To

The Medical Suprintendent,

E.S.I.C. Model Hospital,

Bharat Nagar, Ludhiana.

Subject: Request for purchase of Negative-pressure wound therapysystem.

Sir/ madam,

It is respectfully submitted that:

1. Our department is catering to a multitude of patients with chronic, seeping wounds of various parts of the body. The morbidity and mortality of such chronic wounds is considerable.2. The chronicity of such wounds and their consequent care including dressings and medicines etc is a great financial liability for the corporation.3. Apart from the cost of medical management, the corporation also endures financial losses due to long term absence of such patients from their work and E.S.I.C. has to pay these I.Ps during such absence from their work.

4. Since the last few years, Negative-pressure wound therapy systems have been successfully employed all over the world for the management of such wounds.

5. Negative-pressure wound therapy(NPWT) is a therapeutic technique using a vacuum dressing to promote healing in acute or chronic wounds and enhance healing. 6. The therapy involves the controlled application of sub-atmospheric pressure to the local wound environment, using a sealed wound dressing connected to a vacuum pump.7. The use of this technique in wound management increased dramatically over the 1990s and 2000s and a large number of studies have been published examining NPWT. I am attaching a few of them with this request letter for your study. 8. NPWT appears to be useful fordiabetic ulcers, open abdomen (laparotomy) wounds, venous ulcers, deep burn wounds etc. 9. We have also noticed that we get frequent requests from empanelled hospitals like CMCH for permission to use this technique in our patients admitted there.10. These requests usually mention the cost of such treatment in several thousand rupees and these costs, though seemingly exorbitant, are fully justified because by rapid healing of such wounds, the long term morbidity and mortality is greatly reduced. 11. Hence in the interest of our patients, in a bid to introduce a useful and modern technique of wound management in our hospital and to ensure long term financial gain to the corporation, I wish to request you to kindly direct the medical store to procure two negative-pressure wound therapy systems for our hospital.12. Considering the high volume of such patients in our hospital, I request you to kindly sanction procurement of two such units so that though they would maintained by the department of General Surgery (one each in Male Surgery and Female surgery ward), but they may also be used by orthopaedics or Gynaecology departments on need to need basis.I am attaching the required proforma and the specifications for the needful.

Thanking you,

Date- 23/05/2014.

Yours sincerely,

(Dr. Pushpinder Singh Sandhu)

Specialist & H.O.D.,

Department of General Surgery,

E.S.I.C. Model Hospital,

Bharat Nagar, Ludhiana.

Negative pressure Wound Therapy System

1. Should have sophisticated alarms for safety and troubleshoot, should be portable & light weight not more than 3kg. Convenient to use and can be placed on IV Pole or bedside

2. The System should have night mode facility - to minimize the disturbance to the patient because when the night mode is active then ON-OFF Switch light will be dim and screen will be black.

3. USB and Memory Card Ports for downloading Patient data and Wound Size analysis.

4. Digital wound image feature allows healthcare professionals to measure and calculate wound area and volume, which helps wound progress assessment

5. Therapy History Report: Allow clinician to monitor and track therapy settings , alarm history ,therapy date and time, dressing and canister change records

6. Machine should have intuitive touch screen navigation

7. The system should have digital display screen with screen lock facility for unauthorized handling and should be able to operate on Fingers and Stylus.

8. It should have microprocessor controlled pressure (-25-200mmHg) settings with steps of 25mmHg to efficiently treat entire range of wound etiologies & sizes

9. It should be electrically operated and have atleast 6 hours internal battery backup for enhanced patient freedom

10. The system should operating under 100V to 240V (50/60Hz) Power supply

11. The System should have night mode facility - to minimize the disturbance to the patient because when the night mode is active then ON-OFF Switch light will be dim and screen will be black.

12. The system should be able, to be used on heavily exudating wounds of various sizes and shapes to deal with like trauma wounds, Partial Thickness burns, chronic wounds, diabetic foot, open abdomen, sternal infections etc.

13. It should provide controlled, localized sub-atmospheric pressure in continuous or intermittent mode to help draw wounds closed allowing tissue decompression and enhanced blood flow

14. The following Alarm Facility Should be available :

1. Leak Alarm To detect leakage in Tubing or Dressing

2. Blockage Alarm To detect Blockage in the tubing

3. Canister Full alarm To let the care-giver know the canister is full

4. Canister not engages alarm.

15. It should have dressing system made up of soft open cell reticulated polyurethane foams with pore size 400-600microns.

16. Track Pad Technology which which acts as medium for Negative pressure delivery and a mechanism to provide feedback of the pressure at the wound bed to the Therapy Unit.

17. The foam should come with Drape for sealing the wound with Skin to avoid pressure lead and should come with a Disposable Ruler.

18. The Systems should have an FDA and CE Certifications

19. VAC Therapy system should have following registration and certificates.

1. Registration certificate under the Drugs and Cosmetic Act - India

2. FDA Certificate

3. CE Certificate

4. ISO Certificate

1. Xie, X.; McGregor, M.; Dendukuri, N. (November 2010)."The clinical effectiveness of negative pressure wound therapy: a systematic review".Journal of Wound Care19(11): 4905.PMID21135797.

A 2010systematic reviewfound "consistent evidence of the benefit of NPWT" in the treatment ofdiabetic ulcersof the feet. Results forbedsoreswas "conflicting" and research on "mixed wounds" was of poor quality, but promising. The review did not find evidence of increasedsignificant complications. The review concluded "There is now sufficient evidence to show that NPWT is safe, and will accelerate healing, to justify its use in the treatment of diabetes-associated chronic leg wounds. There is also evidence, though of poor quality, to suggest that healing of other wounds may also be accelerated."