Premature ending of NPWT occasionally occurs due to negative effects on the quality of life (QoL), however, the actual impact on QoL is unknown. The various benefits of this therapy will continue to be explored in the future.Negative pressure wound therapy (NPWT) is a widely accepted treatment modality for open or infected wounds. It is of interest that NPWT may at first glance appear to be a new development, but is actually steeped in history. In the current era, NPWT continues to be advantageous in the healing of complex wounds. Louis Argenta and Michael Morykwas of Wake Forest University School of Medicine. 7 The modern NPWT systems came into being in the 1990's with the use of polyurethane foam and a mechanical vacuum pioneered by Drs. Nail Bagaoutdinov, a Soviet Surgeon, began using a negative pressure unit with foam dressings to treat infected wounds in 1985. The Soviet-Afghanistan War drove this need for advancements in both surgical technique and wound care. In the 20th century, the Russians were innovators in the area of negative pressure treatments. 6 This allowed for wound secretions to be extracted from various parts of the body. Gustav Bier developed a cupping system with glass cups in a variety of shapes and sizes along with tubing and a bulb. In 1821 Dr. Francis Fox, a British physician, invented the “Glass Leech” which was a suction apparatus with a wide neck cup and clung to the skin affectively much like that of a leech. The syringe was a welcome alternative to the lip service normally paid in this era.Ĭupping remained a predominate form of negative pressure therapy throughout the 19th century. 5 This tool was then used to drain abscesses and hematomas. Anel to invent a suction syringe with a triangular tip and wide cannula to replace the need for direct mouth contact. This gruesome and risky act of “wound sucking” inspired Dr. Dominique Anel, a French Surgeon, noted men attached to his regiment known as the “wound suckers” would successfully clear blood clots and foreign bodies from the injured soldiers wounds. 3 If these glass vessels were not readily available then the good old standby, oral suction was performed.īy the 18th century, this “lip service” approach to wound healing was seen as disgusting, but still effective. To activate the suction, heat was applied on the inside of the glass and placed against the patient's flesh, as cooling occurred the suction increased. These dome shaped cupping glasses were applied over the wound site and left in place for at least an hour to draw out fluid. 3 As history proves this was not a successful venture.Īlong with direct mouth suction, the use of “cupping glasses” were utilized to draw fluid out of an open wound. The historian Suetonius wrote that one of these healers was ordered to suck the wound of Cleopatra to attempt to revive her from the bite of the asp. 3 This treatment proved so successful that they were considered indispensible to the Roman army, and even Cato had a group of these sucking healers in his African campaign. Individuals who were thought to have hereditary powers of healing were assigned to give direct suction by mouth to the wound. 3 Deep wounds sustained in battle and possible “poisonous wounds” plagued those who cared for the injured. This historic review highlights the development of NPWT from ancient times to the modern era.ĭuring the Roman era, medical personnel were attached to the various armies throughout the vast empire. Modern medicine should not forget its past, and the knowledge gained from our predecessors. These rudimentary applications are explored in this journey back through the history of NPWT. The use of the human mouth predated the sponge, sealant, and tubing used today. While this technology seems relatively recent to modern medicine, its roots go back to the earliest civilizations. Recently the use of negative pressure wound therapy (NPWT) has been advocated in traumatic injuries likes those sustained in combat situations. 1 This therapeutic modality aids in formation of granulation tissue to facilitate wound healing. Negative pressure wound therapy (NPWT) in its most current form has been used steadily to heal complex wounds since its initial development in the early 1990's.
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