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采用可控盐水滴注的负压伤口治疗(NPWTi):敷料特性及体内肉芽组织反应

Negative Pressure Wound Therapy With Controlled Saline Instillation (NPWTi): Dressing Properties and Granulation Response In Vivo.

作者信息

Lessing Chris, Slack Paul, Hong K Z, Kilpadi Deepak, McNulty Amy

机构信息

KCI, San Antonio, TX; Email:

KCI, San Antonio, TX.

出版信息

Wounds. 2011 Oct;23(10):309-19.

Abstract

Negative pressure wound therapy (NPWT) with reticulated open-cell foam (ROCF) dressings (ROCF G, V.A.C.® GranuFoamTM Dress- ing, KCI USA, Inc, San Antonio, TX) creates a healing environment that removes wound exudates, reduces edema, and promotes perfusion and granulation tissue formation. Controlled instillation of saline dur- ing NPWT (NPWTi) may further enhance healing by facilitating auto- matic and contained volumetric wound irrigation and cleansing. A new ROCF dressing (ROCF-V, V.A.C. VeraFloTM Dressing, KCI USA, Inc, San Antonio, TX) has been developed for use with NPWTi; benchtop and in vivo tests compared the properties and performance of both ROCF-G and ROCF-V. Pore size and density (contributors to microdeformation) are similar for both ROCF-G and ROCF-V, while mechanical testing demonstrates ROCF-V is stronger than ROCF-G under both tensile and tear loading. ROCF-V surface energy is higher than ROCF-G, making ROCF-V less hydrophobic. Under wet conditions ROCF-V wicks more fluid and shows less pressure drop than ROCF-G, suggesting ROCF-V may be better suited for NPWTi. After 7 days of therapy in a porcine full-thickness excisional wound model, NPWTi with ROCF-V resulted in a 43% increase (P < 0.05) in granulation tissue thickness compared to NPWT with ROCF-G. These data suggest NPWTi with ROCF-V creates a wound healing environment that provides enhanced granulation tissue formation compared to standard NPWT with ROCF-G. .

摘要

使用网状开孔泡沫(ROCF)敷料(ROCF G,V.A.C.® GranuFoamTM敷料,美国KCI公司,得克萨斯州圣安东尼奥)的负压伤口治疗(NPWT)可营造一种促进伤口愈合的环境,该环境能够清除伤口渗出液、减轻水肿,并促进灌注及肉芽组织形成。在NPWT期间(NPWTi)控制性滴注生理盐水,可通过实现自动且定量的伤口冲洗和清洁,进一步促进伤口愈合。一种新型ROCF敷料(ROCF-V,V.A.C. VeraFloTM敷料,美国KCI公司,得克萨斯州圣安东尼奥)已研发出来用于NPWTi;台式试验和体内试验比较了ROCF-G和ROCF-V的特性及性能。ROCF-G和ROCF-V的孔径和密度(微变形的影响因素)相似,而机械测试表明,在拉伸和撕裂载荷下,ROCF-V比ROCF-G更坚固。ROCF-V的表面能高于ROCF-G,这使得ROCF-V的疏水性更低。在潮湿条件下,ROCF-V比ROCF-G能吸收更多液体,且压降更小,这表明ROCF-V可能更适合用于NPWTi。在猪全层切除伤口模型中进行7天治疗后,与使用ROCF-G的NPWT相比,使用ROCF-V的NPWTi使肉芽组织厚度增加了43%(P<0.05)。这些数据表明,与使用ROCF-G的标准NPWT相比,使用ROCF-V的NPWTi可营造一个能促进肉芽组织形成的伤口愈合环境。

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