US Army Institute of Surgical Research, Fort Sam Houston, TX 78234, USA.
J Orthop Trauma. 2010 Sep;24(9):598-602. doi: 10.1097/BOT.0b013e3181ec45ba.
The purpose of this study is to determine if negative pressure wound therapy (NPWT) treatment results in fewer bacteria than wet-to-dry (WTD) dressings in a contaminated open fracture wound model.
For Study 1, complex wounds were created on the proximal left leg of goats. The wounds were inoculated with Pseudomonas aeruginosa. The wounds were débrided and irrigated 6 hours after inoculation. The first group received WTD dressing changes twice daily; the second and third groups received NPWT using systems from two different companies. All three groups received repeat débridements every 48 hours for 6 days. Bacteria quantification was performed both immediately before and after each débridement. For Study 2, the only changes were that Staphylococcus aureus was used and only one NPWT group was included.
In Study 1, there were significantly fewer Pseudomonas in both NPWT groups at all imaging sessions after the initial débridement and irrigation. At the 6-day time point, the wounds in the NPWT groups were 43 +/- 14% and 68 +/- 6% of the baseline amount, respectively. The WTD groups were 464 +/- 102% of the baseline amount. In Study 2, NPWT did not reduce the S. aureus contamination within the wound. At the 6-day time point, the wounds in the NPWT and WTD groups contained 115 +/- 19% and 192 +/- 52% of the baseline values, respectively.
NPWT showed a significant and sustained decrease in the Pseudomonas levels compared with WTD dressings at all time points. This beneficial effect was seen not seen in S. aureus.
本研究旨在确定负压伤口治疗(NPWT)与湿性至干性(WTD)敷料相比,在污染的开放性骨折伤口模型中是否能减少细菌。
在研究 1 中,在山羊的左小腿近端创建复杂伤口。将铜绿假单胞菌接种到伤口中。在接种后 6 小时对伤口进行清创和冲洗。第一组每天接受两次 WTD 敷料更换;第二组和第三组分别使用来自两家不同公司的 NPWT 系统。所有三组在 6 天内每隔 48 小时进行重复清创。在每次清创之前和之后立即进行细菌定量。在研究 2 中,唯一的变化是使用金黄色葡萄球菌,并且只包括一个 NPWT 组。
在研究 1 中,在初始清创和冲洗后,所有成像阶段的 NPWT 组中的铜绿假单胞菌数量均明显少于其他两组。在第 6 天时间点,NPWT 组的伤口分别为基线量的 43 +/- 14%和 68 +/- 6%。WTD 组为基线量的 464 +/- 102%。在研究 2 中,NPWT 并未减少伤口内金黄色葡萄球菌的污染。在第 6 天时间点,NPWT 和 WTD 组的伤口分别含有基线值的 115 +/- 19%和 192 +/- 52%。
与 WTD 敷料相比,NPWT 在所有时间点均显示出显著且持续的铜绿假单胞菌水平下降。这种有益的效果在金黄色葡萄球菌中并未看到。