The Influence of Low and High Pressure Levels during Negative-Pressure Wound Therapy on Wound Contraction and Fluid Evacuation

被引:104
作者
Borgquist, Ola
Ingemansson, Richard
Malmsjo, Malin
机构
[1] Lund Univ, Dept Ophthalmol, Lund, Sweden
[2] Lund Univ, Dept Cardiothorac Surg, Lund, Sweden
[3] Skane Univ Hosp, Lund, Sweden
基金
英国医学研究理事会;
关键词
VACUUM-ASSISTED CLOSURE; METALLOPROTEINASES; EXPRESSION; MARKERS; ULCERS;
D O I
10.1097/PRS.0b013e3181fed52a
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background: Negative-pressure wound therapy promotes healing by drainage of excessive fluid and debris and by mechanical deformation of the wound. The most commonly used negative pressure, -125 mmHg, may cause pain and ischemia, and the pressure often needs to be reduced. The aim of the present study was to examine wound contraction and fluid removal at different levels of negative pressure. Methods: Peripheral wounds were created in 70-kg pigs. The immediate effects of negative-pressure wound therapy (-10 to -175 mmHg) on wound contraction and fluid removal were studied in eight pigs. The long-term effects on wound contraction were studied in eight additional pigs during 72 hours of negative-pressure wound therapy at -75 mmHg. Results: Wound contraction and fluid removal increased gradually with increasing levels of negative pressure until reaching a steady state. Maximum wound contraction was observed at -75 mmHg. When negative-pressure wound therapy was discontinued, after 72 hours of therapy, the wound surface area was smaller than before therapy. Maximum wound fluid removal was observed at -125 mmHg. Conclusions: Negative-pressure wound therapy facilitates drainage of wound fluid and exudates and results in mechanical deformation of the wound edge tissue, which is known to stimulate granulation tissue formation. Maximum wound contraction is achieved already at -75 mmHg, and this may be a suitable pressure for most wounds. In wounds with large volumes of exudate, higher pressure levels may be needed for the initial treatment period. (Plast. Reconstr. Surg. 127: 551, 2011.)
引用
收藏
页码:551 / 559
页数:9
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