Sacral Pressure Ulcer Management by Negative Pressure Dressing: a Randomized Open Label Study

The treatment of sacral pressure sores is associated with a high rate of failure and recurrence. If inadequately treated, they severely compromise the quality of life and may herald a terminal event. The present study was undertaken to compare the efficacy of negative pressure wound therapy (NPWT) with conventional dressing treatment for sacral pressure sores. Over a 4-year period, 38 patients of grade III and IV sacral pressure sores were treated by either NPWT (22 patients) or conventional dressing (16 patients) method. Prior to application of NPWT, the wound was debrided and complete hemostasis achieved. The NPWT device was set to deliver a negative pressure of 125 mmHg with 7-min cycle (5 min on pump followed by 2 min off). The dressing was changed after 5 to 7 days. At the end of 3 months of treatment, 4 patients had died in each group. Of the 18 patients alive in NPWT group, 6 patients (33%) achieved complete healing and 9 (50%) had wound size reduction by more than 50%. The corresponding figures in the conventional dressing group were 1 (8%) and 4 patients (33%), respectively. NPWT was found to achieve superior clearance of slough, better generation of granulation tissue, and obliteration of ulcer crater compared to conventional dressing. The negative pressure led to faster reduction of bacterial load promoted angiogenesis and obtained a better rate of wound healing. Moreover, it resulted in a much cleaner and hygienic wound environment, reduced the nursing time in change of dressing, and significantly decreased patient discomfort.