Negative pressure wound therapy with instillation (NPWTi): Current status, recommendations and perspectives in the context of modern wound therapy

Introduction of negative pressure wound therapy (NPWT) revolutionized the conception of wound healing. Currently, increasing number of studies confirmed the high efficiency of this therapy in many clinical scenarios. Moreover, some innovations have been introduced in recent years to improve the management of complex and chronic wounds. NPWT with instillation (NPWTi) combines traditional NPWT with application of topical irrigation solutions within the bed of the wound. Bioburden reduction, decreases time to wound closure, promotes granulation and tissue formation. Fewer operative visits are required when using NPWTi compared to standard NPWT. However, there are still questioned aspects of the NPWTi and thus its superiority over standard NPWT has not been fully indicated. Moreover, based on current studies no firm conclusions have been taken concerning the type of instilled solution preferably used, range of dwelltime phase, range of negative pressure and others. The main goal of the publication is to overview and summarize the current state of art concerning NPWTi. Moreover, mechanisms of action, review of the most commonly used instilled solutions are discussed and clinical evidence of NPWTi are described. Keywords—NPWT, instillation,