Dristi LLC, Cincinnati, OH 45243, USA.
Department of Surgery, University of Cincinnati, Cincinnati, OH 45267, USA.
Mil Med. 2021 Jan 25;186(Suppl 1):364-369. doi: 10.1093/milmed/usaa276.
Negative Pressure Wound Therapy (NPWT) is a procedure used for nonhealing wounds. In NPWT, a special sealed dressing of large cell foam (>400 µm) or gauze is connected to a pump. Most commonly, negative pressures between -10 and -125 millimeters of mercury (mm Hg) are used. The mechanism of healing is unknown but maybe attributable to removal of the exudate and bacteria, and the stimulation of tissue repair through microdeformation. Reticulated foams with micron-size open cells, Capillary Suction Devices (CSD; 100 to 5 µm) exert capillary suction between 10 and 70 mm of Hg with a multilayered foam dressing.
Yorkshire pigs received 5 surgical excision wounds, 3 cm2, on each side of the back. The wounds were covered with a NPWT dressing (110 mm Hg negative pressure by a pump), CSD with capillary suctions of 30 mm Hg (CSD-30) and 70 mm Hg (CSD-70), and a conventional gauze dressing. The wounds were measured on day 2, and then every 4-5 days thereafter; the total fluid collected by the various dressing over time.
By post-wound day 20, the wounds treated with CSD-70 and NPWT were 100% closed while the wounds treated with CSD-30 and gauze were 65% and 45%, respectively. This indicated comparable wound closure efficacies for CSD-70 and NPWT. The average total fluid uptake measured in grams dry weight were similar for CSD-70 and NPWT, 36 and 38 g, respectively, while the values were 24 g for CSD-30 and 12 g for gauze. However, the maximum fluid uptake observed at day 2 indicated that CSD-70 and CSD 30, 24 and 14 g, respectively, were superior to NPWT and gauze 12 and 7 g, respectively.
This data indicate comparable wound closure efficacies for CSD-70 and NPWT. It is felt that CSD is an effective, safe, and lower cost alternative to vacuum-assisted NPWT.
负压伤口治疗(NPWT)是一种用于治疗不愈合伤口的程序。在 NPWT 中,特殊的大细胞泡沫(> 400 µm)或纱布密封敷料连接到泵上。最常用的是在-10 到-125 毫米汞柱(mmHg)之间产生负压。愈合机制尚不清楚,但可能归因于清除渗出物和细菌,并通过微变形刺激组织修复。具有微米尺寸开放细胞的网状泡沫,毛细血管抽吸装置(CSD;100 至 5 µm)在多层泡沫敷料上施加 10 至 70 毫米汞柱的毛细血管抽吸。
约克郡猪背部两侧各有 5 个 3 平方厘米的外科切除伤口。伤口用 NPWT 敷料(通过泵产生 110mmHg 的负压)、毛细血管吸力为 30mmHg(CSD-30)和 70mmHg(CSD-70)的 CSD 以及常规纱布敷料覆盖。第 2 天测量伤口,然后此后每 4-5 天测量一次;随着时间的推移,各种敷料收集的总液体量。
到第 20 天伤口后,用 CSD-70 和 NPWT 治疗的伤口 100%闭合,而用 CSD-30 和纱布治疗的伤口分别为 65%和 45%。这表明 CSD-70 和 NPWT 的伤口闭合效果相当。以克干重测量的平均总液体吸收量,CSD-70 和 NPWT 分别为 36 和 38g,而 CSD-30 和纱布分别为 24 和 12g。然而,第 2 天观察到的最大液体吸收量表明,CSD-70 和 CSD-30 分别为 24 和 14g,优于 NPWT 和纱布 12 和 7g。
本数据表明 CSD-70 和 NPWT 的伤口闭合效果相当。人们认为 CSD 是一种有效、安全、成本较低的负压辅助 NPWT 替代方法。