Does treatment of split-thickness skin grafts with negative-pressure wound therapy improve tissue markers of wound healing in a porcine experimental model?

Objective: Negative-pressure wound therapy (NPWT) is generally applied as a bolster for split-thickness skin grafts (STSG) after the graft has been secured with sutures or skin staples. In this study, NPWT was applied to secure STSGs without any sutures or staples. Surgical outcomes of using NPWT without sutures was compared with a control group. Methods: Patients with STSGs were divided into two groups: a ‘no suture’ group using only NPWT, and a control group using conventional fixings. In the no suture group, the grafts were covered with meshed wound dressing and ointment. The NPWT foam was placed over the STSG and negative pressure applied. In the control group, grafts were fixed in place using tie-over bolster, securing with fibrin glue, or NPWT after sutures. Results: A total of 30 patients with 35 graft sites participated in the study. The mean rate of graft take in the no suture group was 95.1%, compared with 93.3% in the control group, with no significant difference between them. No graft shearing occurred in the no suture group. Although the difference did not reach statistical significance, mean surgical time in the no suture group (31.5 minutes) tended to be shorter than that in the control group (55.7 minutes). Conclusion: By eliminating sutures, the operation time tended to be shorter, suturing was avoided and suture removal was not required meaning that patients could avoid the pain associated with this procedure. Furthermore, the potential for staple retention and its associated complications was avoided, making this method potentially beneficial for both medical staff and patients.

Download Full-text

Initial Experience Combining Negative Pressure Wound Therapy with Autologous Skin Cell Suspension and Meshed Autografts

Journal of Burn Care & Research ◽

10.1093/jbcr/irab075 ◽

2021 ◽

Author(s):

Bonnie C Carney ◽

Laura S Johnson ◽

Jeffrey W Shupp ◽

Taryn E Travis

Keyword(s):

Wound Healing ◽

Negative Pressure ◽

Chart Review ◽

Negative Pressure Wound Therapy ◽

Retrospective Chart Review ◽

Initial Experience ◽

Wound Therapy ◽

Skin Cell ◽

Definitive Operation ◽

Thickness Skin

Abstract The success of autologous split-thickness skin grafts (STSGs) in the treatment of full thickness burns is often dependent on the dressing used to secure it. Tie-over bolsters have been used traditionally, however, they can be uncomfortable for patients and preclude grafting large areas in one definitive operation. Negative pressure wound therapy (NPWT) is used as an alternative to bolster dressings and may afford additional wound healing benefits. In our center, NPWT has become the dressing of choice for securing STSGs. While the RECELL® system is being used in conjunction with STSGs, it is currently unknown whether autologous skin cell suspensions (ASCS) can be used with NPWT. This report is a retrospective chart review of 9 patients treated in this manner. All wounds were almost completely re-epithelialized within 14 days, and their healing was as expected. Wound healing trajectories are shown. There were no significant complications in these patients. This dressing technique can be considered as an option when using ASCS and widely-meshed STSG.

Download Full-text

Negative pressure wound therapy promotes wound healing by suppressing macrophage inflammation in diabetic ulcers

Regenerative Medicine ◽

10.2217/rme-2020-0050 ◽

2020 ◽

Vol 15 (12) ◽

pp. 2341-2349

Author(s):

Haichen Song ◽

Yu Xu ◽

Wenchuan Chang ◽

Junli Zhuang ◽

Xiaowei Wu

Keyword(s):

Wound Healing ◽

Negative Pressure ◽

Negative Pressure Wound Therapy ◽

Beclin 1 ◽

Wound Therapy ◽

Diabetic Ulcer ◽

Thickness Skin ◽

Tnf Α ◽

Gene And Protein Expression

Aim: This work aims to explore the biological role of negative pressure wound therapy (NPWT) in the treatment of diabetic ulcer. Materials & methods: Full-thickness skin defects were created in diabetic (db/db) and non diabetic (db/m) mice to create wound models. The mice were received NPWT or rapamycin injection. Mouse macrophage cells (Raw264.7) were treated with lipopolysaccharide to induce inflammatory response, and then received negative pressure treatment. We observed the wound healing of mice and examined gene and protein expression and CD68+ macrophage levels. Results: NPWT notably enhanced the wound closure ratio, and inhibited the LC3-II/LC3-I ratio and Beclin-1 expression in diabetes mellitus (DM) mice. NPWT decreased CD68+ macrophage levels in wound tissues of DM mice. The influence conferred by NPWT was abolished by rapamycin treatment. Negative pressure repressed the LC3-II/LC3-I ratio and the expression of Beclin-1, TNF-α, IL-6 and IL-1β in the Raw264.7 cells. Conclusion: NPWT promotes wound healing by suppressing autophagy and macrophage inflammation in DM.

Download Full-text

Cost analysis of negative-pressure wound therapy with instillation for wound bed preparation preceding split-thickness skin grafts for massive (>100 cm 2 ) chronic venous leg ulcers

Journal of Vascular Surgery ◽

10.1016/j.jvs.2014.11.076 ◽

2015 ◽

Vol 61 (4) ◽

pp. 995-999 ◽

Cited By ~ 16

Author(s):

C. Kevin Yang ◽

Sean Alcantara ◽

Selena Goss ◽

John C. Lantis

Keyword(s):

Cost Analysis ◽

Negative Pressure ◽

Negative Pressure Wound Therapy ◽

Leg Ulcers ◽

Skin Grafts ◽

Wound Therapy ◽

Venous Leg Ulcers ◽

Thickness Skin ◽

Wound Bed Preparation

Download Full-text

Experience of negative pressure wound therapy over sternal wound healing: A retrospective review

WCET Journal ◽

10.33235/wcet.39.2.9-18 ◽

2019 ◽

Vol 39 (2) ◽

pp. 9-18

Author(s):

Wai Sze Ho ◽

Wai Kuen Lee ◽

Ka Kay Chan ◽

Choi Ching Fong

Keyword(s):

Wound Healing ◽

Negative Pressure ◽

Negative Pressure Wound Therapy ◽

Assessment Tool ◽

Wound Care ◽

Wound Therapy ◽

Treatment Pathways ◽

Wound Assessment ◽

One Year

Objectives The aim of this study was to retrospectively review the effectiveness of negative pressure wound therapy (NPWT) in sternal wound healing with the use of the validated Bates-Jensen Wound Assessment Tool (BWAT), and explore the role of NPWT over sternal wounds and future treatment pathways. Methods Data was gathered from patients' medical records and the institution's database clinical management system. Seventeen subjects, who had undergone cardiothoracic surgeries and subsequently consulted the wound care team in one year were reviewed. Fourteen of them were included in the analysis. Healing improvement of each sternal wound under continuous NPWT and continuous conventional dressings was studied. In total, 23 continuous NPWT and 13 conventional dressing episodes were analysed with the BWAT. Results Among conventional dressing episodes, sternal wound improvement was 2.5–3% over 10 days to 3.5 weeks, whereas 4–5% sternal healing was achieved in 5 days to 2 weeks with sternal wire presence. Better healing at 11% in 1 week by conventional dressing was attained after sternal wire removal. In NPWT episodes, 8–29%, 13–24%, and 15–46% of healing was observed in 2 weeks, 3.5 to 5 weeks and 6 to 7 weeks, respectively. Only 39% wound healing was acquired at the 13th week of NPWT in one subject. With sternal wire present, 6%–29% wound healing progress was achieved by NPWT in 1–4 weeks, and 16–23% wound improvement in 2 to 4.5 weeks by NWPT after further surgical debridement. After sternal wire removal, 6–34% sternal wound healing occurred by continuous NPWT for 1–2 weeks, and maximum healing at 46% after 2.5 weeks of NPWT were observed. Conclusions Better wound healing was achieved in the NPWT group in comparison to conventional dressings alone. However, suboptimal sternal wound healing by NPWT alone was observed. Removal of sternal wire may improve the effectiveness of NPWT. Successful tertiary closure after NPWT among subjects supports the important bridging role of NPWT in sternal wound healing. Factors causing stagnant sternal wound healing by NPWT alone are discussed.

Download Full-text

The effects and use of negative pressure wound therapy – a set of case reports

Perspectives in Surgery ◽

10.33699/pis.2020.99.4.183-188 ◽

2020 ◽

Vol 99 (4) ◽

pp. 183-188

Keyword(s):

Wound Healing ◽

High Risk ◽

Negative Pressure ◽

Negative Pressure Wound Therapy ◽

Chronic Wounds ◽

Wide Spectrum ◽

Case Reports ◽

Modern Medicine ◽

Wound Therapy ◽

Basic Set

Modern medicine offers a wide spectrum of wound healing resources for acute or chronic wounds. Negative pressure wound therapy (NPWT) is a very effective method, allowing complicated defects and wounds to heal. The basic set is usually provided with various special accessories to facilitate the use and support safe application of NPWT to high-risk tissue. Selected case reports are presented herein to document the special use and combinations of materials in negative pressure wound therapy.

Download Full-text