Watch (4:31 min) how to start smart.¹
Veraflo Therapy, or NPWTi-d, combines the benefits of 3M™ V.A.C.® Therapy with an instillation therapy option featuring both automated volumetric delivery of topical wound solutions and a programmable soak feature, which allows solution to dwell in the wound for thorough contact. The first and only clinically evaluated therapy that provides hydromechanical removal of non-viable tissue. Veraflo Therapy with 3M™ Veraflo™ Cleanse Choice Complete™ Dressing or 3M™ V.A.C. Veraflo™ Cleanse Choice Dressing provides a clinically proven therapy that can reduce the number of required surgical debridements and prepare the wound for closure faster.
Delayed healing and wound complications are a significant care and cost burden.
A systematic review of comparative studies and meta-analysis⁶ evaluated the performance of Veraflo Therapy versus control in 13 studies and 720 patients with various wound types:
Based upon the meta-analysis by Allen Gabriel, MD et al. an economic model6 was developed to compare the cost of using Veraflo Therapy to traditional wound care options including V.A.C.® Therapy. Despite higher therapy cost of Veraflo Therapy, the reduction in therapy time and required OR visits resulted in a potential savings of 50%, or up to $33,337 per patient.
Note: The model uses select study data to provide an illustration of estimates of costs for use of Veraflo Therapy or Standard of Care (Control). This model is an illustration and not a guarantee of actual individual costs, savings, outcomes or results. The facility is advised to use this model as an illustration only to assist in an overall assessment of products and pricing.
A recent article, published in Wounds, suggests initial initiation (within 1 day) of Veraflo Therapy helped improve patient outcomes and reduced care costs versus waiting 2 to 7 days. Patients with Day 1 initiation of Veraflo Therapy reported:⁸*
*A retrospective analysis was conducted utilizing a national, all-payer hospital database and included patients who received NPWTi-d (Veraflo Therapy) as an inpatient visit in 2019. A matched cohort of 514 patients who received either early (within 1 day of NPWT application) or late (within 2-7 days of NPWT application) NPWTi-d initiation was created using propensity scoring.
Veraflo Therapy combines trusted V.A.C.® Therapy in combination with the cyclical topical wound solution delivery in order to help manage bioburden and stimulate granulation tissue in one therapy. Veraflo Therapy is delivered through the combination of the V.A.C.® Ulta Therapy Unit and dressings specifically designed for instillation. When used in conjunction with Veraflo Therapy, the array of 1 cm holes featured in 3M™ Veraflo™ Cleanse Choice™ Dressing and 3M™ Veraflo™ Cleanse Choice Complete™ Dressing help facilitate the removal of thick wound exudate and other nonviable tissue, while stimulating granulation tissue.⁹ In addition, these dressings provide a wound cleansing option for clinicians when surgical debridement must be delayed or is not possible or appropriate.¹⁰
NOTE: Specific indications, contraindications, warnings, precautions, and safety information exist for these products and therapies. Please consult a clinician and product Instructions for Use prior to application. This material is intended for healthcare professionals. Rx only.
The V.A.C.® Ulta Therapy Unit is an integrated wound management system that provides four separate and distinct wound treatment options: 3M™ V.A.C.® Therapy, Veraflo™ Therapy, 3M™ Prevena™ Therapy and 3M™ AbThera™ Therapy.
The Veraflo Cleanse Choice Complete Dressing Kit features a uniquely combined single layer foam that offers more versatility in dressing application, along with the gentle skin-friendly strength of the 3M™ Dermatac™ Drape. This powerful combination makes the dressing application and initiation of Veraflo Therapy easier than ever.
3M™ Veraflo™ Therapy, with 3M™ Veraflo™ Cleanse Choice Complete™ Dressing provide hydromechanical removal of infectious materials, non-viable tissue and wound debris which reduces the number of surgical debridements required, while promoting granulation tissue formation, creating an environment that promotes wound healing.
The V.A.C. Veraflo Cleanse Choice Dressing features three foam layers to provide application options for wounds with varying depths, and allows for single or duo pad application.
3M™ Veraflo™ Therapy with 3M™ V.A.C. Veraflo Cleanse Choice™ Dressing provide hydromechanical removal of infectious materials, non-viable tissue and wound debris which reduces the number of surgical debridements required, while promoting granulation tissue formation, creating an environment that promotes wound healing.
Veraflo Therapy combines the benefits of V.A.C.® Therapy with an instillation therapy option featuring both automated volumetric delivery of topical wound treatment solutions with a programmable soak feature, which allows solution to dwell in the wound for thorough contact.
Select the appropriate topical solution for the wound being treated, such as normal saline or wound irrigation solutions and cleansers. The V.A.C.® Ulta Therapy Unit with the Smart Instill Feature automates your selected instillation fill volume and soak time.
Hydromechanical removal of infectious materials, non-viable tissue and wound debris. In addition, instillation can also lower wound fluid viscosity, which in turn facilitates more efficient removal of exudates and infectious material through the foam and into the canister during the V.A.C. Therapy phase.¹³, ¹⁴, ¹⁵
Veraflo Therapy with the 3M™ V.A.C.® Veraflo™ Dressing has been shown to promote granulation tissue formation, increasing thickness by 43% in a porcine model after 7 days of therapy, when compared to V.A.C.® Therapy.⁵
Reduces the number of surgical debridements required.+
Following a boating injury, a 26-year-old female received a transfemoral amputation resulting in a soft tissue defect. During transportation to the facility, the patient had a Combat Tourniquet and received 13 units of packed red blood cells and eight units of fresh frozen plasma. The wound was surgically debrided and irrigated at different stages of the treatment. She received therapeutic plasma exchange, continuous renal replacement therapy after being diagnosed with macrophage activation syndrome, and V.A.C.® Therapy at -125mmHg.
When surgical debridement was not an option, Veraflo Therapy was initiated using a 3M™ V.A.C. Veraflo Cleanse Choice™ Dressing, instilling 100ml of 0.125% Dakin’s Solution to help remove devitalized tissue. As wound healing progressed, Veraflo Therapy was transitioned to using 3M™ V.A.C. Veraflo™ Dressing, instilling 80ml normal saline. After the tangential excision and split-thickness skin graft, it was covered with a non-adherent layer and bolstered using 3M™ V.A.C.® Therapy applied at -125mmHg. Systemic antibiotics were administered throughout the patient’s treatment period.
A) Day 0 of Veraflo Therapy - Wound on Day 9 before initiating 3M™ Veraflo™ Therapy.
B) Day 4 of Veraflo Therapy – wound healing progressed.
C) Day 16 of Veraflo Therapy – Wound on day 25 with significant granulation tissue present and a considerable amount of coverage over the femur fragment.
Patient data and photos courtesy of Brandon Hill, RN, CWCN, FACCWS; Ochsner Louisiana State University Health Shreveport, Shreveport, LA
NOTE: As with any case study, the results and outcomes should not be interpreted as a guarantee or warranty of similar results. Individual results may vary depending on the patient’s circumstances and condition.
Read the full case study (page 18) and 11 other case studies (PDF, 996 KB)
Based on the 2020 "Negative pressure wound therapy with instillation: International consensus guidelines update" by Paul Kim, DPM, MS et al. in the publication International Wound Journal, Veraflo Therapy should be considered early in treatment based on data and experience.¹¹
Appropriate wound characteristics:
Recommended therapy settings:
Discontinue therapy when clinical goals are met.
The Smart Instill Feature uses sophisticated software that automates many of the Veraflo Therapy steps and delivers an easier and less time-consuming interaction when initiating instillation therapy:
Just another reason to start smart with Veraflo technology - Request a demonstration today
(SPEECH) [MUSIC PLAYING] (DESCRIPTION) 3M, Veraflow Therapy, 3M Veraflow Therapy with 3M Smart Instill Feature. A photo of a foot receiving negative pressure wound therapy. An image of a 3M Veraflow machine. Text, Dr. Marc Matthews is a paid consultant for 3M. This video is intended for clinicians. The opinions and testimony in the video are those of the health care provider based on their individual experience and research. The opinions and testimony are not indicative of all outcomes and should not be interpreted as a guarantee or warranty for similar results. Individual patient results may vary depending on the circumstances and condition. (SPEECH) With trauma and burn surgical critical care, we see all types of wounds. The type of wounds that I see are everything from total skin sloughing to total third degree, second degree burns. (DESCRIPTION) Dr. Marc Matthews, MD, MS, M C G, F A C S, Associate Director Arizona Burn Center. (SPEECH) A lot of trauma wounds, a lot of road rash that is converted to burns, things called toxic epidermal necrolysis, things that the local doctors or the doctors in the state don't know what to do with because they've never seen it. We see it just about every day. (DESCRIPTION) An open wound showing pink tissue blood and bone on an ankle is being cleaned with a liquid and cotton swabs. (SPEECH) Most of them come in filthy dirty and that means bacteria. And if, of course, you get dead tissue, that means that bacteria now is infecting that dead tissue, which means that the patient is just a meal for the bacteria. And then, we have to come in and excise that or clean it up some way. Classically, a lot of those patients end up going to the operating room to get their wounds healed, if you will. When we look at that wound, we have to decide, how soon is the operation, how deep is the operation, what is the scope of the operation, and how soon we can get them back to who they were? Which is the objective for any patient, how can I get back to me? My main objective in treating a wound is to remove the dead tissue. (DESCRIPTION) A photo of three wounds with pink red and brown spots. (SPEECH) Get the tissue off and control any infection that's there. How are we now going to try to get that granulation tissue to develop so that we can get this one closed? Well, there are various things, standard wet to moist dressing. Standard wet to moist dressings are stuff that I use when I was an intern back in the dark ages. OK, we've graduated from that, we know a lot more about wound care, and how to treat patients, and how to treat their wounds. Things like, for instance, negative pressure wound therapy, what does that do? We've known this for 25 years to help granulate that wound bed up, so that we're going to be able to get it skin grafted. (DESCRIPTION) Text, 3M Veraflow Therapy. A picture of the 3M N.P.W.T. machine. (SPEECH) But then something else came along called installation. And now, we have three arms, three strong arms to try to get that wound granulated to get it to heal. So we can use all of these things, negative pressure wound therapy, which has the macrostrain and the microstrain, and installation to help us get that wound to granulate to get it towards closure, OK. I'm never using standard negative pressure by itself ever again. My question is, why wouldn't you use installation on everything? If it's on a skin graft, I'm going to use standard care. I get that because you're not going to steal over a top of a skin graft, got it. (DESCRIPTION) Text at bottom of screen, The V A C Ultra Negative Pressure Wound Therapy System with and without instillation is indicated for patients with chronic, acute, traumatic, sub-acute, and dehisced wounds, partial thickness burns, ulcers such as diabetic, pressure and venous insufficiency, flaps and grafts. (SPEECH) But for every other wound, I'm trying to find a reason not to put installation in it. It's like going to the operating room, every 2 to 3 hours, washing that wound out, that's the glory of this device is that we can change negative pressure wound therapy out. (DESCRIPTION) A photo of the VAC Ultra machine in the operating room. (SPEECH) We have installation now. And treat them with repeated washing out of that wound, this is where 3M knocked it out of the park. If we go back and we look at the Gabriel meta-analysis or the Kim economic paper, we see decreased length of stay, decreased number of operations, decrease the time to closure, and for follow up, more wounds closed. (DESCRIPTION) Text, less than 50% Reduction in LOS, 9.88 days vs 21.8 days P=.02, Less than 30% fewer surgical debridements, 1.77 debridements vs 2.69 debridements, P=.008, Ready for closure almost twice as fast, 7.88 days vs 14.36 days, P=.003, Wounds were 2.39 times more likely to close, P=.01. Source: Gabriel et al. Negative-Pressure Wound Therapy With Installation vs Standard of Care in Multiple Wound Types, Systematic Literature Review and Meta-Analysis, Plastic Reconstruction Surgery journal, 2021 Source: Kim, A, Economic model to estimate cost of negative pressure wound therapy with instillation vs control therapies for hospitalized patients in the United States, Germany, and United Kingdom, International Wound Journal 2021. (SPEECH) So in the end, the patient gets out faster, they're closed faster. There's huge cost savings. And as a result of this, the health care burden to society, the health care burden to insurance companies and to the patients themselves. So this is a win all the way around. Everybody wins in this scenario. Welcome to 2022, here we are. (DESCRIPTION) 3M, Veraflow Therapy, 3M Veraflow Therapy with 3M Smart Instill Feature. A photo of a foot receiving negative pressure wound therapy.. An image of a 3M Veraflow machine. (SPEECH) [MUSIC PLAYING] (DESCRIPTION) Text, NOTE, Specific indications, contraindications, warnings, precautions, and safety information exist for these products and therapies. Please consult a clinician and product instructions for use prior to application. Rx only. Copyright 2022 3M. All rights reserved. 3M and the other marks shown are marks and/or registered marks. Unauthorized use prohibited. 3M marks used under license in Canada. All other marks are property of their respective owners. 3M. Science. Applied to Life.
(SPEECH) [MUSIC PLAYING] (DESCRIPTION) Text, 3M Veraflo Therapy, Impetus for Change. Doctor Paul J Kim is a paid consultant for 3M. This video is intended for clinicians. The opinions and testimony in the video are those of the healthcare provider based on their individual experience and research. The opinions and testimony are not indicative of all outcomes and should not be interpreted as a guarantee or warranty for similar results. Individual patient results may vary depending on the circumstances and condition. (SPEECH) There's (DESCRIPTION) Doctor Paul J Kim, Department of Plastic and Orthopedic Surgery, University of Texas Southwestern. (SPEECH) been a seismic change in our health care system here in the United States and globally as well. But this change didn't just happen overnight, it didn't just happen because of COVID. (DESCRIPTION) Electronic signage scrolls COVID safety recommendations outside. (SPEECH) COVID has exposed the fragility of our health care system, (DESCRIPTION) A hallway in a hospital is shown. Sign, COVID 19, access only in hazmat suit. (SPEECH) as well as the complexity of our patients. If you think before COVID, and if you look at the complexity of the patients we were taking care of, they were just getting sicker, and they're getting older. That hasn't changed. For example, if you look across the Medicare population in the United States, there's five-plus comorbidities for any patient that's admitted to the hospital. Now, if you have hypertension, it's not a big deal. But you had hypertension to kidney disease, to diabetes, to renal disease, and so on, then the patient becomes a much more complex. And in that same environment, the health care environment was starting to limit the resources that we had to take care of our patients. If you think early on in the pandemic cycle, a lot of the issues were around supply chain, which we still have some supply chain issues. But now, we're having staffing issues on top of supply chain issues. (DESCRIPTION) A person in a hazmat suit slumps against a wall. (SPEECH) I think we were really at the brink of collapse. And I hate to be dramatic, but it's absolutely true. The pandemic can serve as an impetus of change. Whenever I'm faced with a new patient as a consultation or in my clinic, and we all do this as health care providers, we try to determine their healing potential. We recognize that the wound is simply a sign of the host. (DESCRIPTION) Cardiac monitors in a hospital room with healthcare workers. (SPEECH) And wound healing or wound healing potential allows us some insight on whether a patient can heal or they can't heal. (DESCRIPTION) Healthcare workers in hazmat suits tend to patient. (SPEECH) I often use the equation, the healing potential equation, which I derive by just my observations of patients that I'm faced with. (DESCRIPTION) A blue line is drawn under 1. Blue x's separate bacteria, perfusion, tissue mechanics. (SPEECH) Healing potential equation equals 1 in the numerator, and in the denominator, there's bacteria, there's perfusion, and there's tissue mechanics. We can impact change on bacteria. (DESCRIPTION) A blue line underlines Bacteria, perfusion, and tissue mechanics. (SPEECH) We can impact change on perfusion. And we can address the biomechanics of tissue. But I don't think that's where it ends, I think that's where you start. Those are the low hanging fruit. (DESCRIPTION) A blue line separates Bacteria, perfusion, and Tissue mechanic from the word host in parenthesis. (SPEECH) What drives everything is the host. The host continues to evolve, continues to change, continues to be complex. But on the simplest level, we can count the number of co-morbidities the patient has. (DESCRIPTION) Text, x = unknown. (SPEECH) We need to adapt to the current circumstances. There's always been three drivers of health care, economics, efficiency, and effectiveness. These three E's drive how we deliver health care. We know that health care is expensive. And in some countries, they spend much more than in other countries. For example, the United States leads the globe in health care spending. Yet, if you look at the metrics of success of health care and how it's delivered to a population, we rank last or dead last compared to other developed nations, even though we spend almost double that of other developed nations. (DESCRIPTION) A ventilator pumps. (SPEECH) We have to develop ways to provide more efficient delivery of care. And that's the second E, efficiency. The efficient delivery of care not only reduces waste in health care spending, but targets different biologics, drugs, or devices that can deliver more efficient health care. (DESCRIPTION) Healthcare workers use surgical scissors on a patient. (SPEECH) The last E is effectiveness or efficacy. What that means is we need to challenge our current treatment algorithms, our current uses of device biologics or drugs. And you do that in a systematic way. You do that with good research design. I've watched the evolution and the adoption of negative pressure wound therapy with installation. I've published a lot in this space. And I have had the opportunity to talk to a lot of people over the course of the last 10 years. And at some point during that time period, there's been some holes in the reason why people aren't adopting it. And going back to the three E concepts, economics, efficiency, and effectiveness, there were times when there wasn't enough data to support its efficiency. There were times when there wasn't enough data to support its efficacy. There were times when there wasn't enough data to support its economic argument. Well, that time is gone. (DESCRIPTION) Text, Kim P.J. Lookess S, Bongards C, Griffin L.P. Gabriel A Economic model to estimate cost of negative pressure wound therapy with instillation versus control therapies for hospitalized patients in the United States, Geramany, and United Kingdom, Int Wound J.2021, 1-7. (SPEECH) If you look at the data, clearly, it hits on all three E's, decrease in total cost of care, increase in efficiency as demonstrated by multiple publications in decreasing length of hospitalizations, decreasing the number of OR visits. In effectiveness, if you look at the clinical outcomes of closure coverage, it's clear to me that negative pressure wound therapy with insulation has demonstrated those three things, and there's no more excuses to not use it. (DESCRIPTION) Text, 3M Veraflo therapy, Impetus for Change. (SPEECH) [MUSIC PLAYING] (DESCRIPTION) Text, Note, specific indications, contraindications, warnings, precautions, and safety information exist for these products and therapies. Please consult a clinician and product instructions for use prior to application. R.x. only. Copyright 2022 3M. All rights reserved. 3M and the other marks shown are marks and or registered marks. Unauthorized use prohibited. 3M marks used under license in Canada. All other marks are property of their respective owners. 3M Science, applied to life, trademark.
Learn how to apply the blue foam and hybrid silicone adhesive drape.
Video 8:06 min
A quick reference to resolve common alerts.
Veraflo Therapy has been shown to reduce the number of surgical debridements and shorten length of NPWT.⁶
Look at the recommendation from a group of global multidiciplinary thought leaders for the answer. Use these guidelines to learn about appropriate wound types, wound characteristics, therapy settings and solution recommendations for Veraflo Therapy.
Deepen your clinical expertise with training opportunities and educational resources designed especially for you.
3M webinars and archived events keep you up to date with the latest product guidelines and scientifically supported standards of care.
Providing you with real-world content and thought leadership in one place to provide you with access to some of the best thinking from your peers across the country and around the world.
Center for Healing Solutions is a multi-accredited patient-centered education resource designed to improve patient outcomes through in-person, live and on-demand education on a broad range of topics for a wide-variety of clinical specialties.
Access online courses hosted by leading Key Opinion Leaders (KOLs) - online and on-demand. Increase your knowledge of the latest techniques and training with the wide range of courses available on 3M Health Care Academy. Discover online learning that's right for you, packed with insights from 3M specialists and industry experts.
Viewing on desktop? Register/Login to view all courses
Get the iOS app or the Android app to view all courses on mobile
Discover how negative pressure wound therapy with instillation is easier than ever to help promote healing for complex wounds.
Optimal outcomes start with early treatment and consistent management of traumatic wounds. Together, we can strive to reduce preventable complications, drive toward better outcomes and, ultimately, aspire to restore patients’ lives.
Both Veraflo™ Therapy and Negative pressure wound therapy have been used to aid in reducing the size and depth of stage 3 or 4 pressure injuries.
3M™ V.A.C.® Therapy has been shown to be a successful way to manage wounds for the past 25 years¹⁶. It can be used to reduce hospitalization time and the risk of complications¹⁶,¹⁷, which in turn helps facilitate patient transitions from inpatient to outpatient care settings.
Prevena Incision Management System manages the environment of closed surgical incisions and removes fluid away from surgical incisions via the application of continuous negative pressure.
AbThera Therapy System incorporates functional elements for achieving abdominal protection, access, medial tension, and fluid removal.
Easily initiate V.A.C.® Therapy and Veraflo™ Therapy orders, get prescriptions signed via electronic signature and track order authorization online, in a secure and HIPAA compliant environment.
Welcome to the next step in your healing journey. Use the MyWoundHealing™ Mobile App to help manage your V.A.C.® Therapy. We're here to support you when you need us most. Having a wound can be a challenging and scary experience, but your doctor feels that V.A.C.® Therapy is an appropriate way to manage your wound. This site was developed to help you better understand V.A.C.® Therapy and provide you with best use practices once the therapy is prescribed by your doctor.
Key Features of MyWoundHealing:
Learn more about MyWoundHealing™ App
Download MyWoundHealing™ App
We wrap your patient in support, striving to make this short moment in their recovery journey the least intrusive as possible. We do this, as allowed by their benefit plan, by giving them on-demand access to a team of Virtual Therapy Specialists. This team is extensively trained in high risk patient communication and provides your patient another resource during their NPWT journey.
This way, you can focus on what you need to get the wound healed and we can help them overcome the daily hurdles NPWT patients experience.
In doing so, together we hope to reduce out of pocket expenses for patients and shorten their time on NPWT.
81% of patients use therapy >16 hours after an adherence call.20
Learn more about 3M iOn Progress™ Remote Therapy Monitoring System
Call 1-800-275-4524, x3 for questions and assistance troubleshooting our therapy units.
Call 1-800-275-4524, x3 for questions and assistance troubleshooting our therapy units.
3M is committed to providing customer service, including product reimbursement education and resources, to clinical providers and healthcare facilities that use qualified 3M products.
We are here to help! Get in touch with our customer support team for advice about our products and how to use them.
View our advanced wounds and NPWT portfolios and browse our product catalog.
Find Instructions for Use (IFU) to easily access documents for specific 3M Health Care products.
+3M™ Veraflo™ Therapy with either 3M™ Veraflo™ Cleanse Choice Complete™ Dressing or 3M™ V.A.C. Veraflo Cleanse Choice™ Dressing
References
1.Yao M, Fabbi M, Hayashi H et al. A retrospective cohort study evaluating efficacy in high-risk patients with chronic lower extremity ulcers treated with negative pressure wound therapy. International Wound Journal. 2014;11:483–488
2. September 2014 Survey, N = 240, Surgeons, Podiatrists, WOCNs and PT
3. Posnett J, Gottrup F, Lundgren H, Saal G. The resource impact of wounds on health-care providers in Europe. J Wound Care. 2009;18(4):154-161.1
4. Department of Health (DOH). Comorbidities: A framework of principles for system-wide action. London: DOH, 2014. Accessed March 2019 at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/307143/Comorbidities_framework.pdf
5. Lessing C, Slack P, Hong KZ, Kilpadi D, McNulty A. Negative pressure wound therapy with controlled saline instillation (NPWTi): dressing properties and granulation response in vivo. Wounds. 2011 Oct;23(10):309-319.
6. Gabriel, Allen MD, FACS; Camardo, Mark MS; O’Rorke, Erin BS; Gold, Rebecca BS; Kim, Paul J. DPM, MS, FACFAS Effects of Negative-Pressure Wound Therapy With Instillation versus Standard of Care in Multiple Wound Types: Systematic Literature Review and Meta-Analysis, Plastic and Reconstructive Surgery: January 2021 - Volume 147 - Issue 1S-1 - p 68S-76S doi: 10.1097/PRS.0000000000007614.
7. Camardo, Mark. “Veraflo Meta-Analysis Standardized and Non-Standardized Means.”, 3M Internal Report, San Antonio, Texas, 2020.
8. Collinsworth AW, Griffin LP. The effect of timing of instillation therapy on outcomes and costs for patients receiving negative pressure wound therapy. Wounds. 2022 Nov;34(11):269-275. PMID: 36322918.
9. 3M™ V.A.C.® Ulta Negative Pressure Wound Therapy System Safety Information and 3M™ V.A.C. Veraflo Cleanse Choice™ Dressing System Application Instructions
10. Teot L, Boissiere F, Fluieraru S. Novel foam dressing using negative pressure wound therapy with instillation to remove thick exudate. Int Wound J. 2017; doi: 10.1111/iwj.1217.
11. Kim PJ, Attinger CE, Constantine T, et al. Negative pressure wound therapy with instillation: international consensus guidelines update. Int Wound J. 2020 Feb;17(1):174-186.
12. Brinkert D, Mazen A, Naud M, Maire N, Trial C, Teot L. Negative pressure wound therapy with saline instillation: 131 patient case series. Int Wound J. 2013 Dec;10 Suppl 1:56-60.
13. Bernstein BH, Tam H. Combination of subatmospheric pressure dressing and gravity feed antibiotic instillation in the treatment of post‐surgical diabetic foot wounds: a case series. Wounds 2005;17:37–48.
14. McNulty AK, Nguyen K. What is the benefit of instillation therapy? Int J Low Extrem Wounds 2010;9:68–9.
15. Rycerz AM, Slack P, McNulty AK. Distribution assessment comparing continuous and periodic wound instillation in conjunction with negative pressure wound therapy using an agar‐based model. Int Wound J 2013;10:214–20.
16. Law A L Krebs B. Karnik B. Griffin L. Comparison of Healthcare Costs Associated With Patients Receiving Traditional Negative Pressure Wound Therapies in the Post Acute Setting. Cureus 12(11): e11790. DOI 10.7759/cureus.11790.
17. Page JC, Newsander B, Schwenke DC, Hansen M, Ferguson J. Retrospective analysis of negative pressure wound therapy in open foot wounds with significant soft tissue defects. Adv Skin Wound Care/ 2004;17(7):354-364.
18. Data pulled January 1, 2020-August 31, 2020
19. 3M.iOnHealingOrderstoRelease_Sept2020_InternalReport. 25SEP2020.
20. KCI. National iOn Progress RTM Dashboard. Cutameen/RTM_FINAL_TD4_Tables. [Dec 2016-Oct 2022]