Negative Pressure Wound Therapy (NPWT) has evolved from open wound management to now include closed incision management. It has been a major advance in the management of open wounds and closed incisional wounds especially in orthopaedic trauma surgery. Because of the success of NPWT in the late 1990s and early 2000s, surgeons began using NPWT with adjuncts on closed incisions as a way to help prevent surgical wound dehiscence especially in at-risk patients for wound problems. It has been well established that obesity, diabetes, and smoking in addition to other comorbidities increase the risk of wound dehiscence and surgical site infections in orthopaedic patients. It is widely used for open wound management, often associated with open fractures, and in the mitigation of risk of surgical site infections over closed incisions (incisional negative pressure wound therapy). Newer systems allow the use of various topical wound solutions to be instilled in conjunction with NPWT, termed NPWTi-d. This has shown promising results in difficult wounds that may be resistant to standard NPWT. This article reviews the evolution and use of NPWT in orthopaedic trauma.

中文翻译：

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骨科创伤负压伤口治疗的演变。

负压伤口治疗 (NPWT) 已从开放式伤口管理发展到现在包括闭合切口管理。它在开放性伤口和闭合性切口伤口的管理方面取得了重大进展，特别是在骨科创伤手术中。由于 NPWT 在 1990 年代末和 2000 年代初的成功，外科医生开始在闭合切口上使用 NPWT 和辅助物，以帮助防止手术伤口裂开，特别是在有伤口问题的高危患者中。众所周知，肥胖、糖尿病和吸烟以及其他合并症会增加骨科患者伤口裂开和手术部位感染的风险。它广泛用于开放性伤口管理，通常与开放性骨折有关，以及减少闭合切口手术部位感染的风险（切口负压伤口治疗）。较新的系统允许使用各种局部伤口溶液与 NPWT 一起灌输，称为 NPWTi-d。这在可能对标准 NPWT 有抵抗力的困难伤口中显示出有希望的结果。本文回顾了 NPWT 在骨科创伤中的演变和应用。