Negative pressure therapy in wound healing

The aim of the study was to use negative pressure wound therapy (NPWT) in patients with chronic venous leg ulceration. Intervention: Negative pressure wound therapy was provided by the Genadyne A4TM system. The system consists of three components: a negative pressure generating unit with a disposable canister, a pad with evacuation tube, and a reticulated, open cell sterile polyurethane or a dense open-pore polyvinyl alcohol foam dressing cut to fit the wound. The system unit is programmed to deliver controlled negative pressure ranging from 50 to 200 mmHg (in repeating cycles automatically by the device: in every 3 minutes the pressure increased by 10 mmHg). Treatment was continued until ulcer closure, sufficient granulation tissue formation for healing by secondary intention. NPWT dressing changes were performed every 48-72 hours, no less than three times per week. Measurements: During the wound dressing and compression changes the area of the ulcers was constantly measured. The procedure was as follows. At the outset, homothetic congruent projections of the ulcers were plotted onto transparent foil, after which planimetric measurements of the wounds were taken with the use of digitizer Mutoh Kurta XGT-1218A3. The area of the ulcer was determined once a week until the wound healed completely. All patients received also micronized flavonoid fraction (450 mg diosmin, 50 mg hesperidin), 2 tablets of 500 mg once daily (until ulcer closure, no stategies used to monitor adherence to the daily medication).