Depth of penetration of negative pressure wound therapy into underlying tissues

Murphey, Gary C.; Macias, Brandon R.; Hargens, Alan R.

doi:10.1111/j.1524-475x.2008.00448.x

Cited by 18 publications

(8 citation statements)

References 13 publications

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“…At a distance of 0·1 cm from the wound edge, the tissue pressure decreased gradually with increasing suction pressure. These observations are in line with results from a previous study in mice (14). This finding suggests that NPWT induces a hypobaric environment not only in the wound bed but also in the superficial wound edge tissue.…”

Section: Discussionsupporting

confidence: 92%

The influence of different sizes and types of wound fillers on wound contraction and tissue pressure during negative pressure wound therapy

Anesäter

Borgquist

Hedström

et al. 2011

International Wound Journal

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Negative pressure wound therapy (NPWT) contracts the wound and alters the pressure in the tissue of the wound edge, which accelerates wound healing. The aim of this study was to examine the effect of the type (foam or gauze) and size (small or large) of wound filler for NPWT on wound contraction and tissue pressure. Negative pressures between --20 and --160 mmHg were applied to a peripheral porcine wound (n = 8). The pressure in the wound edge tissue was measured at distances of 0·1, 0·5, 1·0 and 2·0 cm from the wound edge and the wound diameter was determined. At 0·1 cm from the wound edge, the tissue pressure decreased when NPWT was applied, whereas at 0·5 cm it increased. Tissue pressure was not affected at 1·0 or 2·0 cm from the wound edge. The tissue pressure, at 0·5 cm from the wound edge, was greater when using a small foam than when using than a large foam. Wound contraction was greater when using a small foam than when using a large foam during NPWT. Gauze resulted in an intermediate wound contraction that was not affected by the size of the gauze filler. The use of a small foam to fill the wound causes considerable wound contraction and may thus be used when maximal mechanical stress and granulation tissue formation are desirable. Gauze or large amounts of foam result in less wound contraction which may be beneficial, for example when NPWT causes pain to the patient.

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Section: Discussionsupporting

confidence: 92%

The influence of different sizes and types of wound fillers on wound contraction and tissue pressure during negative pressure wound therapy

Anesäter

Borgquist

Hedström

et al. 2011

International Wound Journal

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“…Kairinos shows that tissue pressure increases with the amount of suction in NPWT [20]. However, this increased pressure penetrates no more than 1 mm into the tissue [21]. For deeper penetration, the surface area of applied pressure should be increased [22].…”

Section: Discussionmentioning

confidence: 99%

Extended negative pressure wound therapy-assisted dermatotraction for the closure of large open fasciotomy wounds in necrotizing fasciitis patients

et al. 2014

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BackgroundNecrotizing fasciitis (NF) is a rapid progressive infection of the subcutaneous tissue or fascia and may result in large open wounds. The surgical options to cover these wounds are often limited by the patient condition and result in suboptimal functional and cosmetic wound coverage. Dermatotraction can restore the function and appearance of the fasciotomy wound and is less invasive in patients with comorbidities. However, dermatotraction for scarred, stiff NF fasciotomy wounds is often ineffective, resulting in skin necrosis. The authors use extended negative pressure wound therapy (NPWT) as an assist in dermatotraction to close open NF fasciotomy wounds. The authors present the clinical results, followed by a discussion of the clinical basis of extended NPWT-assisted dermatotraction.MethodsA retrospective case series of eight patients with NF who underwent open fasciotomy was approved for the study. After serial wound preparation, dermatotraction was applied in a shoelace manner using elastic vessel loops. Next, the extended NPWT was applied over the wound. The sponge was three times wider than the wound width, and the transparent covering drape almost encircled the anatomical wound area. The negative pressure of the NPWT was set at a continuous 100 mmHg by suction barometer. The clinical outcome was assessed based on wound area reduction after treatment and by the achievement of direct wound closure.ResultsAfter the first set of extended NPWT-assisted dermatotraction procedures, the mean wound area was significantly decreased (658.12 cm2 to 29.37 cm2; p = 0.002), as five out of eight patients achieved direct wound closure. One patient with a chest wall defect underwent latissimus dorsi musculocutaneous flap coverage, with primary closure of the donor site. Two Fournier’s gangrene patients underwent multiple sets of treatment and finally achieved secondary wound closure with skin grafts. The patients were followed up for 18.3 months on average and showed satisfactory results without wound recurrence.ConclusionsExtended NPWT-assisted dermatotraction advances scarred, stiff fasciotomy wound margins synergistically in NF and allows direct closure of the wound without complications. This method can be another good treatment option for the NF patient with large open wounds whose general condition is unsuitable for extensive reconstructive surgery.

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“…The advantages of NPWT are control and removal of wound secretions, reduction of edema and bacterial load, and increased growth of granulation tissue, angiogenesis, localized blood flow, and epithelial migration. [9][10][11][12][13] Early skin reapproximation and promotion of granulation tissue avoid the necessity to use complex reconstructive surgery with skin flap coverage. [9][10][11][12][13] NPWT has been proposed as an alternative to surgery to treat dehiscence and infected sternal wounds following cardiac surgery and traumatic wounds, as an alternative to repeat surgery, and when there is a need for accelerated wound healing, such as in patients with significant comorbidities.…”

Section: Introductionmentioning

confidence: 99%

“…[9][10][11][12][13] Early skin reapproximation and promotion of granulation tissue avoid the necessity to use complex reconstructive surgery with skin flap coverage. [9][10][11][12][13] NPWT has been proposed as an alternative to surgery to treat dehiscence and infected sternal wounds following cardiac surgery and traumatic wounds, as an alternative to repeat surgery, and when there is a need for accelerated wound healing, such as in patients with significant comorbidities. [14][15][16][17] However, little is known regarding the use of NPWT for wound-healing problems following musculoskeletal tumor surgery.…”

Section: Introductionmentioning

confidence: 99%