Rosalyn Jordan, RN, BSN, MSc, CWOCN, WCC

What are your thoughts on accelerating wound healing in chronic wounds with adjunctive therapies?

With chronic wounds, the healing process is slowed or in some cases, completely stalled. Therefore, the healing time exceeds four weeks. Some examples of chronic wounds include pressure ulcers, vascular ulcers and ulcers related to inflammatory diseases. 

Research has shown that Negative Pressure Wound Therapy can improve the healing time in full-thickness wounds by aiding in the formation of granulation tissue and supporting contraction of the wound bed. The suction provides a stressor to the damaged tissue by promoting sub-atmospheric pressure in the wound bed. 

The purpose is to promote the growth of granulation tissue, increase blood flow and remove exudate from the wound bed. Epithelization, i.e. the epithelial tissue forming and the wound healing, is more likely when a wound has healthy granulation tissue. NPWT requires vigilant observation and evaluation to prevent complications and evaluate healing. Attention to possible hemorrhagic episodes and medical conditions or complications that do not support wound healing is essential.  

Since increasing the rate of healing is the primary purpose of NPWT, monitoring and communication about the healing status of the wound are crucial.

Based on the assessment, if there is no change in the size of the wound after the first two weeks and every 14 days after the initiation of NPWT, you should consider alternative treatment plans.