Advancing Home Care: The Role of Portable Negative Pressure Devices

Negative Pressure Wound Therapy (NPWT) is a continuous or intermittent application of vacuum-like pressure at the surface of a wound.

This vacuum-like pressure improves the wound environment, accelerates healing, and reduces the wound closure time. This unique way of treating wounds has been found to not only significantly speed up the healing process but also reduce the length of hospital stays and lower the cost of treatment.

Originally only available for use in hospital settings, NPWT devices have now evolved to tackle various wound types in any clinical setting. In recent years, NPWT devices have made even more advancements to include portable options, allowing patients to receive treatment at home where they are more comfortable.

Although NPWT is traditionally used to treat complex wounds in hospital settings, it may be hard to picture how a portable device fits into care outside that environment. But in the fall of 2014, the Academic Surgery Unit, Education, and Research Center at the University of South Manchester published a study exploring the effectiveness of portable NPWT devices in home care settings.

To build upon this research and create more awareness for portable NPWT devices, the Cork Medical team put this article together to further inform healthcare professionals on the benefits, use cases, risks, and positive patient outcomes from using portable NPWT devices.

How Does Negative Pressure Wound Therapy Work?

This unique treatment option involves placing a piece of polyurethane foam or gauze, cut to fit the unique shape of the wound, gently inside the wound and covering it with a transparent polyurethane film drape to tightly seal the dressing. This process is also called draping the wound. A small hole is then cut out of the drape to create an opening for the suction tube.

Once the hole is cut and the suction tube is attached, it’s then connected to a vacuum pump, which applies gentle suction. The suction can be applied continuously or in cycles, depending on the wound and treatment plan. Using NPWT on a wound helps:

• Remove extra fluid that may slow healing

• Increase blood flow to the area

• Promote the growth of new, healthy tissue

• Reduce the risk of infection

Why Healthcare Professionals Prefer to Use Negative Pressure Wound Therapy

NPWT is particularly beneficial for patients who suffer from:

• Chronic wounds

• Acute or sub-acute wounds

• Traumatic burns or deep cuts

• Post-surgical wounds slow to close

• Pressure, diabetic, or venous ulcers

• Skin flaps or grafts

Due to these types of wounds being difficult to heal using traditional healing methods, a controlled suction is needed to remove bacteria, decrease swelling, and promote new tissue formation. Studies have found NPWT in the home has shown to be better than standard dressings and at least as good as hospital NPWT in rate of wound closure.

Pros and Cons of Using Portable Home-Based Negative Pressure

Given the ease of use and simplistic design, using NPWT at home can be a quick and easy solution to heal wounds. Reasons NPWT may be recommended for home use include:

• Promoting an equal or faster recovery rate as in a hospital setting.

• Reducing hospital stays to free up more hospital beds.

• Lowering the infection risk by reducing exposure to hospital-acquired infections.

• Bettering the patient’s quality of life because they can stay home and maintain their mobility freedom.

• Potentially saving costs because home care is typically less expensive than hospital stays.

Despite the benefits of using NPWT at home, it may not be suitable for certain patients or wounds that require more specialized care. Reasons NPWT may not be recommended for home use include:

• Having a complex, severe, or highly infected wound that may require close medical supervision in a hospital setting.

• Caring for a patient with a high risk of complications.

• Not having the proper training to correctly apply or seal the dressing.

• Lacking caregiver support if assistance is needed for changing dressings, managing equipment, or monitoring for complications.

• Not being able to frequently change dressings to reduce the risk of infection.

• Patients who experience frequent and significant pain or discomfort during dressing changes.

To prevent complications, trained healthcare professionals usually visit patients every 2–3 days to change dressings and check on healing progress. Patients also need clear instructions on how to use their device properly.

Comparing Negative Pressure Results in Home Care and Hospital Settings

Several studies have shown that portable NPWT is just as effective as hospital-based treatment for many types of wounds, including chronic wounds, acute wounds, surgical wounds such as those from mastectomies or C-sections, and traumatic wounds.

Patients who receive NPWT at home tend to heal just as quickly, and some studies suggest they may even have fewer complications. Additionally, portable NPWT reduces hospital costs and allows patients to return to their normal activities sooner.

What Patients Are Saying About Portable Home-Based Negative Pressure

Most patients report positive experiences with NPWT at home. Some key factors patients have mentioned are ease of use with proper instructions, reduced usage anxieties with follow-up healthcare visits, and minimal pain, except during dressing changes, where some pain or discomfort can occur. However, some studies suggest pain is lower with NPWT compared to traditional wound dressings.

Final Thoughts

Portable NPWT is a promising advancement in wound care, allowing patients to recover in the comfort of their own homes without sacrificing treatment quality. However, it is not suitable for everyone, especially those with complex wounds or high infection risks. While it requires a doctor’s order or prescription, as well as proper clinician and patient training and monitoring, the benefits, including faster healing, improved mobility, and reduced hospital stays, make it an attractive option for both patients and healthcare providers.