Fast and effective wound healing Negative Pressure Wound Therapy

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Muriel Harrington
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1 Fast and effective wound healing Negative Pressure Wound Therapy

2 What are your wound management challenges? Healthcare professionals and KCI are always looking for ways to heal wounds faster and more effectively, to improve the quality of life of patients and to reduce overall therapy costs. Efficacy? Healing times? Patient quality of life? Costs? The challenges of effective wound management are becoming increasingly C J Moffatt, European Wound Management Association (EWMA). Position Document: Topical negative pressure in wound management. London: MEP complex. Ltd,

3 Is there a better approach to wound healing? 3

4 A better approach to wound healing The scientifically and clinically proven mechanisms of action behind V.A.C. Therapy promote fast and effective wound healing. 1 5 Mechanisms of action Moist wound healing Granulation tissue formation Oedema reduction Enhanced perfusion Removes wound exudate containing molecules that can inhibit wound healing Stimulates cell proliferation Case Report: Trauma wound 6 A 91-year-old female with a haematoma to the lower leg secondary to a fall. At presentation Day 0 Day 2 Conclusion 4 Wound after removal of hard necrotic tissue. The undermined area was filled with V.A.C. GranuFoam Dressing. After 48 hours the undermined area had decreased in size. After 8 days inpatient and 14 days care in the home undermining was eliminated and granulation tissue was level with wound margin.

5 The V.A.C. Therapy advantage Macrostrain Tissue level activity V.A.C. GranuFoam Dressing Gauze dressing Advantages V.A.C. GranuFoam Dressings provide direct, complete contact with the wound bed. They contract under negative pressure drawing the wound edges together and reducing wound volume. These pulling forces also remove Microstrain Cellular level activity exudate and infectious materials. GranuFoam Gauze Fibres V.A.C. GranuFoam Dressings induce microdeformation of tissue. 5 Tissue Interaction Tissue Interaction V.A.C. GranuFoam Dressings demonstrate 3x more fibroblast migration when compared with gauze. 5 V.A.C. GranuFoam Dressings demonstrate increased proliferation. Cell death is 2.4 x greater with gauze than with V.A.C. GranuFoam Dressing. 5 V.A.C. Therapy efficiently manages large volumes of exudate and accelerates the healing time of complex wounds. 5

6 V.A.C. Therapy: faster 2 and more effective 4 V.A.C. Therapy prepares the wound bed over twice as fast 2 Faster wound bed preparation in V.A.C. Therapy group 17 days [10-24] 7 days [ ] CONTROL V.A.C THERAPY p = Time to wound bed preparation was cut from 17 to 7 days with V.A.C. Therapy Duration needed for wound bed preparation (days) A Randomised Controlled Trial covering 60 chronic leg ulcer patients compared against advanced moist wound dressings. Graph adapted from: Vuerstaek et al Journal of Vascular Surgery Case Report: Chronic wound 6 A diabetic female following amputation of the left second digit and metatarsal head. 6 Day minus 30 Amputation of head of second metatarsal. Day 0 Day 11 Day 54 Following complications, and removal of non-viable tissue. With no improvement for 1 month, V.A.C. Therapy was applied and reduced slough coverage to 40% of the wound surface. At 54 days V.A.C. Therapy was discontinued as the wound bed showed 100% granulation tissue coverage.

7 V.A.C. Therapy is 71% more effective in reducing wound area 4 Diabetic foot ulcers* 2.53 cm 2 CONTROL p < Wound area reduced by 4.32 cm 2 under V.A.C. Therapy compared to only 2.53 cm 2 under control cm 2 V.A.C THERAPY *Average baseline wound area for patients treated with V.A.C. Therapy is 13.5 cm 2 and for patients treated with AMWT 11.0 cm 2. Reduction in ulcer area at Day 28 (cm 2 ) A Randomised Control Trial of 342 patients compared against predominantly hydrogels and alginates across 37 centres. Graph adapted from: Blume et al Diabetes Care The healed foot is functional and can be accommodated within semibespoke footwear, the plantar tissues show no significant scarring or areas of high pressure. 7

8 Impacting positively on healthcare providers and patients V.A.C. Therapy cuts treatment costs by a third 7 Treatment costs cut by $12,852 using V.A.C. Therapy. 7 Average total cost to achieve 100% healing $ $ CONTROL V.A.C THERAPY 0 5,000 10,000 15,000 20,000 25,000 30,000 35,000 40,000 45,000 USD ($) A Randomised Controlled Trial of 162 patients using V.A.C. Therapy treating diabetic foot wounds compared against advanced moist wound care. Graph adapted from: Apelqvist et al The American Journal of Surgery Case Report: Acute wound 6 A 55-year-old woman with necrotising fasciitis requiring radical surgical debridement. 8 Day 0 Initiation of V.A.C. Therapy after radical surgical debridement of abdominal wound. Day 0 Day 24 Day 60 V.A.C. Therapy was applied over exposed bowel. The patient was discharged home on the V.A.C. Freedom unit after a 72% reduction in wound size. V.A.C. Therapy was discontinued. 98% of skin graft was taken successfully.

9 V.A.C. Therapy significantly improves patient quality of life 8 Physical complaints Everyday life complaints *** *** **p<0.01 ***p<0.001 Overall quality of life improved with V.A.C. Therapy. 8 Social life complaints *** Psychological complaints *** Therapy burden *** Complaints with satisfaction ** Overall complaints *** PRIOR TO V.A.C THERAPY AFTER V.A.C THERAPY = no impact 5 = high impact A questionnaire comparison study in which 98 centres compared data before and after V.A.C. Therapy. Graph adapted from: Augustin et al MMW-Fortschritte der Medizin Originalien, V.A.C. Therapy was used to promote rapid growth of granulation tissue in a patient with a number of comorbidities who was at risk of delayed healing. 9

10 You care for your patient: we ll give you the support you need KCI your wound care partner Introductory training and ongoing education. 24-hour customer service to address real-time requirements. Continued research and development investment. Support from our healthcare economic team with any budget concerns. More than 137,000 caregivers trained world wide in 2007 alone. 10

11 V.A.C. Therapy is the validated NPWT Over 16 Randomised Controlled Trials. Over 450 peer-reviewed articles including health economic evidence. More than 3 million patients treated to date with 30,000 patients assisted world-wide every single day. Established mechanisms of action at cellular and tissue levels. To date over 16 Randomised Control Trials over 450 peer-reviewed articles over... 3 million patients treated with V.A.C. Therapy 11

12 V.A.C. Therapy. Faster, more effective and clinically proven wound healing. Prepares the wound bed over twice as fast. 71% more effective in reducing wound area. Cuts treatment costs by a third. Significantly improves quality of life. Comprehensive customer, technical training and support. Over 16 RCT s and 450 peerreviewed articles to date. Can you think of a patient who could benefit from V.A.C. Therapy today? Contact KCI today References 1. Hunter JE, Teot L, Horch R, Banwell PE. Evidence based medicine: vacuum-assisted closure in wound care management. International Wound Journal 2007, 4: Vuerstaek JD, Jeroen DD, Vainas T, Wuite J, Nelemans P, Neumann MHA, Veraart JCJM. State-of-the-art treatment of chronic leg ulcers: A randomized controlled trial comparing vacuumassisted closure (V.A.C. ) with modern wound dressings. Journal of Vascular Surgery 2006, 44(5): Armstrong DG & Lavery LA. Negative Pressure Wound Therapy after partial Diabetic Foot Amputation: a multicentre, randomised controlled trial. Lancet 2005, 366: Blume PA, Walters J, Payne W, Ayala J, Lantis J. Comparison of Negative Pressure Wound Therapy using Vacuum-assisted Closure with Advanced Moist Wound Therapy in the Treatment of Diabetic Foot Ulcers. Diabetes Care 2008, 31: McNulty AK, Schmidt BS, Feeley T, Kieswetter K. Effects of negative pressure wound therapy on fibroblast viability, chemotactic signaling, and proliferation in a provisional wound (fibrin) matrix. Wound Repair and Regeneration 2007, 15: Gray, D. Russell, F. Timmons, J: Editors. VAC Therapy: An introduction and practical guide. Wounds UK, Apelqvist J, Armstrong DG, Lavery LA, Boulton AJM. Resource utilization and economic cost of care based on a randomized trial of Vacuum-assisted Closure therapy in the treatment of diabetic foot wounds. The American Journal of Surgery 2008, 195(6): Augustin M, Zschocke I. Nutzenbewertung der Ambulanten und Stationaeren V.A.C. Therapie aus Patientensicht. MMW-Fortschritte der Medizin Originalien 2006, 1(148):S Patient photographs are posed by models. United Kingdom KCI Medical Ltd KCI House Langford Business Park Langford Locks Kidlington OX5 1GF United Kingdom 24h Customer Support KCI Advantage Centre Tel +44 (0) Fax +44 (0) kci international head office KCI Europe Holding B.V. Parktoren, 6th Floor Van Heuven Goedhartlaan 11 PO Box AC Amstelveen The Netherlands Tel +31 (0) Fax +31 (0) GLOBAL HEAD OFFICE KCI International 8023 Vantage Drive San Antonio TX U.S.A. T(free) , extension 6335 Tel Fax KCI Licensing, Inc. All Rights Reserved. All trademarks designated herein are property of KCI Licensing, Inc, its affiliates and licensors. Those KCI trademarks designated with the symbol are registered and those designated with TM are considered to be proprietary trademarks or are pending trademark applications in at least one country where this product/ work is commercialized. Most KCI products referred to herein are subject to patents or patent applications. KCI Product code KCII En

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COMPLIANCE WITH THIS DOCUMENT IS MANDATORY COVER SHEET NAME OF DOCUMENT TYPE OF DOCUMENT Policy DOCUMENT NUMBER DATE OF PUBLICATION August 2011 RISK RATING Medium Risk LEVEL OF EVIDENCE REVIEW DATE August 2014 FORMER REFERENCE(S) EXECUTIVE SPONSOR