Kalypto Medical NPD 1000

From the Kalyto perpective, NPWT technology starts with the dressing. The revolutionary Kalypto 8 oz. pump technology is made possible by their proprietary dressing. This dressing begins with an FDA approved wound contact layer made of Silverlon, a minimally adherent, "plated" medical nylon material infused with silver (Ag) ions that have an bactericidal effect. The next layer includes a two-fiber, non-woven exudate collection pad made up of a hydrophilic, water attracting fiber that wicks fluids into a super absorbent, molecularly bonding inner pad. The pad swells as fluid is absorbed and will not occlude within the capacity of the dressing. Periwound masceration is not an issue because the pad is protected by a hydrophobic (water resistant) Gore membrane, similar to that found in vascular grafts and dialysis filters, which secures the trapped fluid and bacteria infused exudate securely within the dressing. The collection pad is laminated to a non-woven, semi-occlusive polyurethane film for strength and conformability. The Kalypto system is completed by a hydrogel gasket surrounding the periphery of the wound, which flows into the ridges of the healthy skin, preventing any adhesive leaks that might compromise the suction of the pump.

Three windows contained within the exterior bandage monitor the exudate traveling to the pressure port connecting the wound dressing to the suction pump via a proprietary "quick connect pigtail" and tubing. This design allows for application of compression wraps, offloading, and other therapeutic interventions, as determined by the clinican. This truly portable, 8 oz pump operates on three AA alkaline batteries, offering pressure settings between 40-125mmHg with continuous and intermittent pressure modes. No exudate travels through the tubing, which eliminates the need for canister storage and inherent disposal issues. Initial dressing application and subsequent changes require less than five minutes time to complete, with bacteria safely and hygenically contained within the interior dressing.

MANAGING EXUDATE
Choice of dressing to manage exudate is important. A number of properties can be considered in dressing choice such as the desired moisture balance and the dressing’s ability to assist healing or prevent wound deterioration. While many dressings will absorb exudate or manage exudate through evaporation, other considerations for dressing characteristics include:
Retention: Dressings that form a cohesive gel tend to maintain their structure during use and may reduce the risk of periwound maceration, by preventing fluid from tracking through the dressing.
Sequestration: The ability, demonstrated in vitro, of some dressings' to trap bacteria and components of exudate within the dressing.

INFECTION CONTROL
All wounds, even postoperative wounds, are colonized by a variety of aerobic and anaerobic bacteria. However, the presence of bacteria in a wound is not inherently harmful – infection only occurs when the bioburden exceeds the level manageable by the host. Wound bioburden refers to the presence of bacteria in the wound competing for a limited supply of oxygen and nutrients, which creates a burden on the wound-healing process. Bioburden is more than just a quantitative assessment of the number of bacteria present in the wound; diversity, virulence, and interaction of organisms are also key factors of the negative impact of micro-organisms on the wound. Toxins released from certain bacteria, such as Pseudomonas aeruginosa, are known to affect progression toward healing.

When should NPWT be discontinued?

When the treatment goal is met, NPWT should be stopped. It has been recommended that a 50% improvement in wound size over four weeks is a good indication that the therapy is working and that the wound will heal. In addition, careful attention should be paid to the development of worsening infection, necrotic tissue, and uncontrolled bleeding with the use of NPWT. In some cases, NPWT can be used until wound closure, although in most cases, it is used until the wound is filled with good granulation tissue and ready for standard wound therapy, skin graft, or flap.

For more information on Kalypto Medical Devices, visit www.kalyptomedical.com.