Department of Burn Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.
Department of Burn and Plastic Surgery, Shenzhen Institute of Translational Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, People's Republic of China.
Int Wound J. 2023 Feb;20(2):351-358. doi: 10.1111/iwj.13883. Epub 2022 Jul 19.
Water irrigation is an efficacious decontaminating method for dermis exposures to corrosive agents and hence has been widely applied to treat especially alkali burns. Nevertheless, once alkali has infiltrated the deep subcutaneous tissue, washing the tissue surface with water irrigation does not attenuate the damage progress. Therefore, significant efforts have been devoted to promising strategies aimed at removing the deeply infiltrated lye. According to a recent report, the negative pressure wound therapy (NPWT) reduces the pH value of the exudate from alkali-provoked burns thus accelerating wound healing. However, it remains to be ascertained whether or not NPWT coupled with water irrigation, that is, iNPWT, more effectively hinders the alkali injury deepening. In this study, we compared the effectiveness of an early application of water irrigation with or without NPWT in preventing the progressive deepening of the alkali burn in an animal model. Our histological examination results showed no appreciable difference in tissue injury depth, dermal retention, inflammatory cell infiltration, re-epithelization, and cellular function between iNPWT and water irrigation alone treatments. Thus, our results prove that the more expensive NPWT coupled with water irrigation does not more effectively hinder the alkali's injury deepening. Hence, iNPWT use should be more cautious in clinical practice.
水冲洗是一种有效的去污方法,适用于皮肤暴露于腐蚀性物质的情况,因此已广泛应用于治疗特别是碱性烧伤。然而,一旦碱渗透到深皮下组织,用水冲洗清洗组织表面并不能减轻损伤进展。因此,人们已经做出了巨大的努力,寻找有前途的策略,旨在去除深层渗透的碱。根据最近的一份报告,负压伤口治疗(NPWT)可降低碱性烧伤渗出液的 pH 值,从而加速伤口愈合。然而,NPWT 联合水冲洗,即 iNPWT,是否更有效地阻止碱损伤的加深,仍有待确定。在这项研究中,我们比较了早期应用水冲洗与 NPWT 联合应用在预防动物模型中碱烧伤深度进展方面的效果。我们的组织学检查结果表明,iNPWT 和单独水冲洗治疗在组织损伤深度、真皮保留、炎症细胞浸润、再上皮化和细胞功能方面没有明显差异。因此,我们的结果证明,更昂贵的 NPWT 联合水冲洗并不能更有效地阻止碱的损伤加深。因此,在临床实践中应更谨慎地使用 iNPWT。