. 2023 Aug 30;23:e54.

TABLE 5.

ARTICLES REPORTING GRANULATION TISSUE DEVELOPMENT WITH NPWTi-d USE

Article	Study type	Study population	Outcomes
Blalock, 2019²³	Case series	19 patients Arterial ulcer DFU PI Surgical wounds Trauma	NPWTi-d use resulted in reduced devitalized tissue Increased development of granulation tissue in the wound bed was observed Instilling the topical wound solution into the wound bed helped solubilize infectious material, debris, and wound exudate NPWTi-d use helped contribute to successful limb salvage in 2 patients
Brinkert et al, 2013⁴⁵	Case series	131 patients Dehiscence DFU Necrotizing fasciitis Trauma Ulcer	Increase in granulation tissue development observed with NPWTi-d use Reduction in wound volume also observed Wound closure occurred in 98% of patients following surgical debridement and use of NPWTi-d
Eckstein et al, 2019³³	Case series	15 patients Surgical wounds (oral and maxillofacial)	NPWTi-d use helped reduce bacterial load Granulation tissue development observed in 14/15 wounds Mean patient LOS, 13.33 days Healing by secondary intention observed in 14/15 patients
Felte et al, 2016³⁴	Case series	11 patients Necrotizing fasciitis Trauma	Increased granulation tissue development observed Wound volume reduction was observed Use of NPWTi-d with Dakin's solution helped remove infectious materials, resulting in clean wound bed with beefy red granulation tissue
Fernández et al, 2020²⁵	Case series	19 patients PI Surgical wounds Trauma	Development of healthy granulation tissue in wound bed All patients were discharged to home or to other care facilities NPWTi-d provided effective and rapid removal of thick exudate and infectious material and promoted granulation tissue development
Fluieraru et al, 2013⁴⁶	Case series	24 patients Dehiscence DFU Necrotizing fasciitis PI Trauma	12/24 patients had previously failed to achieve wound healing with NPWT No complications were observed with NPWTi-d use Increased development of healthy granulation tissue was observed with NPWTi-d use Positive wound outcomes observed in 23/24 patients
Latouche et al, 2020¹⁶	Case series	15 patients PI Surgical wounds Trauma	Mean duration of NPWTi-d was 19.4 days Mean number of dressing changes was 6.6 NPWTi-d provided early-stage wound cleansing and promoted development of healthy granulation tissue
McElroy, 2019²⁶	Case series	14 patients Dehiscence DFU Necrotizing fasciitis PI	Improved granulation tissue development, less malodor, less erythema, and demarcation of healthy tissue from devitalized tissue with NPWTi-d use All wounds showed removal of devitalized tissue Fewer surgical debridements than expected were observed
Sir et al, 2019³⁶	Case series	10 patients Surgical wounds	Granulation tissue formation observed with NPWTi-d use NPWTi-d provided continue removal of infectious material and exudate while maintaining a moist wound environment
Uncu et al, 2017⁴⁷	Case series	15 patients Chronic wounds	11/15 patients showed development of healthy granulation tissue Leg amputations were required in 2 patients One patient required iliofemoral bypass One patient showed maceration NPWTi-d use was well tolerated
Yang et al, 2015¹⁸	Case series	10 patients VLU	Average LOS, 13.4 days At 6 months, 8/10 wounds were closed, the remaining 2 showed 70%–78% graft take Estimated cost of use was lower with NPWTi-d vs standard compression therapy ($27,000 vs $28,000)
Zhang et al, 2021¹⁹	Case series	32 patients Necrotizing fasciitis	Average of 12.5 days of treatment before closure Mean patient LOS, 22.8 days Patients reported minor to moderate pain reduction during dressing changes with NPWTi-d Minor periwound skin maceration was observed in 3/32 patients All wounds were closed without complications or adverse events Authors believed NPWTi-d provided beneficial cleansing of the wound bed that contributed to wound healing success
Yane et al, 2022²²	Comparative study	37 historical controls, 37 NPWTi-d patients Surgical wounds	Development of granulation tissue in NPWTi-d patients Similar LOS between groups (9.0 vs 10.0 days; P = .453) Reduced rates of SSI in NPWTi-d group (0 vs 6 patients) Authors attributed reduces SSI rates to wound bed cleansing and removal of solubilized slough, exudate, and infectious material

DFU, diabetic foot ulcer; LOS, length of hospital stay; NPWTi, negative pressure wound therapy with instillation; NPWTi-d, negative pressure wound therapy with instillation and dwell time; PI, pressure injury; SSI, surgical site infection; VLU, venous leg ulcer.