Improvement of Granulation Tissue Formation through “Low Cost” Intermittent Negative Pressure Wound Therapy (NPWT): Randomized Controlled Trial
Abstract
Objective: Intermittent negative pressure wound therapy (NPWT) may enhance granulation, but commercial systems are costly. This study evaluated a low-cost, improvised intermittent NPWT system.
Material and Methods: A randomized controlled trial was conducted with 32 patients having open wounds unsuitable for primary closure. Participants were allocated to intermittent NPWT (5 minutes on/-125 mmHg, 2 minutes off; n=16) or continuous NPWT (n=16) using an improvised system. The primary outcome was the percentage of granulation tissue coverage, assessed by blinded plastic surgeons on days 0, 3, 6, and 9. A linear mixed model was used for analysis.
Results: The intermittent NPWT group demonstrated significantly greater granulation tissue formation than the continuous group (Group main effect: F(1)(1,30)=5.297, p-value=0.028). By day 9, the estimated marginal mean granulation coverage was 94.6% (95% CI: 88.0, 101.1) for intermittent NPWT versus 82.8% (95% CI: 76.3, 89.4) for continuous NPWT, with a significant between-group difference of 11.7% (p-value=0.029). Pain scores at day 9 did not differ between groups (p-value=0.876).
Conclusion: An improvised intermittent NPWT system significantly improved granulation tissue formation compared to continuous NPWT, without increasing patient pain. Clinically, this accelerated granulation implies earlier readiness for definitive wound closure or skin grafting. This low-cost approach offers a practical and accessible solution for improving wound care in resource-constrained settings.
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