Negative pressure therapy (NPT) involves applying sub-atmospheric pressure to the burn wound.

The use of NPT in burn care is increasing. It is applied to improve the quality of the wound bed by stimulating blood flow to the wound bed, removing exudate and reducing edema.

When applied on top of skin grafts, NPT can support graft survival. When applied on top of a dermal substitute, it supports bio-integration.

NPT is mainly considered as an option for challenging anatomical areas such as the axilla, neck and groin.

Indications

• Management of burns healing slowly.
• Preparation of the wound bed before skin grafting, for example for burns with exposed bone and tendons.
• Use of a bolster dressing over a skin graft.
• Use of a dressing to integrate a bilaminate dermal substitute (e.g. Integra®).

Procedure

Apply the NPT system according to the instructions and leave in place for several days, usually between 3 and 5 days.

An advantage of NPT is that it allows less frequent dressing changes, therefore reducing bacterial colonization, opioid requirements and the burden on nursing staff. NPT also provides secure wound coverage, allowing patients to be discharged. When the NPT system is removed after a few days, evaluate the condition of the wound and decide whether to continue with the NPT.