RESUMO
OBJECTIVE: To determine the effect of noncontact normothermic wound therapy (NNWT) versus standard wound care on chronic full-thickness pressure ulcers. DESIGN: Prospective, randomized, controlled trial. SETTING: Veterans administration medical center and 7 long-term-care facilities. PATIENTS: 40 inpatients with 43 Stage III and IV pressure ulcers. INTERVENTIONS: A sterile noncontact wound dressing was applied to 21 wounds for 24 hours per day, 7 days per week. Each day after the wound was irrigated and the noncontact dressing was changed, a heating element in the dressing was activated for 3 1-hour periods for 12 weeks or until wound closure. Twenty-two control wounds were treated with standard, moisture-retentive dressings 24 hours per day, 7 days per week for 12 weeks or until wound closure. MAIN OUTCOME MEASURE: Measurement of wound surface area. MAIN RESULTS: Healing rate for the NNWT group was significantly greater than for the control group (0.52 cm2 per week and 0.23 cm2 per week, respectively; P<.02). A clinically significant increase was seen among the NNWT group in the incidence of closure among wounds that completed the entire 12-week protocol compared with controls (11 of 14 or 79% and 8 of 16 or 50%, respectively; not significant). The mean slope of the individual regression analyses for the NNWT group was significantly different from the mean slope for the control group (-0.07 and -0.033, respectively; P<.05). Large wounds in the NNWT group demonstrated a significantly greater healing rate than large wounds in the control group (P <.05). CONCLUSION: Wounds treated with NNWT healed significantly faster than wounds in the control group. The healing rate was greatest for larger wounds treated with NNWT.
