University Center for Orthopedics, Trauma and Plastic Surgery, Faculty of Medicine Carl Gustav Carus, TU Dresden, Fetscherstraße 74, 01307 Dresden, Germany.
University Center for Orthopedics, Trauma and Plastic Surgery, Faculty of Medicine Carl Gustav Carus, TU Dresden, Fetscherstraße 74, 01307 Dresden, Germany.
Microvasc Res. 2022 Mar;140:104301. doi: 10.1016/j.mvr.2021.104301. Epub 2021 Dec 28.
Topical negative pressure wound therapy (TNPWT) is a regularly used method in modern wound treatment with a growing and diverse potential for clinical use. So far positive effects on microcirculation have been observed and examined, although precise statements on the underlying mechanism appear unsatisfying.
The aim of our study was to extend the understanding of the effect of TNPWT on tissue perfusion and determine the time frame and the extent to which the tissue perfusion changes due to TNPWT.
TNPWT was applied to the anterior thighs of 40 healthy individuals for 30 min, respectively. Before and up to 90 min after the application, measurements of the amount of regional haemoglobin (rHb), capillary venous oxygen saturation (sO2), blood flow (flow) and velocity were conducted with spectrophotometry (combining white light spectrometry and laser Doppler spectroscopy) within two different depths/skin layers. A superficial measuring probe for depths up to 3 mm and a deep measuring probe for up to 7 mm were used.
All parameters show significant changes after the intervention compared to baseline measurements. The greater effect was seen superficially. The superficially measured rHb, sO2 and flow showed a significant increase and stayed above the baseline at the end of the protocol. Whereas deeply measured, the rHb initially showed a decrease. The flow and sO2 showed a significant increase up to 60 min after the intervention.
The application of TNPWT on healthy tissue shows an increase in capillary-venous oxygen saturation and haemoglobin concentration of at least 90 min after intervention. A possible use in clinical practice for preconditioning to enhance wound healing for high-risk patients to develop wound healing disorder, requires further studies to investigate the actual duration of the effect.
局部负压伤口治疗（TNPWT）是现代伤口治疗中常用的方法，其临床应用潜力不断增加且多样化。尽管已经观察到并研究了其对微循环的积极影响，但对于其潜在机制的准确描述似乎并不令人满意。
本研究旨在进一步了解 TNPWT 对组织灌注的影响，并确定 TNPWT 导致组织灌注变化的时间范围和程度。
将 TNPWT 应用于 40 名健康个体的前大腿，分别应用 30 分钟。在应用前和应用后长达 90 分钟，使用分光光度法（结合白光光谱法和激光多普勒光谱法）在两个不同的深度/皮肤层内进行局部血红蛋白（rHb）、毛细血管静脉血氧饱和度（sO2）、血流（flow）和速度的测量。使用一个浅层测量探头（最大深度 3 毫米）和一个深层测量探头（最大深度 7 毫米）。
与基线测量相比，所有参数在干预后均显示出显著变化。浅层测量的影响更大。浅层测量的 rHb、sO2 和 flow 显示出显著增加，并在方案结束时保持在基线以上。而深层测量的 rHb 最初显示出下降。flow 和 sO2 在干预后 60 分钟内显示出显著增加。
TNPWT 在健康组织上的应用可使毛细血管静脉血氧饱和度和血红蛋白浓度至少在干预后 90 分钟内增加。为了预防高危患者发生伤口愈合障碍，在临床实践中可能需要进一步研究来调查实际效果的持续时间。
