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A One Year Comparison of Outcomes for Normal Saline and an Antiseptic Solution for Negative Pressure Wound Therapy with Instillation
Ryan Mathis, MD, Ersilia L. Anghel, BS, BA, Anagha Kumar, MS, MA, Paul J. Kim, DPM, Christopher E. Attinger, MD.
Georgetown University, Washington, DC, USA.

PURPOSE:
Negative Pressure Wound Therapy with Instillation is an adjunctive treatment to debridement that utilizes periodic installation of a solution and negative pressure. The objective of this study was to compare normal saline versus an antiseptic solution that is more often used.
METHODS:
This randomized, prospective longitudinal effectiveness study compared 0.9% normal saline versus 0.1% polyhexanide + 0.1% betaine for adjunctive treatment of infected wounds requiring hospitalization and operative debridements. Number of operative visits, length of stay, and proportion of closed, infected, or dehisced wounds at several time points were measured.
RESULTS:
Of the 92 patients randomized, there was no statistically significant difference between the demographic profiles between the two cohorts except for a larger proportion of males to females (p=0.004). Percentage of closed wounds at 30, 60, 90, 180, and 360 days post discharge for normal saline and antiseptic solution were 65.96% and 65.91%, 51.06% and 54.55%, 70.21% and 59.09%, 65.96% and 59.09%, 70.21% and 65.91%, respectively. Of the time points recorded, none showed a statistical significant difference in wound closure.
CONCLUSION:
For patients treated with Negative Pressure Wound Therapy with Instillation as an adjunct to debridement, there was statistically no difference in wound closure over 1 year, length of index hospitalization, or number of operations prior to 30days between use of compared 0.9% normal saline versus 0.1% polyhexanide + 0.1% betaine. Antiseptic solutions are commonly used and are associated with significant cost, based on these findings; normal saline is equally efficacious and can be used as a substitute.


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