Boone Deva, Braitman Elissa, Gentics Cynthia, Afthinos John, Latif Jawad, Sordillo Emilia, Todd George, Lantis Ii John C
St. Luke's-Roosevelt Hospital Vascular/Endovascular Surgery; New York, New York; Email:
Wounds. 2010 Feb;22(2):32-7.
Abstract: Negative pressure wound therapy (NPWT) has consistently shown significant clinical benefits in wound healing, but the mechanisms are not fully elucidated. While a reduction in bacterial burden is one possible contributor, studies have shown mixed results in this regard. The present study used a porcine infected wound model to test the effect of NPWT on bacterial burden.
Infected wounds (Pseudomonas aeruginosa, coagulase negative Staphylococcus, and Bacteroides fragilis) in a porcine model were treated with V.A.C.® therapy with the standard GranuFoam™ dressing, V.A.C. therapy with the GranuFoam Silver® dressing, or moist gauze for a period of 7 days with three dressing changes. Quantitative and semiquantitative bacterial cultures, histological samples, and digital photographs were taken at dressing changes.
The wounds continued to show gross and microscopic improvement when treated with standard NPWT and NPWT with silver compared to moist wound care controls. However, the bacterial burden in all wounds continued to increase and broadened to include local skin flora, which had been absent immediately after wounding. These increases in bacteria were not affected by the use of silver dressings.
Negative pressure wound therapy with either standard NPWT foam or silver NPWT foam produced significant improvements in local wound appearance. This occurred despite a persistently high level of bacterial infection; thus, the improvement in healing of these infected wounds cannot be explained by a change in the bacterial burden. .
摘要：负压伤口治疗（NPWT）在伤口愈合方面一直显示出显著的临床益处，但其机制尚未完全阐明。虽然细菌负荷的降低是一个可能的因素，但研究在这方面的结果不一。本研究使用猪感染伤口模型来测试NPWT对细菌负荷的影响。
用标准的GranuFoam™敷料的V.A.C.®疗法、用GranuFoam Silver®敷料的V.A.C.疗法或湿纱布对猪模型中的感染伤口（铜绿假单胞菌、凝固酶阴性葡萄球菌和脆弱拟杆菌）进行治疗，为期7天，更换三次敷料。在更换敷料时进行定量和半定量细菌培养、组织学样本采集及数码拍照。
与湿性伤口护理对照组相比，用标准NPWT和含银NPWT治疗的伤口在肉眼和显微镜下持续改善。然而，所有伤口中的细菌负荷持续增加，并扩大到包括局部皮肤菌群，这些菌群在受伤后即刻并不存在。细菌的这些增加不受使用含银敷料的影响。
使用标准NPWT泡沫或含银NPWT泡沫进行负压伤口治疗可使局部伤口外观显著改善。尽管细菌感染水平持续较高，但仍出现这种情况；因此，这些感染伤口愈合的改善不能用细菌负荷的变化来解释。
