Miller Quintessa, Bird Erin, Bird Kim, Meschter Carol, Moulton Michael J
Department of General Surgery, Keesler Medical Center, Room 1A248, Keesler Air Force Base, 301 Fisher Street, MS 30534, USA.
Curr Surg. 2004 Mar-Apr;61(2):205-8. doi: 10.1016/j.cursur.2003.07.015.
Vacuum-assisted closure (VAC), originally developed as an adjunct to wound care, has gained popularity in managing complex, chronic wounds. This study was designed to compare VAC with traditional saline-wet-to-dry (WD) dressings on acute wound healing in a pig model.
Nine animals were divided into groups of 3. Three rows of 2, 4-cm diameter circular defects were excised on each animal. Vacuum-assisted closure therapy was applied to 2 adjacent wound beds, WD dressings were applied to 2 adjacent wound beds, and ventilated transparent dressing covered the 2 remaining wounds as controls. Random members from each group had their wounds harvested on postoperative days (POD) number 4, 7, and 9, respectively. The specimens were histopathologically evaluated and graded with regard to immature granulation tissue, mature granulation tissue, necropurulent surface crust, proliferating cell nuclear antigen (PCNA), and collagen deposition.
The WD-treated wounds had less necropurulent material on the surface compared with the VAC and control groups (p < 0.05). Day 9 specimens demonstrated increased immature collagen in the VAC and WD groups compared with control. No other statistically significant variations existed between the treatment groups.
Under the conditions of this study, the histopathologic observations do not support more rapid wound healing for the acutely injured VAC-treated wound compared with the WD-treated wound in young healthy pigs.
负压封闭引流（VAC）最初作为伤口护理的辅助手段开发，现已在处理复杂慢性伤口方面得到广泛应用。本研究旨在比较VAC与传统生理盐水湿-干（WD）敷料对猪急性伤口愈合的影响。
将9只动物分成3组，每组3只。在每只动物身上切除三排直径为4厘米的圆形缺损。对相邻的2个伤口床应用负压封闭引流治疗，对另外相邻的2个伤口床应用WD敷料，其余2个伤口用透气透明敷料覆盖作为对照。每组随机选取的动物分别在术后第4、7和9天取伤口样本。对样本进行组织病理学评估，并根据未成熟肉芽组织、成熟肉芽组织、坏死脓性表面痂皮、增殖细胞核抗原（PCNA）和胶原沉积进行分级。
与VAC组和对照组相比，WD处理的伤口表面坏死脓性物质较少（p < 0.05）。与对照组相比，第9天的样本显示VAC组和WD组未成熟胶原增加。各治疗组之间没有其他统计学上的显著差异。
在本研究条件下，组织病理学观察结果不支持在年轻健康猪中，VAC处理的急性损伤伤口比WD处理的伤口愈合更快。
