NEGATIVE PRESSURE WOUND THERAPY WITH SALINE INSTILLATION VERSUS CONVENTIONAL NEGATIVE PRESSURE WOUND THERAPY — A COMPARATIVE STUDY TO EVALUATE PATIENTS OUTCOMES”

Background: Wound management continues to be a critical challenge in surgical practice, with delayed healing often resulting in prolonged hospital stays, increased healthcare costs, and higher morbidity. Negative pressure wound therapy (NPWT) has been widely adopted to improve healing, and the addition of saline instillation (NPWTi) has emerged as a promising modification. However, comparative evidence assessing its effectiveness over conventional NPWT remains limited. Objective: To compare wound outcomes between negative pressure wound therapy with saline instillation and conventional negative pressure wound therapy without instillation of normal saline. Methods: A randomized controlled trial was conducted at the Department of General Surgery, Combined Military Hospital, from September 2022 to February 2023. Sixty-six patients meeting the inclusion criteria were enrolled and randomly assigned into two equal groups: Group A (NPWTi) and Group B (NPWT). Baseline characteristics including age, gender, and wound site were recorded. Patients were assessed for key wound outcome parameters: number of days until final surgical procedure, number of operative visits, percentage of wound closure, and percentage of wounds that remained closed at 30-day follow-up. Data were analyzed using SPSS version 22.0 with p < 0.05 considered statistically significant. Results: The mean age of participants was 45.50 ± 6.53 years, with 37 (56.10%) males and 29 (43.90%) females. Foot was the most common wound site (60.60%). Mean days until final surgical procedure were significantly fewer in the NPWTi group (21.24 ± 1.67) compared to the NPWT group (25.33 ± 1.76; p = 0.000). Operative visits were also lower in NPWTi (4.06 ± 1.06 vs. 5.45 ± 1.12; p = 0.000). Differences in wound closure (87.88% vs. 78.79%; p = 0.322) and closure at 30 days (75.76% vs. 57.58%; p = 0.117) were not statistically significant. Conclusion: Negative pressure wound therapy with saline instillation demonstrated superior outcomes in terms of reducing time to surgical closure and operative visits, supporting its use as an effective advancement over conventional NPWT.