Professor of Biomedical Engineering, The Herbert J Berman Chair in Vascular Bioengineering, Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Israel.
Br J Nurs. 2022 Aug 11;31(15):S8-S12. doi: 10.12968/bjon.2022.31.15.S8.
This article provides an introduction to the theory of, what is termed, the 'influence zone' in the context of negative pressure wound therapy (NPWT). It is a quantitative bioengineering performance measure for NPWT systems, to indicate their effectiveness, namely, how far from the wound bed edges a specific system is able to deliver effective mechano-stimulation into the periwound, and at which intensity. The influence zone therefore provides objective and standardised metrics of one of the fundamental modes of action of NPWT systems: the ability to effectively and optimally deform both the wound and periwound macroscopically and microscopically. Most important is the mechanical deformation of the periwound area to activate cells responsible for tissue repair, particularly (myo)fibroblasts. Notably, the influence zone must extend sufficiently into the periwound to stimulate (myo)fibroblasts in order that they migrate and progress the wound healing process, facilitating the formation of scar tissue, without overstretching the periwound tissues so as not cause or escalate further cell and tissue damage. The inclusion of the influence zone theory within research to investigate the efficacy of NPWT systems facilitates systematic comparisons of commercially available and potentially new systems. This approach has the capacity to guide not only research and development work, but also clinical decision-making. Recently published research found that inducing an effective influence zone first and foremost requires continuous delivery of the intended pressure to the wound bed.
本文介绍了负压伤口治疗（NPWT）中所谓的“影响区”理论。它是 NPWT 系统的一种定量生物工程性能衡量标准，用于指示其有效性，即特定系统能够在多远的距离内从伤口床边缘输送有效的机械刺激到周围组织，并达到何种强度。因此，影响区提供了 NPWT 系统基本作用模式之一的客观和标准化指标：有效且最佳地宏观和微观变形伤口和周围组织的能力。最重要的是，周围组织区域的机械变形可以激活负责组织修复的细胞，特别是（肌）成纤维细胞。值得注意的是，影响区必须足够延伸到周围组织以刺激（肌）成纤维细胞，以便它们迁移并推进伤口愈合过程，促进疤痕组织的形成，而不会过度拉伸周围组织，以免造成或加剧进一步的细胞和组织损伤。在研究中纳入影响区理论，以调查 NPWT 系统的疗效，可以促进对商业上可用的和潜在新系统的系统比较。这种方法不仅有能力指导研究和开发工作，还能指导临床决策。最近发表的研究发现，要首先形成有效的影响区，首要的是要持续向伤口床输送预期的压力。
