Recommendation for NHSScotland

Negative pressure wound therapy (NPWT) should be considered for people with diabetes who require treatment for either post-operative foot wounds or foot ulcers.

There is inadequate evidence to determine whether NPWT is clinically and cost effective in the following wound types: pressure ulcers; venous leg ulcers; burns; open traumatic wounds; open abdomen; wounds healing by primary intention (including split-thickness skin grafts, caesarean section wounds and closed incision wounds); surgical wounds healing by secondary intention; and sternal wound infections after cardiothoracic surgery.

Consensus statements to guide best practice

Exploratory work by SHTG highlighted the need for guidance on the appropriate and safe use of NPWT in NHSScotland. Therefore consensus statements to guide best practice have been produced by a group of clinical experts. These have been published as a supplement to this advice statement.

Consensus was reached on seven statements of best practice. These included NPWT contraindications, NPWT precautions and the need for all staff involved in the provision of NPWT to have device specific training.

Consensus was not reached on the wound types for which NPWT was clinically indicated.

NHSScotland is required to consider the Scottish Health Technologies Group (SHTG) advice.

What were we asked to look at?

We were asked to provide advice on the use NPWT across a range of wound types, based on the published evidence and via the development of consensus statements to guide best practice.

Why is this important?

NPWT is a widely used treatment in NHSScotland. It has been used for approximately 20 years and its’ use has expanded to include a variety of different wound types. It is used by many clinical specialities, including tissue viability, podiatry, trauma and surgery. NPWT involves the use of sealed negative pressure (a vacuum) over a wound. The clinical intent of NPWT is to progress a wound towards healing. There are anecdotal concerns that NPWT is used inconsistently, and sometimes inappropriately, across different healthcare professionals and boards in NHSScotland.

Referred by

Heather Hodgson, Lead Nurse Tissue Viability, NHS Greater Glasgow and Clyde