Terapia de presión negativa: intervención enfermera en heridas complejas

• Autores: David Arcusa Puente, Ángela Rodríguez Val, Laura Gracia Galindo, Diana Alonso Sáenz, Eliana Solari Mendoza, Diego Laborda Galindo
• Localización: Revista Sanitaria de Investigación, ISSN-e 2660-7085, Vol. 6, Nº. 8, 2025
• Idioma: español
• Enlaces
  • Texto completo
• Resumen
  • español

    La terapia de presión negativa (TPN) es una técnica avanzada para el tratamiento de heridas que consiste en la aplicación de presión subatmosférica en el lecho de la herida, facilitando así la formación de tejido de granulación, la reducción del edema y la disminución de la carga bacteriana. Esta presión negativa se aplica de manera controlada a través de un sistema cerrado y es una competencia de enfermería.

    La TPN se aplica en heridas complejas como úlceras por presión, heridas quirúrgicas infectadas, úlceras vasculares y heridas traumáticas. Este trabajo revisa los fundamentos de la TPN, su efectividad clínica, indicaciones, contraindicaciones y cuidados de enfermería. Además, también señala la importancia de la educación al paciente y la gestión interdisciplinaria.

    Se concluye que la TPN es una herramienta efectiva en el tratamiento de heridas complejas, siempre que se integre dentro de un abordaje integral y personalizado.

  • English

    Negative pressure wound therapy (NPWT) is an advanced technique for wound management that involves the application of subatmospheric pressure to the wound bed, thereby promoting the formation of granulation tissue, reducing edema, and decreasing the bacterial load. This negative pressure is applied in a controlled manner through a closed system and falls within the scope of nursing practice.

    NPWT is used for complex wounds such as pressure ulcers, infected surgical wounds, vascular ulcers, and traumatic injuries. This paper reviews the principles of NPWT, its clinical effectiveness, indications, contraindications, and nursing care. It also highlights the importance of patient education and interdisciplinary management.

    It is concluded that NPWT is an effective tool in the treatment of complex wounds, provided it is integrated into a comprehensive and personalized care approach.

• Referencias bibliográficas
  • Apelqvist J, et al. Resource utilization and economic costs of care in vacuum-assisted closure therapy. Am J Surg. 2008;195(6):782–788.
  • Morykwas MJ, et al. Vacuum-assisted closure: a new method for wound control. Ann Plast Surg. 1997;38(6):553–562.
  • Mouës CM, et al. Comparing gauze therapy to vacuum-assisted closure: a randomized trial. J Plast Reconstr Aesthet Surg. 2007;60(6):672–681.
  • Schintler MV. Negative pressure therapy: theory and practice. Diabetes Metab Res Rev. 2012;28(Suppl 1):72–77.
  • Gregor S, et al. Negative pressure wound therapy: a vacuum of evidence? Arch Surg. 2008;143(2):189–196.
  • European Wound Management Association. Guidelines on the use of NPWT. J Wound Care. 2008;17(Suppl 1):1–38.
  • Armstrong DG, Lavery LA. NPWT after partial diabetic foot amputation. Lancet. 2005;366(9498):1704–1710.
  • Joseph E, et al. NPWT versus standard therapy of chronic non-healing wounds. Wounds. 2000;12(3):60–67.
  • Dumville JC, et al. NPWT for treating surgical wounds. Cochrane Database Syst Rev. 2015;(6):CD011278.
  • Lehner B, et al. Complications of NPWT in trauma and orthopaedics. Unfallchirurg. 2006;109(5):372–379.
  • Orgill DP, Bayer LR. Update on negative-pressure wound therapy. Plast Reconstr Surg. 2011;127 Suppl 1:105S–115S.
  • Webb LX. New techniques in wound management: vacuum-assisted wound closure. J Am Acad Orthop Surg. 2002;10(5):303–311.
  • Banwell PE, Téot L. Topical negative pressure (TNP): the evolution of a novel wound therapy. J Wound Care. 2003;12(1):22–28.
  • Malmsjö M, et al. The effects of NPWT on wound edge microvascular blood flow. Wound Repair Regen. 2009;17(4):511–516.
  • WUWHS. Principles of best practice: NPWT recommendations. World Union of Wound Healing Societies. 2016.
  • Téot L, et al. The role of the nurse in NPWT. Wounds Int. 2012;3(2):38–44.
  • Timmers MS, et al. Pain associated with NPWT. Wound Repair Regen. 2005;13(5):486–491.
  • Sibbald RG, et al. Skin and wound care in NPWT. Adv Skin Wound Care. 2011;24(3):128–144.
  • Ubbink DT, et al. Topical NPWT for chronic wounds. Arch Surg. 2008;143(2):189–196.