Negative Pressure Wound Therapy With Instillation and Dwell Time: Mechanisms of Action Literature Review.

Background: Negative pressure wound therapy (NPWT) is commonly used in wound management of both acute and chronic wounds. As wound care has advanced, traditional NPWT has evolved to include instillation and dwell time (NPWTi-d). To better understand the potential clinical benefits of NPWTi-d, an assessment of the available literature focusing on NPWTi-d mechanisms of action in wound management was conducted. Methods. A literature search was performed for abstracts and articles published between 2010 and 2023. Published studies in English that discussed NPWTi-d mechanisms of action and included a study population larger than 10 patients were examined. Results: A total of 1878 articles were identified through the literature search. After removal of duplicates and article reviews, 29 studies discussing the mechanisms of action for NPWTi-d were found. Study types included case series (n = 20), comparative study (n = 6), randomized controlled trial (n = 2), and retrospective study (n = 1). These studies included approximately 1108 patients who received NPWTi-d as part of a wound care treatment plan. NPWTi-d use was associated with improved wound and clinical outcomes through wound cleansing, removal of exudate and infectious materials, and promotion of granulation tissue development. Conclusions: The mechanisms of action for NPWTi-d helps provide wound management through wound cleansing, removal of exudate and infectious materials, and promoting the development of granulation tissue. Additional studies are warranted to fully assess the potential clinical and health economic benefits of NPWTi-d use.