A Comparative Study of Effectiveness of Negative Pressure Wound Therapy (NPWT) Versus Standard Chlorhexidine Gauze Dressing in the Management of Post Traumatic Soft Tissue Defects in the Extremities- One Year Hospital Based Randomized Clinical Trial
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 4, Pages 1985-1998
AbstractIntroduction: Soft tissue defects are more commonly seen in the extremities following high velocity trauma & occupational injuries posing countless challenges in their management. Early flaps or skin grafts reduce the chance of infections in the soft tissue defects. Both are done after thorough surgical debridement. In some cases wound related and patient related factors won’t allow early coverage of these defects. During which, one has to consider alternative methods of managing the soft tissue defects in the primary set up. One of the available modality for managing soft tissue defects in the initial periods is Negative Pressure Wound Therapy. This has been found to have a vast benefit over conventional dressings like tulle grass and others. This present study has been conducted in our hospital which is a tertiary care centre, to evaluate the efficacy of Negative Pressure Wound Therapy (NPWT) in the management of soft tissue defects in the extremities over the conventional method of managing the wounds with chlorhexidine dressing.
Materials and Methods: A randomized clinical trial was carried out in Belagavi Institute of Medical sciences, Belagavi from 1st Nov 2020 to 31st Oct 2021 and required data was collected from the 40 patients who underwent either Negative Pressure Wound Therapy (Group A) or Chlorhexidine gauze dressing (Group B) for post traumatic soft tissue defects in the extremities and the outcome was assessed in terms of formation of healthy granulation tissue, absence of slough/infection, wound retraction after intervention in both the groups
Results:In the present study all forty patients were having unhealthy pale yellow granulation tissue at day 0. At day 5, seventeen out of twenty patients were having healthy red granulation tissue in group A compared to five out of twenty patients in group B. At day 10, the remaining three patients were having healthy red granulation tissue in group A and thirteen out of fifteen remaining patients were having healthy red granulation tissue in group B. At day 15, remaining two patients were having healthy red granulation tissue in group B with p value less than 0.0001 (using chi square test) and this difference was considered to be extremely statistically significant.
Conclusion: Thus, we conclude that rate of formation of healthy red granulation tissue was faster, slough was reduced rapidly and mean surface area of the wound is reduced significantly in the Negative Pressure Wound Therapy, making Negative Pressure Wound Therapy a superior option in the management of patients with post traumatic soft tissue defects in the extremities.
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