Development of Simplified Negative Pressure Wound Therapy Device for Low-Resource Settings

摘要

Negative pressure wound therapy (NPWT), a successful, open wound treatment, is not readily available in low-resource settings (LRSs): the developing world, combat fields, and disaster relief. This is due to its high electrical power requirement (upwards of 70 Watts), lack of portability (approximately 12.5 lbs.), and high cost ($20-25K per unit, typically rented for $120/day; and $30/day for disposables). Aiming to expand this therapy and breakdown all major barriers to widespread implementation, a simplified negative pressure wound therapy (sNPWT) system, the Wound-Pump, was designed and developed. A blow molded, bellows pump was determined to satisfy all of the necessary functional requirements. It was designed to integrate with most wound dressings, which allows sNPWT to be more widespread by eliminating the requirement for specific disposables. In its final embodiment, the Wound-Pump system is purely mechanical, weighs less than half a pound, and costs less than $3 to manufacture. It was initially tested on intact tissue to verify its function and performance. Internal Review Board (IRB) approval was granted at the Massachusetts General Hospital (MGH), yet expired before any clinical data was collected. Then, the earthquake on January 12, 2010 in Haiti resulted in an epidemic of acute wounds. With knowledge of the previous IRB approval, the effectiveness of NPWT, and the austere conditions in Haiti, a deployed wound care team brought several Wound-Pump systems in their treatment "toolbox". Therapy was applied to five of their 300 patients. The sNPWT treated wounds were clean and granulating at the end of their two week deployment.