtindia.com Contact: +91 9971722111 www.npwtindia.com INDICATED FOR VENUS/ARTERIAL LEG ULCERS AN ISO 13485:2003 CERTIFIED COMPANY
- 30. info@npwtindia.com Contact: +91 9971722111 INDICATED FOR ABDOMINAL COMPARTMENT SYNDROME www.npwtindia.com Infected Laprotomy **Please seek advice for special Dressing selection AN ISO 13485:2003 CERTIFIED COMPANY
- 31. info@npwtindia.com Contact: +91 9971722111 www.npwtindia.com Venus Leg ulcer with complications of sickle cell anaemia AN ISO 13485:2003 CERTIFIED COMPANY
- 32. info@npwtindia.com Contact: +91 9971722111 www.npwtindia.com CCNPWT application for 10 days 20 days post follow-up AN ISO 13485:2003 CERTIFIED COMPANY
- 33. info@npwtindia.com Contact: +91 9971722111 www.npwtindia.com ROAD ACCIDENT LACERATION AN ISO 13485:2003 CERTIFIED COMPANY
- 34. info@npwtindia.com Contact: +91 9971722111 www.npwtindia.com AN ISO 13485:2003 CERTIFIED COMPANY
- 35. info@npwtindia.com Contact: +91 9971722111 www.npwtindia.com Road Accident case : with no vessels for primary closure (results of 13days NPWT Dressing Application) AN ISO 13485:2003 CERTIFIED COMPANY
- 36. info@npwtindia.com Contact: +91 9971722111 www.npwtindia.com INFECTED COMPOUND FRACTURE AN ISO 13485:2003 CERTIFIED COMPANY
- 37. info@npwtindia.com Contact: +91 9971722111 www.npwtindia.com AFTER Ist DRESSING CHANGE AN ISO 13485:2003 CERTIFIED COMPANY
- 38. info@npwtindia.com Contact: +91 9971722111 www.npwtindia.com AFTER 2nd DRESSING CHANGE AN ISO 13485:2003 CERTIFIED COMPANY
- 39. info@npwtindia.com Contact: +91 9971722111 www.npwtindia.com FOLLOW-UP POST FLAP AN ISO 13485:2003 CERTIFIED COMPANY
- 40. info@npwtindia.com Contact: +91 9971722111 www.npwtindia.com Crushed Injury Amputation CCNPWT applied for 4 days AN ISO 13485:2003 CERTIFIED COMPANY
- 41. info@npwtindia.com Contact: +91 9971722111 www.npwtindia.com ROAD ACCIDENT LACERATION Patient : HBsAg Positive AN ISO 13485:2003 CERTIFIED COMPANY
- 42. info@npwtindia.com Contact: +91 9971722111 www.npwtindia.com CCNPWT Applied for 7 days AN ISO 13485:2003 CERTIFIED COMPANY
- 45. info@npwtindia.com Contact: +91 9971722111 www.npwtindia.com PRESSURE ULCER (GRADE IV) AN ISO 13485:2003 CERTIFIED COMPANY
- 46. info@npwtindia.com Contact: +91 9971722111 www.npwtindia.com Result of 8 days / 2 dressing change AN ISO 13485:2003 CERTIFIED COMPANY
- 49. info@npwtindia.com Contact: +91 9971722111 www.npwtindia.com WHAT INTERVENTIONS WILL MAXIMIZE HEALING? Debride wound prior to Negative Pressure Therapy Off load pressure ulcers consistently Minimize time off NPWT to < 4 hours in a day Manage co-morbid condition Increased blood flow Reduce oedema Minimize infection Control blood glucose level AN ISO 13485:2003 CERTIFIED COMPANY
- 50. info@npwtindia.com Contact: +91 9971722111 www.npwtindia.com WHAT ARE THE EXPECTED OUTCOMES? • May observe increased exudate and wound size during the first 48-72 hours due to the decompression of interstitial space and removal of extra-cellular fluid and debris. • Gradual reduction of fluid and surface area should be observed with each assessment. • Colour of wound bed should become a deeper red as perfusion to the site increases. • Measurements should decrease weekly. • If healing is not observed in a week, treatment should be re-evaluated. • The average treatment with NPWT is 1-4 weeks. Length of treatment is determined by goals of therapy. AN ISO 13485:2003 CERTIFIED COMPANY
- 51. info@npwtindia.com Contact: +91 9971722111 www.npwtindia.com HOW DO YOU MANAGE WOUND WITH CCNPWT? Change dressing two/three times per week. Monitor frequently Observe wound and peri-wound area for signs and symptoms of infection Remove dressings carefully to protect new tissue growth. Bright gush flow red blood in canister requires immediate evaluation. Measure and document per facility protocol Note : To initiate it is recommended to follow CCNPWT protocol, to ensure optimal results, as ithese are tried and tested protocol designed by various CCNPWT expert wound managers AN ISO 13485:2003 CERTIFIED COMPANY
- 52. info@npwtindia.com Contact: +91 9971722111 www.npwtindia.com WOUND ASSESMENT CHART AN ISO 13485:2003 CERTIFIED COMPANY
- 53. info@npwtindia.com Contact: +91 9971722111 www.npwtindia.com WOUND ASSESMENT CHART AN ISO 13485:2003 CERTIFIED COMPANY
- 54. info@npwtindia.com Contact: +91 9971722111 www.npwtindia.com WOUND TREATMENT PLAN CHART AN ISO 13485:2003 CERTIFIED COMPANY
- 56. info@npwtindia.com Contact: +91 9971722111 www.npwtindia.com Thank you for your patience For any queries feel free to contact our local representative or visit www.npwtindia.com email: info@npwtindia.com or npwtindia@gmail.com TRIAGE MEDITECH PVT. LTD. Care : +91 9971722111/9650440444 AN ISO 13485:2003 CERTIFIED COMPANY