Prospera - Negative Pressure Wound Therapy

FAQs

What are the indications for Negative Pressure Wound Therapy?
The Prospera PRO Negative Pressure Wound Therapy pumps are indicated for patients who would benefit from a suction device, particularly as the device may promote wound healing.

Is NPWT recommended for use all the way to healing?
NPWT is an interim adjunctive therapy for wounds of significant tissue deficit in which granulation and contraction are necessary for timely progress. Prospera does not promote the use of NPWT until closure. The provider should have a goal of therapy in mind and know when to implement NPWT and when to evaluate and discontinue.

Are there any Contraindications for using the PRO-I or PRO-II?
When used for wound healing, the PRO-I and PRO-II are contraindicated in the presence of:


			Necrotic Tissue

			Unexplored or non-enteric fistulas

			Untreated Osteomyelitis

			Wounds containing malignant tissue

			Exposed arteries, veins, or organs

Precautions should be taken in the presence of:


			Anticoagulation or active bleeding

			Difficult wound hemostasis

			Close proximity of blood vessels, organs, muscle and fascia requiring adequate protection

			Irradiated vessels ands tissue

			Bony fragments

			Untreated malnutrition

			Non-compliance

What is VPT®
In contrast to intermittent therapy which indicates pressure is on and then off, Prospera advocates using a higher pressure of 60-80 mmHg and a lower pressure of 30-40 mmHg. Pressures increase and decrease in small increments creating a 'gentle massage' of the wound tissue. This concept of Variable Pressure Therapy establishes a continuous environment of negative pressure using alternating prescribed pressures. Using variable pressures allows negative pressure wound therapy to draw blood cells to the wound and during the lower pressure cycle allow dispersion of the newly arrived cells without losing the negative pressure environment.

How do I decide whether to use continuous pressure or VPT®
The amount of exudate output should be your guide to Continuous or VPT. Heavily exuding wounds or high output fistulas that collect enough fluid requiring canister changes with each dressing change should be controlled using Continuous NPWT. Routine canister changes are recommended once a week. The decision to use Continuous or VPT is up to the provider. Wounds that 'stall' can show improvement when changed from Continuous to VPT. Any wound can benefit from VPT if the exudate or effluent is controlled. Fistula closure can be promoted with lower VPT settings as the effluent begins to decrease. Recent and ongoing research is focusing on Variable Pressure Therapy at lower settings.

Are there guidelines or recommendations for how to choose appropriate pressure settings?
Yes. For fully detailed information please refer to Drain and Pressure Therapy.

Why do you use antimicrobial gauze as your cover dressing?
NPWT can be beneficial to wounds by controlling and removing exudate which in turn reduces the environment for bacterial growth. Unlike the current guideline, any wound (using moist antimicrobial gauze) with a planned or unplanned interruption in NPWT of over 4 hours does not require a dressing change. The use of AMD gauze, which contains polyhexamethylene biguanide (PHMB), offers a 48 hour microbe controlled environment.

Will I give up efficacy or speed to healing by using simple antimicrobial gauze?
The concept of NPWT was first documented in 1908. Although the concept has been around for 100 years the exact science was not well understood. The contact layer next to the wound has been a subject of great debate. Recent studies with gauze has shown impressive wound healing. Comparative research has not be done to date and it is unforeseen a randomized double blind controlled placebo study will be done. It would be very difficult to blind the products for unbiased use. NPWT research continues to be done emphasizing the concept of NPWT itself and not the contact layer.

If my patient is temporarily off the pump do I have to change the dressing within a given time frame?
No. Moist antimicrobial gauze offers two unique properties: the hydrophilic nature of gauze meaning it has an absorptive property and the antimicrobial protection provided by PHMB. If NPWT was interrupted, these two characteristics would allow the wound to remain in a 'safe' environment as the dressing continues to control exudate and microbes.

How do I choose the appropriate drain?
The versatility of the drains provides clinicians the opportunity to customize their wound dressings. As a rule of thumb; the bigger the wound, the bigger the drain. See Drain and Pressure Therapy.

What kind of safety features do you have on the PRO-I and PRO-II?
Advanced alarms include: open system, closed system, battery low, battery empty, battery hot, battery fault, internal error, restart pump. If alarms sound at night or when the patient is alone the pump can be turned off until a clinician is available to address alarm issue. Our dressing system will provide antimicrobial protection for up to 48 hours depending on volume of exudate.

Is your product reimbursable?
Yes. All Negative Pressure Wound Therapy devices are billed under the same HCPCS code. Our products are reimbursable under most third party payer plans. We also have Medicare HCPCS codes which are available under the reimbursement tab at the top of the page.

How is your pump different from other pumps on the market?
Prospera pumps are lightweight, provide virtually silent operation, fully customizable pressure options(VPT and CPT) and settings and multiple alarms for patient safety.

My patients complain of excruciating pain during dressing changes. Do you have any tips on how to make this process less painful?
Patients have reported to us that our dressing protocol is comfortable both during use and particularly during dressing changes. Moist antimicrobial gauze will not adhere to the wound and will not allow in-growth of the granulation tissue into the cotton fiber weave. Dressings are easier to release and remove from the granulation (or other structure). If adherence of the cotton layer to the wound bed should occur, simply hydrating the gauze will promote its release.

How about pain during use?
Prospera® recommended lower pressure settings provide added patient comfort. Our customizable VPT® settings provide a gentle massage effect at the wound bed. Many patients report not even feeling pressure changes. The fully customizable features of the pump allow clinicians to adjust settings to accommodate differing patient pain thresholds.

Are the PRO-I and PRO-II available in my area?
Prospera PRO-I and PRO-II pumps are available through our national distributor: RecoverCare. We also have several regional distributors who may provide service in your area. Please contact us for specific information.

Can I use the PRO-I and PRO-II devices on fistulas?
Most definitely! The drain variety allows the end-user to select the appropriate drain size for the amount of effluent and debris. Large lumen drains promote easy effluent and debris removal reducing the risk of clogged dressings.