Negative Pressure Wound Therapy with Instillation in Polymorbid Surgical Patients: A Retrospective Single-Centre Analysis

Abstract Background Negative pressure wound therapy with instillation (NPWTi) represents an advanced wound management modality that combines the mechanical effects of negative pressure with cyclic instillation of topical solutions. Although its efficacy has been demonstrated in selected indications, clinical experience from general surgery departments remains limited. Aim To describe clinical experience with NPWTi in a general surgery setting, assess its effectiveness, and evaluate the potential association between treatment failure and patient multimorbidity. Methods A retrospective single-centre analysis was conducted in 15 adult patients treated with NPWTi between 2021 and 2025. NPWTi was applied using the 3M™ V.A.C. Ulta Therapy Unit with four instillation cycles per day and a 15-min dwell time, employing an electrochemically activated mineral salt solution. Demographic data, wound characteristics, treatment parameters, comorbidities, and laboratory markers were analysed. Treatment was assessed as successful, in the case of wound cleanse and healing promotion, that enabled subsequent wound reconstruction, all other outcomes were classified as failure. Associations between treatment outcomes and comorbidities, including multimorbidity, were evaluated by statistical analysis. Results The mean patient age was 64.3 ± 13.5 years. Overall treatment success was achieved in 11 patients (73%), while treatment failure occurred in 4 patients (27%). NPWTi was most used for abscesses, postoperative wound dehiscence, and diabetic foot syndrome with gangrene. Cardiovascular disease, diabetes mellitus, and obesity were highly prevalent. Multimorbidity was present in 14 patients. No statistically significant association was observed between multimorbidity and NPWTi treatment outcome ( p = 1.00). Conclusion In this cohort of predominantly elderly and polymorbid patients, NPWTi demonstrated a high success rate and appeared effective across a broad spectrum of complex surgical wounds. These findings support NPWTi as a valuable adjunctive therapy in high-risk patient populations, although larger prospective studies are required to further define its role and optimal indications.