While this is not a new discussion for us at SALSA, we thought it appropriate to get the discussion out into the ether.
For so very long, we have been asking why NPWT with foam works so well– particularly when compared with certain types of gauze. Is there some magic property between the two? After all, a vacuum is a vacuum– and the most perfect way to have a vacuum might be to have nothing in contact with the surface?!
We have thought that the main reason that foam- particularly polyurethane (PU) foam- works well is because it stays porous and provides channels for even distribution of NPWT and won’t “clog up the line” with wound debris.
Perhaps this holds true when we discuss our concept of “wound chemotherapy” by way of streaming fluid through the wound. When we stream that fluid through the wound, we are unclogging channels in the PU foam. This most certainly must have a positive therapeutic effect. It also partly explains why we see a reduction in maceration and a reduction in slough in the wound.
Finally, this explains why we often don’t frequently see this change in the wound with intermittent streaming (ie instilling fluid with a “hold” period in NPWT). This might not have the same hydrodynamic effect.
Anyway, we look forward to your feedback as always.