The Role of Negative Pressure Wound Therapy in Managing Chinese Patients With Wound-derived Acute Severe Illness.

[INTRODUCTION] Resulting mostly from major injury or infection, severe acute wounds are often accompanied by septic shock or multiple organ failure and associated with high disability and mortality rates. In managing Chinese patients with wound-derived acute severe illnesses, salvage treatment in the emergency department has traditionally prioritized life support and protection of vital organs before wound repair.

[OBJECTIVE] This retrospective review evaluated the outcomes of patients with wound-derived acute severe illness who were treated with a new salvage protocol that combined proactive wound care with simultaneous life-support measures.

[MATERIALS AND METHODS] Records from 2011 to 2013 at Peking Union Medical College Hospital (PUMCH) in Beijing, China, were reviewed to identify patients with wound-derived acute severe illness treated with the new protocol. The plastic surgery department, emergency department, and intensive care unit developed the protocol, which included proactive wound treatment with negative pressure wound therapy (NPWT), interdepartmental cooperation, and comprehensive patient treatment.

[RESULTS] Fifty-six patients were managed with the new protocol. At presentation, all patients were in septic shock and 29 of 56 (51.8%) required mechanical ventilation. Of the treated patients, 21 (37.5%) fully recovered and 29 (51.8%) improved sufficiently enough for transfer to a general ward. Six patients (10.7%) died of causes unrelated to NPWT.

[CONCLUSIONS] At PUMCH, the new collaborative salvage protocol with proactive use of NPWT with simultaneous life- support methods resulted in greater therapeutic effects than traditional salvage treatment could offer.