Gefen Amit, Russo Serena, Ciliberti Marino
Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Tel Aviv, Israel.
Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
Int Wound J. 2024 Dec;21(12):e70098. doi: 10.1111/iwj.70098.
Negative pressure wound therapy is used often in the management of surgical incisions, chronic wounds and subacute lesions, and there are numerous publications discussing its clinical application and outcomes. However, whilst clinical use and associated literature have expanded since these systems became commercially available in the 90s, important research and discussion around the mode of action have waned, leading to a deficit in the understanding of how this important therapy influences healing. Further, much research and many publications are predominantly reflective, discussing early theorem, some of which have been proven incorrect, or at least not fully resolved leading to misunderstandings as to how the therapy works, thus potentially denying the clinician the opportunity to optimise use towards improved clinical and economic outcomes. In this narrative review, we discuss established beliefs and challenges to same where appropriate and introduce important new research that addresses the manner in which mechanical strain energy (i.e., deformations) is transferred to tissue and how this influences biological response and healing. In addition, we assess and discuss the effect of different negative pressure dressing formats, how they influence the mode of action and how this understanding can lead to more efficient and effective use and clinical economic outcomes.
负压伤口治疗常用于手术切口、慢性伤口和亚急性损伤的处理，并且有大量出版物讨论其临床应用和效果。然而，自这些系统在20世纪90年代上市以来，尽管临床应用和相关文献有所增加，但围绕其作用方式的重要研究和讨论却减少了，导致人们对这种重要治疗方法如何影响愈合的理解存在不足。此外，许多研究和出版物主要是反思性的，讨论早期理论，其中一些已被证明是错误的，或者至少没有得到充分解决，导致对该治疗方法如何起作用产生误解，从而可能使临床医生失去优化使用以改善临床和经济结果的机会。在这篇叙述性综述中，我们将在适当的地方讨论既定的观点和面临的挑战，并介绍重要的新研究，这些研究探讨了机械应变能（即变形）如何传递到组织以及这如何影响生物反应和愈合。此外，我们评估并讨论不同负压敷料形式的效果、它们如何影响作用方式以及这种理解如何能带来更高效和有效的使用以及临床经济结果。
