Table 6.

Recommendations for use of NPWT with instillation

• * Diffuse or extensive osteomyelitis is encountered or if large areas of post‐debridement bone or joint are present

• * Postoperative infection following total joint arthroplasty

• * A wound is suspected to be critically colonized and subsequently has become stalled, yet needs continued NPWT

• * An alternative to antibiotic‐impregnated beads is needed

• † Wounds at a high risk for a major amputation due to infection

• † Open fracture wounds to prevent wound infections or osteomyelitis

• † To decrease the viscosity of wound exudate

• † Exposed hardware or foreign bodies including mesh

• † Infected wounds that remain infected after a trial of NPWT/ROCF

^* Adapted from Bernstein et al (101)

^† †Tom Wolvos, MD, FACS, e‐mail communication, July 21, 2009