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

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.

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

WCET Journal ◽  
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.

The role of angiopoetic factors in wound healing among patients with diabetes treated with negative-pressure wound therapy

Leczenie Ran ◽  
2015 ◽  
Vol 11 (4) ◽  
pp. 171-178
Author(s):  
Beata Mrozikiewicz-Rakowska ◽  
Joanna Kania ◽  
Ewelina Bucior ◽  
Adriana Nowak ◽  
Tomasz Grzela ◽  
...  
Keyword(s):  
Wound Healing ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Wound Therapy ◽  
Patients With Diabetes

scholarly journals Associating Insulin Instillation with Negative Pressure Wound Therapy Reduces Insulin Resistance in Diabetic Patients with Infected Foot Wounds

2020 ◽  
Vol 7 (3) ◽  
pp. 1-8
Author(s):  
Xin-long Chen
Keyword(s):  
Insulin Resistance ◽  
Wound Healing ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Serum Levels ◽  
Treated Group ◽  
Post Treatment ◽  
Diabetic Patients ◽  
Wound Therapy ◽  
Tnf Α

In this work we investigated whether a joint treatment with insulin instillation and negative pressure wound therapy (NPWT) would reduce insulin resistance (IR) in diabetic patients with infected diabetic foot ulcers (DFUs) and improve their healing. We also studied the effects of insulin+NPWT treatment on the inflammatory response coupled with wound healing. Seventy-five diabetic patients with infected DFUs were recruited and randomly divided into equal (n=25) groups treated respectively with NPWT alone, NPWT+insulin, and conventional dressings (controls). Thereafter, the ulcers’ healing progress was assessed. The serum levels of Tumor Necrosis Factor-α (TNF-α), Interleukin-2 (IL-2), and Interleukin-6 (IL-6) were measured at 1 day before and at 7, 14, and 21 days after each treatment using specific double-antibody sandwich enzyme-linked immunosorbent assays (ELISA). Serum glucose was measured via a glucose-oxidase method, and serum insulin via radioimmunoassay. In each patient, IR was appraised via the Homeostasis Model Assessment (HOMA-IR) and the quantitative insulin sensitivity check index (QUICKI). Our results showed that at 7, 14 and 21 days post-treatment, with respect to the control group the two NPWT-treated groups had (i) significantly (p < 0.05) lower serum levels of TNF-α, IL-2 and IL-6; (ii) a significantly (p < 0.01) greater reduction in IR; and (iii) significantly (p < 0.05) higher wound healing rates. Moreover, at 14- and 21-days post-treatment, the NPWT+insulin-treated group had a significantly (p < 0.05) higher wound healing rate than the NPWT alone-treated group. In conclusion, the combined NPWT+insulin instillation treatment gave superior results by improving wound healing, decreasing inflammation at the wounds surface, and reducing IR in diabetic patients with infected DFUs.

scholarly journals Modification of Breast Pump as a Negative Pressure Wound Therapy for Accelerating Wound Healing of Diabetic Ulcer

Jurnal NERS ◽  
2015 ◽  
Vol 10 (1) ◽  
pp. 104 ◽  
Author(s):  
Yunita Sari ◽  
Iwan Purnawan ◽  
Hartono Hartono
Keyword(s):  
Wound Healing ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Control Group ◽  
Necrotic Tissue ◽  
Wound Therapy ◽  
Diabetic Ulcer ◽  
Pressure Therapy ◽  
Breast Pump ◽  
Experimental Group

Introduction: Negative Pressure Wound Therapy (NPWT) is considered as the best treatment for accelerating wound healing, including diabetic ulcer. However, this device is still not available in Indonesia. Therefore, the purpose of this study were to make NPWT by using modifi cation of breast pump, and to elucidate the effect of this device on acceleration of wound healing in diabetic ulcer. Method: NPWT was made by using digital breast pump. Wounds were divided into two groups; wound-treated by NPWT (experimental group) and wound-untreated by NPWT (control). The negative pressure used for this study was 85 mmHg. Rats were sacrifi ced on day 7, and wound samples and surrounding skin were stained with Hematoxylin and Eosyn. Infl ammation, intensity of necrotic tissue, and wound closure were observed. Result: The device could deliver a negative pressure at a range of 85–140 mmHg. Wound size in the experimental group was smaller than in control group. Infl ammation was also less in the experimental group than control group. Discussion: The modifi cation of breast pump could be used as a negative pressure therapy for wounds, and has effect on reducing infl ammation and necrotic tissue. Further study is needed to elucidate the effect of this device on human subject.Keywords: diabetic wound, breast pump, negative pressure, wound healing

scholarly journals The Role of Portable Incisional Negative Pressure Wound Therapy (piNPWT) in Reducing Local Complications of Post-bariatric Brachioplasty: A Case-Control Study

2021 ◽  
Author(s):  
Federico Facchin ◽  
Andrea Pagani ◽  
Paolo Marchica ◽  
Laura Pandis ◽  
Carlotta Scarpa ◽  
...  
Keyword(s):  
Wound Healing ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Body Contouring ◽  
Full Description ◽  
Wound Therapy ◽  
Level Of Evidence ◽  
Operative Complications ◽  
Post Operative Complications

Abstract Background Due to the great impact of bariatric surgery on the overweight epidemic, the number of post-bariatric body-contouring procedures is constantly increasing worldwide. The portable incisional negative pressure wound therapy (piNPWT) is a promising medical device for accelerating wounds closure and controlling post-operative complication, which have been shown promising results in post-bariatric population. We aimed to evaluate the role of piNPWT in optimizing wound healing and controlling post-operative complications after a post-bariatric brachioplasty. Patients and Methods 26 post-bariatric female patients who underwent a brachioplasty followed by either a piNPWT (14 cases) or a standard wound treatment (12 controls) were analyzed. The number of post-operative dressing changes, the rate of local post-operative complications (re-operation, hematoma and serosa development, dehiscence and necrosis), the time to dry as well as the scar quality and hospitalization length were evaluated. Results None of the patients prematurely stopped treatment with piNPWT due to intolerance. The piNPWT patient group showed a significant lower healing time as well as a significant reduction of the number of post-operative dressing changes and hospital stay. Despite the scarring process was excellent from the functional point of view in the long term, we noticed a higher rate of hyperchromic scarring at 90 days after surgery. Conclusion The piNPWT is a cost-effective and user-friendly medical tool that increase and promote wound healing. We suggest the use of this device in post-bariatric patients who undergo a brachioplasty, especially if there is the need to minimize the number of post-operative dressing changes. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based Medicine ratings, please refer to Table of Contents or the online Instructions to Authors www.springer.com/00266.

scholarly journals Combining Negative Pressure Wound Therapy with Insulin Instillation Reduces Insulin Resistance and Accelerates Healing in Patients with Chronically Infected Wounds

2020 ◽  
Vol 7 (3) ◽  
pp. 1-7
Author(s):  
Xin-long Chen
Keyword(s):  
Insulin Resistance ◽  
Wound Healing ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Interleukin 2 ◽  
Serum Levels ◽  
Model Assessment ◽  
Wound Therapy ◽  
Tnf Α ◽  
Infected Wounds

Aim: This study aimed at evaluating the effects of negative pressure wound therapy (NPWT) combined with insulin instillation on wound healing and insulin resistance (IR) in patients with chronically infected wounds. Methods: Sixty-three patients were recruited and randomly divided into three groups (21 cases each) according to treatments: NPWT only; NPWT+insulin; and controls (conventional dressings). Both NPWT treatments lasted for three weeks. Thereafter, wounds’ healing conditions were assessed. At 1 day before and 7, 14, and 21 days posttreatment Interleukin- 6 (IL-6), Interleukin- 2 (IL-2), and Tumor Necrosis Factor-α (TNF-α) serum levels were assessed via specific double-antibody sandwich enzyme-linked immunosorbent assays; and plasma glucose and insulin were quantified via glucose-oxidase and radioimmunoassay, respectively. IR was appraised via homeostasis model assessment (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI). Results: At 7, 14, and 21 days after treatments onset the two NPWT groups had significantly (P = 0.0001) lower IL-6, IL-2, and TNF-α serum levels and HOMA-IR values than controls while wound healing rates were higher (P < 0.001) than controls. Notably, the NPWT+insulin treatment results were better (P < 0.01) than those of NPWT alone. Conclusion: NPWT+insulin instillation improved wound healing, mitigated inflammation, and reduced IR in patients with chronically infected wounds.

scholarly journals Role of customised negative-pressure wound therapy in the integration of split-thickness skin grafts: A randomised control study

2017 ◽  
Vol 50 (01) ◽  
pp. 043-049 ◽  
Author(s):  
Mir Mohsin ◽  
Haroon Rashid Zargar ◽  
Adil Hafeez Wani ◽  
Mohammad Inam Zaroo ◽  
Peerzada Umar Farooq Baba ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Financial Burden ◽  
Wound Therapy ◽  
Graft Take ◽  
Thickness Skin ◽  
Custom Made ◽  
Split Thickness Skin Grafting ◽  
Control Study

ABSTRACT Background: Split-thickness skin grafting (STSG) is a time-tested technique in wound cover, but many factors lead to suboptimal graft take. Role of custom-made negative-pressure wound therapy (NPWT) is compared with conventional dress in the integration of STSG and its cost is compared with widely used commercially available NPWT. Materials and Methods: This is a parallel group randomised control study. Block randomisation of 100 patients into one of the two groups (NPWT vs. non-NPWT; 50 patients each) was done. Graft take/loss, length of hospital stay post-grafting, need for regrafting and cost of custom-made negative pressure wound therapy (NPWT) dressings as compared to widely used commercially available NPWT were assessed. Results: Mean graft take in the NPWT group was 99.74% ± 0.73% compared to 88.52% ± 9.47% in the non-NPWT group (P = 0.004). None of the patients in the NPWT group required second coverage procedure as opposed to six cases in the non-NPWT group (P = 0.035). All the patients in the NPWT group were discharged within 4–9 days from the day of grafting. No major complication was encountered with the use of custom-made NPWT. Custom-made NPWT dressings were found to be 22 times cheaper than the widely used commercially available NPWT. Conclusions: Custom-made NPWT is a safe, simple and effective technique in the integration of STSG as compared to the conventional dressings. We have been able to reduce the financial burden on the patients as well as the hospital significantly while achieving results at par with other studies which have used commercially available NPWT.

scholarly journals Filling the vacuum: Role of negative pressure wound therapy in open wound management in cats

2021 ◽  
Vol 23 (9) ◽  
pp. 823-833
Author(s):  
Mirja C Nolff
Keyword(s):  
Wound Healing ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Treatment Options ◽  
Evidence Base ◽  
Wound Management ◽  
Current Evidence ◽  
Open Wound ◽  
Wound Therapy

Practical relevance: Open wounds and their treatment present a common challenge in veterinary practice. Approaching 15 years ago negative pressure wound therapy (NPWT) started to be incorporated into clinical veterinary medicine, and its availability is becoming more widespread in Europe and the USA. Use of this therapy has the potential to significantly increase the healing rate of open wounds as well as free skin grafts in small animals, and it has been occasionally described for the management of feline wounds. Aim: This review describes the mechanisms of action of, and indications for, NPWT, and offers recommendations for NPWT specific to feline patients. Evidence base: The information presented is based on the current evidence and the author’s clinical experience of the technique gained over the past 12 years. Comparative studies of different treatment options are lacking and, since wound healing in cats and dogs differs, cat-specific studies are especially needed. Well-designed wound healing studies comparing different advanced techniques will improve open wound healing in cats in the future, and potentially allow better understanding of the role of NPWT in this setting.

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

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.

Sign in / Sign up

Export Citation Format

Share Document