A solution for complex wounds: the evidence for negative pressure wound therapy with instillation.

Negative pressure wound therapy with instillation and dwell time (NPWTi-d) is an adjunctive therapy that can be used in the management of complex wounds with infection. NPWTi-d incorporates the intermittent instillation of a topical solution to the wound in a programmed manner. Unlike standard negative pressure wound therapy, NPWTi-d delivers topical wound solutions directly to the wound, allows the solution to dwell over the wound bed, and removes the solution during the negative pressure phase. The authors review the evidence for using NPWTi-d and the role it may potentially play in helping to reduce hospital stay, number of debridement operations and cost.