Patient's pain feedback using negative pressure wound therapy with foam and gauze

Abstract

Wounds can be caused by different mechanisms and have a significant morbidity and mortality. Negative pressure wound therapy (NPWT) is one of the most successful treatment modalities for wound healing. We have been using both foam and gauze-based NPWT. During application of NPWT, we noticed that the patient's pain was of varying intensity depending on the filler used. The aim of our work was to compare the level of pain and feedback before, during the treatment and at the dressing change after treatment with NPWT with two different fillers. For this study, we compared a pool of 13 gauze-treated patients with a pool of 18 foam-treated patients regarding the level of pain and feedback before, during the treatment and at the dressing change after treatment with NPWT. They were all post-traumatic patients with loss of tissue up to the muscular band. The patients were asked to respond to a questionnaire interviewed by the same physician to assess the level of pain using VNS (verbal numerical scale). We observed similar difference of means before and during the treatment with NPWT with gauze and foam. Regarding the pain at the dressing change, the mean of the scores for the foam was 6·5 while for the gauze was 4·15. In this case, we noticed the most significant difference between means from the scores given: 2·35 which was a statistically significant difference between the two groups (P = 0·046). The finding of this study confirms less pain at the dressing change after treatment with gauze-based NPWT. In our opinion, this finding is related to the more adhesive property of the foam probably because of the ingrowth of the granulation tissue in the micropores present on the foam. Considering this statement, we recommend the foam for neuropathic and paraplegic patients and the gauze for patients with bone and tendon exposition wounds, patients that do not tolerate NPWT with foam and low compliant patient particularly paediatric and old-age patients. We remind that the performance of this study was not sponsored by any company.