Chen Shao-Zong, Li Jing, Li Xue-Yong, Xu Long-Shun
Department of Plastic Surgery and Burns, Tang-Du Hospital, The Fourth Military Medical University, Xi'an, China.
Asian J Surg. 2005 Jul;28(3):211-7. doi: 10.1016/S1015-9584(09)60346-8.
To study the mechanism through which vacuum-assisted closure (VAC) induces an increase in blood flow and reduces oedema on skin wounds.
Thirty-two Japanese large-ear white rabbits were used. A round full-thickness skin defect (retaining the perichondrium), 2 cm in diameter, was created on each dorsal ear. The wound on the left ear was assigned to the experimental group, and the wound on the right ear to the control group. In the experimental group, the sterile foam dressing was trimmed to the appropriate size and geometry for the given wound and placed into the wound defect. The surface of the wound containing the foam dressing was covered with an adhesive drape to create an airtight seal. Afterwards, negative pressures of -5, -10, -15 and -20 kPa were exerted on the same wound, each lasting for 20 minutes, at intervals of 10 minutes. In the control group, the wound was treated with petrolatum gauze only. At different time points, the microcirculation microscope and image pattern analysis were used to observe the variation in wound microcirculation through a detective window.
It was found that VAC promoted capillary blood flow velocity, increased capillary calibre and blood volume, stimulated endothelial proliferation and angiogenesis, narrowed endothelial spaces, and restored the integrity of the capillary basement membrane.
By increasing capillary calibre and blood volume and by stimulating angiogenesis, VAC could improve blood circulation in wounds. By narrowing endothelial spaces and by restoring the integrity of capillary basement membranes, VAC could decrease the permeability of blood vessels and wound oedema.
研究负压封闭引流（VAC）促使皮肤伤口血流量增加及减轻水肿的机制。
选用32只日本大耳白兔。在每只兔的背部耳郭制造一个直径2 cm的圆形全层皮肤缺损（保留软骨膜）。左耳伤口为实验组，右耳伤口为对照组。实验组将无菌泡沫敷料修剪成适合给定伤口的大小和形状，放入伤口缺损处。覆盖有泡沫敷料的伤口表面用粘性贴膜覆盖以形成气密密封。之后，对同一伤口施加-5、-10、-15和-20 kPa的负压，每次持续20分钟，间隔10分钟。对照组伤口仅用凡士林纱布处理。在不同时间点，使用微循环显微镜和图像模式分析通过检测窗口观察伤口微循环的变化。
发现VAC可促进毛细血管血流速度，增加毛细血管管径和血容量，刺激内皮细胞增殖和血管生成，使内皮间隙变窄，并恢复毛细血管基底膜的完整性。
通过增加毛细血管管径和血容量以及刺激血管生成，VAC可改善伤口血液循环。通过使内皮间隙变窄和恢复毛细血管基底膜的完整性，VAC可降低血管通透性和伤口水肿。
