Orlov Aleksei, Ciliberti Marino, Somma Rosa, Gefen Amit
Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Tel Aviv, Israel.
Wound Care Centre (Centro Aziendale di Riparazione Tissutale), Castellammare di Stabia, Italy.
Int Wound J. 2023 Oct 3;21(2). doi: 10.1111/iwj.14426.
We applied a market-leading, single-use negative pressure wound therapy device to a robotic venous leg ulcer system and compared its fluid handling performance with that of standard of care, superabsorbent and foam dressings and compression therapy. For each tested product, we determined a metrics of retained, residual, evaporated and (potential) leaked fluid shares, for three exudate flow regimes representing different possible clinically relevant scenarios. The single-use negative pressure wound therapy system under investigation emerged as the leading treatment option in the aspects of adequate fluid handling and consistent delivery of therapeutic-level wound-bed pressures. The superabsorbent dressing performed reasonably in fluid handling (resulting in some pooling but no leakage), however, it quickly caused excessive wound-bed pressures due to swelling, after less than a day of simulated use. The foam dressing exhibited the poorest fluid handling performance, that is, pooling in the wound-bed as well as occasional leakage, indicating potential inflammation and peri-wound skin maceration risks under real-world clinical use conditions. These laboratory findings highlight the importance of advanced robotic technology as contemporary means to simulate patient and wound behaviours and inform selection of wound care technologies and products, in ways that are impossible to achieve if relying solely on clinical trials and experience.
我们将一种市场领先的一次性负压伤口治疗设备应用于机器人静脉腿部溃疡系统,并将其液体处理性能与护理标准、超吸收性敷料、泡沫敷料及加压疗法的液体处理性能进行比较。对于每种测试产品,我们针对代表不同临床相关可能情况的三种渗出液流动状态,确定了留存、残余、蒸发及(潜在)渗漏液体份额的指标。所研究的一次性负压伤口治疗系统在充分的液体处理及持续提供治疗水平的伤口床压力方面成为领先的治疗选择。超吸收性敷料在液体处理方面表现尚可(导致一些积液但无渗漏),然而,在模拟使用不到一天后,由于肿胀,它很快导致伤口床压力过高。泡沫敷料的液体处理性能最差,即在伤口床积液以及偶尔渗漏,表明在实际临床使用条件下存在潜在的炎症和伤口周围皮肤浸渍风险。这些实验室研究结果凸显了先进机器人技术作为模拟患者和伤口行为以及指导伤口护理技术和产品选择的当代手段的重要性,而仅依靠临床试验和经验是无法做到这些的。