Leung Braden K, LaBarbera Lori A, Carroll Christopher A, Allen Diwi, McNulty Amy K
Kinetic Concepts, Inc, Global Research and Development, San Antonio, Texas; Email:
Wounds. 2010 Jul;22(7):179-87.
Acute and chronic wounds impact the lives of millions of patients. Since its introduction, negative pressure wound therapy using reticulated open cell foam (NPWT/ROCF) has significantly improved the healing outcome for many of these wounds.
The effects of intermittent instillation of normal saline in conjunction with NPWT were investigated to determine if instillation therapy provides additional benefits in wound healing. Conventional NPWT/ROCF as delivered by V.A.C.® Therapy was compared to V.A.C. Instill® Therapy with normal saline in the treatment of porcine full-thickness excisional wounds. Wounds were treated with NPWT/ROCF or NPWT/ROCF with instillation therapy at approximately 4 cycles of normal saline instillation per day and dwell times of either 5 or 60 minutes for the instilled saline on the wound bed.
Instillation therapy with normal saline at either dwell time elicited a faster rate of wound filling with granulation tissue that contained an increase in total collagen content compared to continuous NPWT/ROCF alone. Analyses of wound contraction and the hydration state of the treated tissue exhibited no apparent differences between the experimental instillation therapy groups and the control NPWT/ROCF group.
Collectively, these data suggest that instillation therapy with normal saline may lead to wound fill with higher quality granulation tissue composed of increased collagen following wounding of cutaneous tissue compared to the use of NPWT/ROCF alone. .
急性和慢性伤口影响着数百万患者的生活。自从采用网状开孔泡沫进行负压伤口治疗(NPWT/ROCF)以来,显著改善了许多此类伤口的愈合效果。
研究了间歇性滴注生理盐水联合NPWT的效果,以确定滴注疗法在伤口愈合中是否能提供额外益处。将V.A.C.®疗法提供的传统NPWT/ROCF与采用生理盐水的V.A.C. Instill®疗法在治疗猪全层切除伤口方面进行比较。伤口分别采用NPWT/ROCF或NPWT/ROCF并结合滴注疗法进行治疗,生理盐水每天滴注约4个周期,滴注到伤口床的生理盐水驻留时间分别为5分钟或60分钟。
与单独持续使用NPWT/ROCF相比,两种驻留时间的生理盐水滴注疗法均使伤口更快地被含总胶原蛋白含量增加的肉芽组织填充。对伤口收缩和处理后组织水合状态的分析显示,实验性滴注疗法组与对照NPWT/ROCF组之间无明显差异。
总体而言,这些数据表明,与单独使用NPWT/ROCF相比,皮肤组织受伤后,生理盐水滴注疗法可能使伤口被由增加的胶原蛋白组成的更高质量的肉芽组织填充。