McNulty Amy, Spranger Ian, Courage James, Green Jeff, Wilkes Robert, Rycerz Anthony
Kinetic Concepts, Inc. San Antonio, Texas; Email;
Wounds. 2010 May;22(5):114-20.
Negative pressure wound therapy (NPWT) is used to manage wounds and promote wound healing. The most common form of NPWT utilizes reticulated, open cell foam (ROCF). Pressure is transferred to the wound by ROCF using T.R.A.C.™ Technology (regulated pressure feedback [RPF]) creating an environment that promotes healing. This study examines the effectiveness of ROCF versus gauze in inducing macrostrain and investigates the ability of NPWT/ROCF/RPF to consistently deliver negative pressure to the wound, compensating for constantly changing wound fluid characteristics. In an in-vitro model, ROCF induced significantly greater macrostrain than gauze demonstrating a 57% decrease in dressing surface area following negative pressure application. The decrease measured with gauze under suction (GUS) was insignificant. The NPWT/ROCF/RPF system consistently delivered negative pressure to the wound when compared to GUS or ROCF without RPF. Further, with the negative pressure source elevated 36 in (90 cm) above surrogate wounds, GUS demonstrated a 7- to 10-fold pressure drop when compared to NPWT/ROCF/RPF. Systems without RPF are limited because they cannot sense or measure pressure delivered at the wound. In situations where pressure drop occurs, neither the clinician nor patient would necessarily know that suboptimal pressure was being delivered to the wound. Therefore, a system with ROCF and RPF capability that effectively monitors and maintains the NPWT environment plays a crucial role in the optimal induction of macrostrain and microstrain. The ability of the NPWT/ROCF/RPF system to monitor and maintain controlled, consistent delivery of negative pressure would seem important to achieve desired clinical outcomes.
负压伤口治疗(NPWT)用于处理伤口并促进伤口愈合。NPWT最常见的形式是使用网状开孔泡沫(ROCF)。ROCF利用T.R.A.C.™技术(调节压力反馈[RPF])将压力传递至伤口,从而营造促进愈合的环境。本研究考察了ROCF与纱布在引发宏观应变方面的有效性,并探究了NPWT/ROCF/RPF持续向伤口输送负压以补偿不断变化的伤口液体特性的能力。在体外模型中,ROCF引发的宏观应变显著大于纱布,负压施加后敷料表面积减少了57%。而在负压吸引下使用纱布(GUS)时的减少量不显著。与GUS或无RPF的ROCF相比,NPWT/ROCF/RPF系统持续向伤口输送负压。此外,当负压源高于替代伤口36英寸(90厘米)时,与NPWT/ROCF/RPF相比,GUS的压力下降了7至10倍。没有RPF的系统存在局限性,因为它们无法感知或测量伤口处施加的压力。在出现压力下降的情况下,临床医生和患者不一定都知道伤口所接受的压力未达最佳。因此,具有ROCF和RPF功能且能有效监测和维持NPWT环境的系统,在最佳诱导宏观应变和微观应变方面起着关键作用。NPWT/ROCF/RPF系统监测并维持可控、一致的负压输送的能力,对于实现理想的临床效果似乎很重要。