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Matiasek et al. Plast Aesthet Res 2018;5:36 Plastic and
DOI: 10.20517/2347-9264.2018.50 Aesthetic Research

Originial Article Open Access

Negative pressure wound therapy with instillation:
effects on healing of category 4 pressure ulcers

Johannes Matiasek , Gabriel Djedovic , Marcus Kiehlmann , Ralph Verstappen , Ulrich M. Rieger 2
2
1
2
3
1 Department of Plastic and Reconstructive Surgery, St. Josef Hospital, Vienna 1130, Austria.
2 Department of Plastic and Aesthetic Surgery, Reconstructive & Hand Surgery, St. Markus Hospital, Frankfurt 60431, Germany.
3 Department of Hand, Plastic and Reconstructive Surgery, St. Gallen Cantonal Hospital, St. Gallen 9000, Switzerland.
Correspondence to: Prof. Ulrich M. Rieger, Department of Plastic and Aesthetic Surgery, Reconstructive & Hand Surgery, St. Markus
Hospital, Frankfurt 60431, Germany. E-mail: dr.ulrich.rieger@gmail.com

How to cite this article: Matiasek J, Djedovic G, Kiehlmann M, Verstappen R, Rieger UM. Negative pressure wound therapy with
instillation: effects on healing of category 4 pressure ulcers. Plast Aesthet Res 2018;5:36.
http://dx.doi.org/10.20517/2347-9264.2018.50
Received: 26 Jun 2018 First Decision: 9 Aug 2018 Revised: 24 Aug 2018 Accepted: 28 Aug 2018 Published: 28 Sep 2018

Science Editor: Raymund Engelbert Horch Copy Editor: Yuan-Li Wang Production Editor: Zhong-Yu Guo

Abstract

Aim: The use of negative pressure wound therapy (NPWT) is well established in the treatment of chronic wounds.
NPWT with instillation (NPWTi) combines traditional NPWT with the application of a topical irrigation solution (in
this case octenidine based octenilin® wound irrigation solution) within the wound bed. The purpose of the study was to
investigate the impact of NPWTi on pressure ulcers (PUs).

Methods: In total 13 patients with PUs in different locations were treated with negative pressure therapy combined with
ocitenidine based instillation fluid after first surgical debridement. After 6 days the dressing was removed and wound
closure using different local flaps was performed.

Results: Normal wound healing without irritation was found 30 days post-debridement and after 90 days the wounds
showed complete healing. No adverse incidents occurred and no toxic tissue reactions were documented. During the
follow up period, there was no recurrence of the PU in any of the treated patients.

Conclusion: It is generally recognised that for chronic wounds to heal, optimum wound bed preparation is of paramount
importance. This helps prepare for secondary healing, skin grafting or coverage with flaps. Tests were performed in
vitro simulating real clinical conditions using PU vacuum exudates. These tests quantified the antiseptic efficacy of
octenilin® wound irrigation solution in the eradication of microorganisms. Further research is needed to establish the
role of NPWTi with octenilin® in the management of category 4 PUs, but these initial results on 13 patients lead in the

© The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
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