TABLE 1.
Overview of the included studies
| Citation | Blome‐Eberwein et al 19 | Brinkert et al 20 | Chowdhry et al 21 | Daeschlein et al 22 | Gabriel et al 7 | Gabriel et al 8 | Garcia‐Ruano et al 10 |
|---|---|---|---|---|---|---|---|
| Year | 2018 | 2013 | 2019 | 2016 | 2014 | 2008 | 2016 |
| Country | USA | France | USA | Germany, Switzerland, UK | USA | USA | Spain |
| Study type | Single centre retrospective case series | Multicentre prospective case series | Retrospective cohort study | Prospective case series | Retrospective case series | Prospective case series | Retrospective case series |
| Number of patients | 21 | 131 | 15 | 9 | 48 | 15 | 11 |
| Male | 76.2% | 58.1% | 53.3% | 33.3% | 50.0% | N/R | 63.6% |
| Mean age (year) | 48.7 | 59.2 | 70.5 (6.8) | 74 ± 10 | 42.7 | 57.13 ± 11.64 | 64.8 ± 15.2 |
| Number of wounds | 21 (15 Burns, 6 Necrotising Fasciitis.) | 131 | 15 | 33 | 48 | 15 | 11 |
| Mean wound duration (week) | N/R | N/R | 7.9 (3.1) | N/R | N/R | N/R | N/R |
| NPWTi‐d settings | |||||||
| Dwell time (minutes) |
Burns: 7.73 ± 2.22 Necrotising Fasciitis: 11.0 ± 4.69 |
10 | 20 | 20 | 1‐60 seconds | 30‐45 seconds | 5 |
| Dwell Frequency | N/R | 6‐hourly | 2‐hourly | 1‐hourly | N/R | N/R | 3‐5 hourly |
| NPTW‐I Time (hours) | 4‐6 | 4‐12 | N/R | N/R | 1‐2 | 2 | N/R |
| Instillation solution |
Mafenide solution (n = 14) ¼ Dankins Solution (n = 6), Normal Saline (n = 1) |
Normal Saline | 1/8th Strength Dankins Solution | 0.02% Polyhexanide (SERAG‐Wiessner, Naila, Germany) |
Saline or polyhexanide (Prontosan, B. Braun Medical Inc, Bethlehem, Pennsylvania) |
Silver nitrate |
Hypertonic Saline ‐ 30‐50 mL depending on wound size (Apiroserum, Hypertonic NaCl 2%) |
| Number of dressing changes | Every 2‐3 days | Every 3 days | Every 3 days | N/R | Every 2‐3 days | N/R | Every 3 days |
| Therapy duration (days) | N/R | 12 | 5.4 ± 2.1 | N/R | 4.1 | 9.87 ± 4.31 days | 19.73 ± 9.5 days |
| Time to wound closure | 10.0 ± 6.83 days | N/R | 7.9 ± 2.3 | N/R | 4.1 days | 13.20 ± 6.75 days | N/R |
| Method of wound closure |
Split‐thickness skin graft (n = 13) Graft and flap (n = 3) Secondary intention (n = 1) Primary intention and graft (n = 1) Amputation (n = 3) |
Skin graft 74 (57·76%)Flap 22 (17·33%)Primary suture 32 (24·83%) |
Pectoralis Major flap reconstruction | I/R | N/R |
Primary Intention (n = 2) Secondary intention (n = 4) Skin graft (n = 5) Local flap (n = 4) |
Simple closure (n = 5) Debridement and closure (n = 1) |
| Number of wounds with complete closure | 18 | 128 | 15 | 33 | N/R | 15 | 6 |
| Number of wounds that failed treatment | 3 | 3 | 0 | 0 | N/R | 0 | 5 |
| Complication |
Average pain using NPWT‐i 2.95 ± 2.40 out of 10. |
Death unrelated to therapy (n = 2). Recurrence of chronic osteomyelitis (n = 1) | N/R | N/R | N/R | N/R |
Recurrence of hernia(n = 3) New wound dehiscence (n = 1) |
| Length of follow up | 32.0 ± 26.1 days | 4‐12 months | 90 days | 3 months | 8.1 days | 14.67 ± 9.18 days | 66 days |
| Citation | Jain et al 11 | Kim et al 16 | Kim et al 9 | Ludolph et al 23 | Milcheski et al 24 | Omar et al 5 |
|---|---|---|---|---|---|---|
| Year | 2018 | 2015 | 2014 | 2018 | 2017 | 2016 |
| Country | USA | USA | USA | Germany | Brazil | Germany |
| Study type | Retrospective case series | Prospective, Randomised, Effectiveness study | Retrospective, Historical, Cohort, Controlled study | Prospective case series | Prospective case series | Prospective series and matched retrospective control |
| Number of patients | 10 |
83 Normal Saline n = 42 0.1% Polyhexadine +0.1% Betaine n = 41 |
68 | 111 | 10 | 10 |
| Male | 9 | 61 | 42 | 66 | 4 | 6 |
| Mean age (year) | 40 | 59.45 |
6 minute dwell group1 = 63 ± 16 20‐minute dwell group2 = 55 ± 17 |
58.6 | 40.7 | 49 |
| Number of wounds | 11 | 100 | 68 | 111 | 10 | 10 |
| Mean wound duration (week) | N/R | N/R | N/R | N/R | N/R | N/R |
| NPWTi‐d settings | ||||||
| Dwell time (minutes) | 10 | 20 | 6, 20 | 20 | 20 | 15 |
| Dwell frequency | N/R | N/R | N/R | 2 hourly | 2 hourly | 4 hourly |
| NPTW‐I time (hours) | 3.5 | 2 | 3.5 hours for group 1, 2 hours for group 2 | 2 | 2 | 4 |
| Instillation solution |
Normal Saline = 9 ¼ Dankins Solution = 2 |
Normal Saline = 42 0.1% Polyhexadine +0.1% Betaine = 41 |
Polyhexamethylene biguanide (0.1%) + betaine (0.1%) (Prontosan ©) |
0.4 mg/1 mL Polihexanide | Normal Saline | Normal Saline |
| Number of dressing changes | N/R | N/R | N/R | 3 times a week | N/R | N/R |
| Therapy duration (days) |
Mean = 10 Median = 7 |
Mean = 12.95 |
11.9 ± 7.8 days for group 1 11.4 ± 5.1 days for group 2 |
11.5 days (SD 3.9 days) range of 7 up to 31 days |
11.4 days | Range = 1‐7 days |
| Time to wound closure | 4.5 days |
NSS = 5.6 days 0.1% PH + 0.1% B = 7.5 days |
7.8 ± 5.2 days (group 1) 7.5 ± 3.1 days (group 2) | N/R | 6.3 days | Median = 9 |
| Method of wound closure | Delayed partial or primary closure | Primary closure, local or free flap coverage, application of a xenograft or a Split thickness Skin Graft, or debridement | N/R | Local/Free Flaps, Skin Grafts, Secondary Wound Closure | Skin Grafting/Surgical Flaps | SSG or Secondary closure |
| Number of wounds with complete closure | 6 | 62 |
24 (group 1) 14 (group 2) |
N/R | 2.4 | 10 |
| Number of wounds that failed treatment | 0 | N/R | N/R | N/R | 0 | 0 |
| Complication | N/R | N/R | N/R | N/R | 0 | N/R |
| Length of follow up |
Mean = 12.11 1 lost to f/u |
30 days | 30 days | N/R |
Mean = 6 Range = 3‐9 |
N/R |
Abbreviations: I/R, incomplete reporting; N/R, not reported.