Singh Dylan, Livingstone John P, Lautze Jacob, Murray Patrick C
Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, USA.
Orthopedic Surgery, Queen's Medical Center, Honolulu, USA.
Cureus. 2021 Sep 4;13(9):e17720. doi: 10.7759/cureus.17720. eCollection 2021 Sep.
Background Negative pressure wound therapy (NPWT) has been shown to promote the healing of acute and chronic wounds. In our previous study, we demonstrated that a near-circumferential NPWT dressing provided "lift-off" on an in-vitro extremity model resulting in decreased pressure. We hypothesized that this decrease in pressure may increase perfusion distal to the NPWT dressing by increasing lymphatic drainage and venous flow. Methods In this study, we tested if a near-circumferential NPWT dressing caused any appreciable skin movement around the dressing. We then used a thermal imaging camera to test if there was an increase in perfusion to the foot when a near-circumferential NPWT dressing was placed around the lower leg and tested at various negative pressures. Finally, we wanted to see if an artificial "lift-off" mechanism would lead to an increase in perfusion. Results The skin was noted to stretch between the short ends of the NPWT dressing, consistent with our previously described "lift-off" mechanism. However, there was no correlation between negative pressure and perfusion to the foot in the other experiments. Conclusion This study demonstrated that a near-circumferential NPWT dressing may not have any appreciable effects on perfusion when applied on a healthy patient, however, future studies are needed to determine if similar results would be seen on a traumatized or otherwise compromised extremity.
背景 负压伤口治疗(NPWT)已被证明可促进急慢性伤口的愈合。在我们之前的研究中,我们证明了一种近乎环形的NPWT敷料在体外肢体模型上产生了“掀起”效果,从而降低了压力。我们推测这种压力降低可能通过增加淋巴引流和静脉血流来增加NPWT敷料远端的灌注。方法 在本研究中,我们测试了近乎环形的NPWT敷料是否会在敷料周围引起任何明显的皮肤移动。然后,我们使用热成像相机测试当在小腿周围放置近乎环形的NPWT敷料并在不同负压下进行测试时,足部的灌注是否增加。最后,我们想看看人工“掀起”机制是否会导致灌注增加。结果 注意到皮肤在NPWT敷料的短端之间伸展,这与我们之前描述的“掀起”机制一致。然而,在其他实验中,负压与足部灌注之间没有相关性。结论 本研究表明,近乎环形的NPWT敷料应用于健康患者时可能对灌注没有任何明显影响,然而,需要进一步研究以确定在受伤或其他受损肢体上是否会出现类似结果。