Negative-Pressure Wound Therapy I: The Paradox of Negative-Pressure Wound Therapy
- 1 February 2009
- journal article
- clinical trial
- Published by Ovid Technologies (Wolters Kluwer Health) in Plastic and Reconstructive Surgery
- Vol. 123 (2), 589-598
- https://doi.org/10.1097/prs.0b013e3181956551
Abstract
Does negative-pressure wound therapy reduce or increase the pressure of wound tissues? This seemingly obvious question has never been addressed by a study on living tissues. The aim of this study was to evaluate the nature of tissue pressure changes in relation to negative-pressure wound therapy. Three negative-pressure wound therapy dressing configurations were evaluated-circumferential, noncircumferential, and those within a cavity-on 15 human wounds, with five wounds in each category. Tissue pressure changes were recorded (using a strain gauge sensor) for each 75-mmHg increment in suction, up to -450 mmHg. In the circumferential and noncircumferential groups, tissue pressure was also measured over a 48-hour period at a set suction pressure of -125 mmHg (n = 10). In all three groups, mean tissue pressure increased proportionately to the amount of suction applied (p < 0.0005). Mean tissue pressure increments resulting from the circumferential dressings were significantly higher than those resulting from the noncircumferential (p < 0.0005) or cavity group (p < 0.0005); however, there was no significant difference between the latter two groups (p = 0.269). Over the 48-hour period, there was a significant mean reduction in the (increased) tissue pressure (p < 0.04 for circumferential and p < 0.0005 for noncircumferential), but in only three of 10 cases did this reduce to pressures less than those before dressing application. Negative-pressure wound therapy increases tissue pressure proportionately to the amount of suction, although this becomes less pronounced over 48 hours. This suggests that negative-pressure wound therapy dressings should be used with caution on tissues with compromised perfusion, particularly when they are circumferential.Keywords
This publication has 15 references indexed in Scilit:
- Negative-Pressure Wound Therapy II: Negative-Pressure Wound Therapy and Increased Perfusion. Just an Illusion?Plastic and Reconstructive Surgery, 2009
- Skeletal Muscle Capillarity during Hypoxia: VEGF and Its ActivationHigh Altitude Medicine & Biology, 2008
- Haptotaxis of Endothelial Cell Migration Under FlowPublished by Springer Science and Business Media LLC ,2007
- Effect of vacuum-assisted closure on blood flow in the peristernal thoracic wall after internal mammary artery harvestingEuropean Journal of Cardio-Thoracic Surgery, 2006
- The Effects of Varying Degrees of Pressure Delivered by Negative-Pressure Wound Therapy on Skin PerfusionAnnals of Plastic Surgery, 2005
- New Best Practice Guidelines for Managing Pressure Ulcers With Negative Pressure Wound Therapy PublishedHome Healthcare Now, 2005
- Blood Flow Responses in the Peristernal Thoracic Wall During Vacuum-Assisted Closure TherapyThe Annals of Thoracic Surgery, 2005
- Effects of vacuum‐assisted closure therapy on inguinal wound edge microvascular blood flowWound Repair and Regeneration, 2004
- Vacuum-Assisted Closure: A New Method for Wound Control and TreatmentAnnals of Plastic Surgery, 1997
- Vacuum-Assisted Closure: A New Method for Wound Control and TreatmentAnnals of Plastic Surgery, 1997