Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital of Leipzig, 04103 Leipzig, Germany.
Biomed Res Int. 2021 Oct 21;2021:5846724. doi: 10.1155/2021/5846724. eCollection 2021.
Incisional negative wound pressure therapy (iNPWT) is a relatively novel dressing technique with the aim of reducing postoperative wound infections and dehiscence in high-risk wounds after all kinds of surgical procedures. There is a lack of theoretical knowledge about the way those dressing would ameliorate wound healing. One aspect is the reduction of superficial tension, but significant remaining seroma might still cause deep wound infections. The aim of this study was the evaluation of technical modifications of the standard iNPWT dressing to increase seroma evacuation.
iNPWT dressings were applied on the porcine abdominal wall, and an incremental pressure ramp from 50 to 200 mmHg was performed. The resulting wound pressures were measured using (i) balloon manometry and (ii) esophageal manometry catheter. Seroma evacuation was analyzed with a seroma model. All measurements were performed with (i) standard iNPWT dressing, (ii) wound gauze diverted through the incision, and (iii) placement of suction drain tube into iNPWT.
Due to the modifications of the iNPWT dressing, the vacuum applied by the iNPWT dressing could be transferred into the wound and was not only restricted to superficial layers. More importantly, placement of wound gauzes or suction drain tubes led to complete extraction of wound seroma. The placement of the suction drain tube showed the best combination of increased intrawound pressure as well as seroma evacuation.
Addition of a suction drain tube to the iNPWT dressing leads to an improved function of the iNPWT dressing in our model.
切口负压伤口治疗（iNPWT）是一种相对较新的敷料技术，旨在减少各种手术后高风险伤口的术后感染和裂开。关于这些敷料如何改善伤口愈合的理论知识还很缺乏。一方面是减少表面张力，但仍可能存在大量残余血清肿，导致深部伤口感染。本研究旨在评估 iNPWT 敷料的技术改进，以增加血清肿的排出。
iNPWT 敷料应用于猪的腹壁上，并进行从 50mmHg 到 200mmHg 的递增压力斜坡。使用（i）气囊测压和（ii）食管测压导管测量产生的伤口压力。通过血清肿模型分析血清肿排出情况。所有测量均采用（i）标准 iNPWT 敷料、（ii）通过切口转移的伤口纱布和（iii）将引流管放入 iNPWT 中进行。
由于 iNPWT 敷料的改进，iNPWT 敷料施加的负压可以转移到伤口中，而不仅仅局限于浅层。更重要的是，放置伤口纱布或引流管可完全抽出伤口血清肿。放置引流管显示出增加伤口内压力和血清肿排出的最佳组合。
在我们的模型中，将引流管添加到 iNPWT 敷料中可改善 iNPWT 敷料的功能。
