Negative pressure wound therapy is being considered for a diabetic foot ulcer. Which of the following findings in the wound would be a contraindication to applying NPWT?

• A Untreated osteomyelitis beneath the ulcer ✓
• B Exposed cortical bone covered by healthy granulation tissue
• C Moderate serous exudate requiring frequent dressing changes
• D A previously meshed skin graft over part of the wound

Explanation

NPWT is contraindicated over untreated osteomyelitis, malignant tissue in the wound, non-enteric unexplored fistulas, necrotic eschar, and directly exposed blood vessels, anastomotic sites, nerves, or organs, because suction can cause catastrophic erosion or bleeding. Exposed bone with granulating coverage, exudate, and grafted areas are all acceptable settings where NPWT actively helps healing.

Reference: Bailey and Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.