Wikipedia says: A Cochrane Review of studies published regarding NPWT stated that there was no evidence that the procedure significantly increased the healing rate of wounds compared to alternative treatment, calling for more and better research to be performed before a final conclusion could be reached.
The "cylinder with accordion-like folds" looks like the business end of the toilet plunger I recently bought, so it's already mass produced and easy to source cheaply.
I hate to naysay an effort that was obviously intended as a righteous humanitarian effort, but is testing these devices in Haiti an ethical action?
We have rigorous rules about testing medical treatments on our own citizens, but it seems that in the time of Haiti's worst crisis, their citizens become our guinea pigs. Maybe she was helping out lots of people down there, but maybe she was getting in the way of real, proven medicine. If so, these Haitians are further suffering so that we can conduct some more medical research? The article certainly doesn't say these devices brought an iota of healing to the people of Haiti, and that's a warning sign too.
Even if this was a good singular decision, it's a slippery slope to send scientists down to disaster sites to test their gizmos.
To be honest, I can barely tell if this is just a troll comment. If you are serious though, perhaps the testing isn't of the "medical" effectiveness which appears to be known but rather its "engineering" effectiveness.
A friend of my dad's developed a low-cost medical device for use in Africa. It worked, but not as well as expensive devices, and it wasn't taken up.
There's a lot of bureaucracy that stands in the way of getting affordable (but less advanced) medical equipment onto the field.
On the other hand, if you want to field test an expensive device in a third world country, you can lobby the right people and splash a few bribes around. The Constant Gardener (fictional, yes, but I doubt it's far from the truth) is about this. Cheap devices aren't worth the effort.
This is a cheaper way to apply a known-effective wound treatment -- not a speculative implant or drug that's hard to monitor. The participation means more professional attention to those treated. The alternative is not expensive state-of-the-art suction dressing, but cruder care and less attention.
To apply the expensive risk-averse rules of a rich country to a poor country would be more unethical.
From the article it sounds like better devices are available, it's just that they cost a lot of money ($100/day rental, it says) and need electricity to run. For this reason it might never be considered ethical to test it in a richer country where those expensive devices are available. For a poorer country where the expensive alternative is not an option things may be different though.
It seems that in the underlying concepts that show that this device can work are already well known. That is, it is known that vacuum suction helps wounds and there are already existing approved devices that already do that.
So the only think she was testing is whether the rather simple mechanics of that particular device will work as expected.
So it does not seem to be something especially dangerous.
How do you test this? Healing rates are hugely dependant on quirks of the patient... So you can't really have a control group not using the apartus... Do you inflict a second, identical wound to the individual to compare which heals faster?
Natural experiment. You take a whole bunch of people who have naturally received wounds, classify them as best you can by severity of wound, some people get suction, some people merely get bandages, and keep track of how long it takes people to heal. With enough people in the study (probably not all that many if the effect is as large as the article makes it out to be) any difference in individual healing time or minor problems in the mischaracterization of wounds will average out. Problems like this are exactly why statistical tests take into account things like standard deviation.
I've seen a study where they've caused minor wounds by puncturing the skin of a finger, so I guess its possible here, you can get people to volunteer for all sorts of things.
Specific study was a psychology one though,not a medical one,but it was to test how long wounds took to heal (independent variable being the happiness of patients or similar).
What is the science behind vacuum suction healing? Does anyone have information on why this works? I see the theory from the article, but I would love to know more about this.
as far as I know, it's not particularly clear yet (surprising, since Negative Pressure Wound Therapy - NPWT - has been around for ages. The USSR had some guys working on it, inc. Bagoutdinov). Possibly, it's just vacuuming up nasty crap, keeping the wound moist but not covered in pus. alternatively, it's directing the growth inwards. lastly, it might be creating conditions unfavourable to bacterial colonisation (low pressure, low oxygen, etc)
I was reading up about a patent dispute involving precisely this type of device (connected to an active pump, not this accordion) and the innovation there was a big of sponge placed in the wound (and then the lot is wrapped in clingfilm). The pressure it applies - evenly - also seems to help wound healing, especially by preventing overgrowth, and keeping the clingfilm off the wound itself.
Just something to note if you want to try this at home.
Is NPWT similar to 拔火罐 in China? It also creates a near vacuum negative pressure using hot air. It's been practiced for thousands of years. And it also costs about 3 dollars, in RMB.
I think it differs in that fire cupping is not traditionally done over an existing open wound but rather specific locations on the body (neck, back). It might be a cheap way to do NWPT, but it would be hard to apply to uneven or bony areas like joints or hands/feet.
it's a main tool in traditional chinese medecine. I am not sure if there were any western scientific studies to understand cupping/suction as done by chinese, but it's been "field-tested" for thousands of years
Why just Haiti - sell these in drugstores in the USA too (except in the USA I am sure the markup will be crazy under the guise to pay for R&D)
Some of us can't afford insurance (and still won't in a few years, the fine is much cheaper) so DIY for $3 sounds great if I needed one instead of a doctor/hospital visit.
I know that there are similar devices coming on the market in USA soon. The devices are in FDA trials now, which can take a few years.
Also, I should point out that here in the USA you still should go to a doctor for your wounds and not try to DIY a bandage. Even these NPWT treatments described in the article need someone who knows what they're doing to apply and change the dressings. Remember that you are more likely to die from the infection than the wound itself!
This is brilliant! I love simple and cheap things that can save your life. Unfortunately the pharmaceutical "mafia" don't have interest in investing in simple and cheap medicine. So will go on taking expensive medicine that don't work anyway.
