Negative Pressure Wound Therapy and its Use in Burn Wounds: An Updated Systematic Review.

Abstract

Negative pressure wound therapy (NPWT) is a form of wound coverage that involves negative pressure and a semi-occlusive membrane to manage wound closure. In burn care, NPWT are currently utilized as temporary dressings for large wounds, skin-grafted burn wounds, and as a dressing on dermal substitutes. Little is known regarding optimal roles and indications of NPWT in burn care. This systematic review better characterizes the role of NPWT in burn care and provides updated recommendations. A systematic review of PubMed and Cochrane databases was performed utilizing PRISMA guidelines. All peer-reviewed publications published any time through September 17, 2021 were included. Inclusion criteria consisted of studies containing a control group without NPWT, an intervention group with NPWT, and studies involving the use of NPTW in burn care. A total of 15 studies were analyzed, with a Risk of Bias (ROB) analysis performed to rate the quality of included studies. We find NPWT is superior to conventional dressings as a modality for skin grafting coverage, dressing on dermal substitutes, dressing on donor site wounds, and dressing on moderate to large burns. Outcomes such as length of hospitalization, length of wound healing, and rates of infections were improved in those treated with NPWT compared to conventional dressings. In conclusion, several clear benefits to utilizing NPWT have been defined for several modalities in burn care. However, further research with more robust controlled clinical trials is necessary to better quantify the role of NPWT in burn care and to better define parameters to optimize wound healing.