Negative Pressure Wound Therapy (NPWT) Contraindications and Risk Factors

Table 1: NPWT is contraindicated for these wound types/conditions:
  • necrotic tissue with eschar present
  • untreated osteomyelitis
  • non-enteric and unexplored fistulas
  • malignancy in the wound
  • exposed vasculature
  • exposed nerves
  • exposed anastomotic site
  • exposed organs

Table 2: Patient risk factors/characteristics to consider before NPWT use:
  • patients at high risk for bleeding and hemorrhage
  • patients on anticoagulants or platelet aggregation inhibitors
  • patients with:
    • friable vessels and infected blood vessels
    • vascular anastomosis
    • infected wounds
    • osteomyelitis
    • exposed organs, vessels, nerves, tendons, and ligaments
    • sharp edges in the wound (i.e. bone fragments)
    • spinal cord injury (stimulation of sympathetic nervous system)
    • enteric fistulas
  • patients requiring:
    • MRI
    • Hyperbaric chamber
    • Defibrillation
  • patient size and weight
  • use near vagus nerve (bradycardia)
  • circumferential dressing application
  • mode of therapy- intermittent versus continuous negative pressure

FDA Safety Communication: UPDATE on Serious Complications Associated with Negative Pressure Wound Therapy Systems

Date Issued: February 24, 2011

Retrieved: http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm244211.htm

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