Clinical meaning
NPWT applies sub-atmospheric pressure to the wound bed. This removes exudate/infectious material, reduces edema, and creates 'microstrain' on cells which stimulates mitosis, angiogenesis (new blood vessels), and granulation tissue formation.
Diagnosis & workup
Diagnostics & workup: - Order wound culture and sensitivity for signs of infection - Order prealbumin and albumin to assess nutritional status for wound healing - Order ABI (ankle-brachial index) for lower extremity vascular assessment - Order tissue biopsy if wound bed appears abnormal or non-healing - Order vascular duplex ultrasound if peripheral vascular disease suspected - Order HbA1c for diabetic wound patients (poor control impairs healing) - Order transcutaneous oxygen measurement (TcPO2) to assess healing potential - Order wound photography and serial measurements for documentation
Risk factors: - Chronic wounds (diabetic ulcers, venous stasis) - Post-surgical wound dehiscence - Traumatic wounds with tissue loss - Pressure injuries stage III-IV - Malnutrition (albumin < 3.0) - Peripheral vascular disease - Immunosuppression - Obesity
