Fagerdahl et al listed risk factors for problems during negative pressure wound therapy (NPWT). These can help to identify a patient who may benefit from more aggressive management. The authors are from Stockholm.
Risk factors for unsuccessful treatment and/or complications:
(1) peripheral vascular disease
(2) positive culture for Staphylococcus aureus
(3) positive culture for Pseudomonas aeruginosa
(4) pressure ulcer
where:
• Cultures need to be taken carefully. Pseudomonas colonization of the surface associated with water needs to be distinguished from a wound infected with Pseudomonas aeruginosa.
• Complications included wound infection, hematoma, worsening of skin status adjacent to wound, deterioration in quality of life.
Recommendations:
(1) The patient should be evaluated for peripheral vascular disease prior to treating a wound on an extremity. Revascularization may be required for wound therapy to be effective.
(2) The wound should be cultured and antibiotics given based on antibiotic susceptibility pattern.
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