Rasmussen John C, Schmidt Marisa, Morton Janelle E, Mann Samantha, Kieswetter Kristine, Sevick-Muraca Eva M
Center for Molecular Imaging, The Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston, Houston, Texas, USA.
Medical Surgical Business, Solventum, San Antonio, Texas, USA.
Int Wound J. 2025 May;22(5):e70180. doi: 10.1111/iwj.70180.
Closed incisional Negative Pressure Therapy (ciNPT) has demonstrated improved post-surgical healing with reduced oedema and hematoma/seroma formation in patients. The underlying mechanism of action is poorly understood, although evidence indicates that lymphatics play a role. The effects of ciNPT on oedema and lymphatic recovery were assessed following bilateral, surgical undermining of swine mammary tissues. One incision was treated with ciNPT, and the control covered with clear dressing. Near-infrared fluorescence imaging was used to visualise lymphatic activity. Oedema and lymph node size were measured using ultrasound. LYVE-1 and podoplanin were quantified with ELISA. Analysis of lymphatic activity revealed a contralateral effect of ciNPT on control sites. Statistically higher pulsatile rates were observed at both incisions when ciNPT was active, compared with when it was removed. Separate evaluations with dressings off and on showed no differences between treatments. While not significant, lower surgical site oedema, lymph node volume, and incidence/severity of seroma were observed in treated sites along with increased lymphatic vessel markers in lymph draining tissues. Taken together, evidence suggests that ciNPT may influence watersheds outside the treated area. Similar systemic impacts owing to manual lymphatic drainage have previously been reported in healthy individuals and those with cancer-related lymphedema.
闭合切口负压疗法（ciNPT）已证明可改善患者术后愈合情况，减少水肿以及血肿/血清肿的形成。尽管有证据表明淋巴管发挥了作用，但其潜在作用机制仍知之甚少。在对猪乳腺组织进行双侧手术剥离后，评估了ciNPT对水肿和淋巴管恢复的影响。一个切口采用ciNPT治疗，对照组用透明敷料覆盖。使用近红外荧光成像来观察淋巴管活动。用超声测量水肿和淋巴结大小。用酶联免疫吸附测定法对淋巴管内皮透明质酸受体1（LYVE-1）和血小板内皮细胞黏附分子（podoplanin）进行定量分析。对淋巴管活动的分析揭示了ciNPT对对照部位的对侧效应。与移除ciNPT时相比，当ciNPT起作用时，在两个切口处均观察到统计学上更高的搏动率。敷料取下和盖上时的单独评估显示不同治疗之间没有差异。虽然不显著，但在治疗部位观察到手术部位水肿、淋巴结体积以及血清肿的发生率/严重程度较低，同时引流淋巴组织中的淋巴管标志物增加。综上所述，有证据表明ciNPT可能会影响治疗区域以外的分水岭区域。先前在健康个体以及患有癌症相关淋巴水肿的个体中也报道过因手法淋巴引流产生的类似全身影响。
