Pain Free Negative Pressure Wound Therapy

Abstract

Objective: Wound vacuum-assisted closure (VAC) is a technique used frequently by orthopedic surgeons to facilitate wound closure. Bedside VAC removal can be a source of great pain for patients, which we hypothesize can be decreased by topical lidocaine application.

Study Design: Prospective randomized double-blinded study

Place and Duration of Study: This study was conducted at the Plastic and Reconstructive Surgery Department of Liaquat National Hospital, Karachi from November 2015 to October 2017.

Materials and Methods: Non diabetic, adult patients requiring at least 2 extremity wound VAC dressing changes were involved. In a double-blinded fashion using crossover intervention technique, topical lidocaine (1%) was compared with topical normal saline (0.9% NaCl) after injection into the VAC sponge. The patients were evaluated using visual analog pain scores.

Results: A total of 72 patients were enrolled for a total of 144 VAC changes. The lidocaine infiltration was associated with 2.03 points less on the 0–10 visual analog scale for pain (P value <0.0001, during the VAC sponge removal.

Conclusion: The patients undergoing an extremity wound VAC dressing removal at the bedside should be pretreated with topical lidocaine because it decreases pain.