Negative Pressure Wound Therapy Systems Currently Used in Taiwan
(This article is reproduced from STORY: Plastic Surgery Story Vol. 3)
Author: Hao-Chih Tai (Attending Plastic Surgeon, National Taiwan University Hospital)
Negative pressure wound therapy (NPWT) is an adjunctive treatment that utilizes the suction principle to maintain negative pressure between the wound and the dressing. This helps to reduce the wound area and gathers the exudate in a collection canister. In some newer types of negative pressure systems, exudate is also managed through polymer dressings.
NPWT can promote wound healing, prevent infection, and reduce the frequency of dressing changes. It is commonly used in complex acute trauma wounds, surgical wounds, burns, various chronic wounds, and skin grafting, including flap surgeries.
In a paper published in 1999, Philbeck et al. studied the cost-effectiveness of NPWT for pressure ulcers by comparing it with the cost of wet gauze dressing changes. The results showed that wounds treated with NPWT healed faster, with an average healing time of 97 days, and on average cost US$14,546 per patient. This compared with the control group where wounds were treated with wet gauze dressing and required an average of 247 days to heal, with an average cost of US$23,465 per patient. Moreover, NPWT significantly reduced the overall cost of care due to the shorter treatment duration.
The demand for wound treatment has grown in recent years, driving technological R&D and new advancements. According to the classification of Frost & Sullivan, a market research company, new types of high-end medical dressings can be divided into four categories*: wet, antibacterial, active, and NPWT. Nowadays, high-end wound dressings encompass a comprehensive market segment, with NPWT attracting the most attention. At annual meetings of the European Wound Management Association (EWMA), medical professionals from around the world exchange clinical experiences and research achievements. Often, the topic of NPWT and its applicability in various types of wounds account for one-third of the discussions, reflecting the significant potential for R&D in this field.
Generally, NPWT requires a stable sub-atmospheric pressure source through specific machines or equipment. Therefore, most patients need to undergo treatment while hospitalized or rent the equipment for treatment outside the hospital. Apart from the inconvenience of restricted mobility, this also increases the frequency of hospital visits. In recent years, new portable types of NPWT have emerged, allowing for more suitable use in home care settings. Unlike traditional NPWT devices, which are limited in size and weight, portable models are lightweight and easy to operate.
Table 1 shows a summary of the nine manufacturers of NPWT systems currently used in Taiwan.
Table 1. Features of Various Negative Pressure Wound Therapy Systems
|Brand / Features
|Power||Electric motor||Electric motor||Electric motor||Electric motor||Electric motor||Mechanical tension||Electric motor||Electric motor||Electric motor|
|Place of Use||Home||Home & portable||Portable||Home & portable||Home||Portable||Portable||Home||Portable|
|Negative Pressure Dressing||Patented foam||Black-colored foam||Polymer dressing||Black-colored foam||Black-colored foam||Polymer dressing||Green-colored foam||Black-colored foam||Black-colored foam|
|Manufactured in Taiwan||No||No||Yes||Yes||Yes||Yes||No||No||No|
Four of the systems (ZIP, Carilex, Curatios, Anscare) are products from Taiwanese manufacturers. The APEX ZIP was the first domestically developed wearable and portable NPWT system. It improved on a liquid collection device by replacing the conventional glass canister with a soft collection bag that contains absorbent polymers to handle exudate. Meanwhile, Anscare is a medical dressing brand from BenQ Materials. The Anscare SIMO NPWT System is a portable, non-electric suction device that generates negative pressure through the simple pressing of a micro-device, making it the only device of its kind that does not rely on electric motors to create negative pressure (Figure 1). The integration of Anscare's patented polymer dressing allows direct absorption of exudate. Moreover, eliminating the need for a liquid collection canister reduces mobility restrictions for patients and minimizes disruptions to their daily lives.
Figure 1. The Anscare SIMO NPWT System uses mechanical force to generate negative pressure. Lift the air shaft on the device. Rotate clockwise 90 degrees and press down twice to start the negative pressure.
The wound treatment process for chronic wounds often lasts for several months or even years. Therefore, the research and development of wound care products should emphasize not only treatment and cost effectiveness but also on patient comfort and convenience in maintaining their daily lives. Over the long term, NPWT offers a simpler care process and more effective treatment outcomes, leading to reduced treatment time and overall cost, which is beneficial to patients.
In recent years, the concept of "healing from home" in wound treatment has risen in popularity. This is especially evident in the wake of the COVID-19 pandemic, which emphasizes the significance of at-home care to minimize the risks of hospital-acquired infections. Since NPWT can effectively reduce the duration of treatment, it allows patients to avoid prolonged hospital stays. In the future, new miniaturized negative pressure systems will enable high-quality medical care at home, ultimately enhancing a patient’s quality of life.
* Frost & Sullivan, a market research company, classifies new high-end medical dressings into four main categories:
- Wet dressing: This category includes hydrogel dressings, hydrophilic dressings, seaweed dressings, foam dressings, and more. This category has the largest number of items and quantities.
- Antibacterial dressing: These dressings contain antibacterial materials, such as silver ions and antimicrobial agents.
- Active dressing: These dressings contain biological substances such as collagen and growth factors.
- Negative pressure dressing: This category involves using a negative pressure therapy machine to create a sub-atmospheric environment around the wound, promoting wound healing. It is suitable for larger acute and chronic wounds.
This classification provides a clear overview of the different types of high-end medical dressings available in the market.