scholarly journals Effects of limited access dressing in chronic wounds: A biochemical and histological study

2015 ◽  
Vol 48 (01) ◽  
pp. 022-028 ◽  
Author(s):  
Thittamaranahalli Muguregowda Honnegowda ◽  
Pramod Kumar ◽  
Padmanabha Udupa E G ◽  
Anurag Sharan ◽  
Rekha Singh ◽  
...  
Keyword(s):  
Wound Healing ◽  
Negative Pressure ◽  
Total Protein ◽  
Inflammatory Infiltrate ◽  
Chronic Wounds ◽  
Histological Study ◽  
Inflammatory Cells ◽  
Collagen Deposition ◽  
Pressure Therapy ◽  
Limited Access

ABSTRACT Background: Negative pressure wound therapy has emerged as an attractive treatment modality for the management and healing of chronic ulcers. Though numerous clinical studies are available, there is a lack of biochemical and histological studies evaluating the healing of chronic wounds. Materials and Methods: In the present study, a total 60 patients were divided into two groups: Limited access dressing (LAD) group (n = 30) and conventional dressing group (n = 30). Various biochemical parameters such as hydroxyproline, total protein and antioxidants such as reduced glutathione (GSH), glutathione peroxidase (GPx), catalase (CAT) and oxidative biomarker malondialdhyde (MDA) are measured in the granulation tissue. Histologically amount of inflammatory infiltrate, angiogenesis, and collagen deposition are studied to assess wound healing. Results: Patients treated with LAD have shown significant increase in the mean (±standard deviation) hydroxyproline (77.3 ± 30.1 vs. 32.3 ± 16.18; P = 0.026), total protein (13.89 ± 9.0 vs. 8.9 ± 4.59; P = 0.004), GSH (7.4 ± 1.91 vs. 5.1 ± 1.28; P = 0.039), GPx (122.3 ± 59.3 vs. 88.7 ± 34.11; P = 0.030), CAT (1.80 ± 1.14 vs. 0.9 ± 0.71; P = 0.002) and decrease in MDA (13.4 ± 5.5 vs. 8.6 ± 3.8; P = 0.004). Histological study showed comparatively fewer inflammatory cells, increased and well organised collagen bundles, and more angiogenesis in the LAD group when compared with that with conventional dressing after 10 days of treatment. Conclusion: In the present study, we have found beneficial effect of newer intermittent negative pressure therapy in combination with moist environment (LAD) on chronic wound healing by increasing collagen deposition and angiogenesis; and reducing oxidative stress and inflammatory infiltrate.

scholarly journals Exploiting potency of negative pressure in wound dressing using limited access dressing and suction-assisted dressing

2012 ◽  
Vol 45 (02) ◽  
pp. 302-315 ◽  
Author(s):  
Pramod Kumar
Keyword(s):  
Wound Healing ◽  
Negative Pressure ◽  
Wound Dressing ◽  
Chronic Wounds ◽  
Bacterial Invasion ◽  
Limited Access ◽  
Advantages And Disadvantages ◽  
Superficial Skin ◽  
Excellent Research ◽  
Pressure Dressing

ABSTRACTRole of negative pressure dressing and moist wound healing are well established in the treatment of both acute and chronic wounds with certain advantages and disadvantages in both the techniques. Both these techniques prevents wound colonization, but the negative pressure dressing method has proved to have a greater potency to remove secretions, prevent wound invasion and eradication established infection. In both these techniques there is no accessibility to wound environment. Limited access dressing (LAD) is a moist wound dressing with negative pressure. It provides limited access to the wound through two small ports for both dressers and pathogens. The LAD design has notable advantages like wound isolation that reduces chance of wound colonization and safe disposal of infected materials (important factor to reduce hospital-acquired infections), while avoiding some major disadvantages such as opacity of dressing materials, inaccessible offensive smelling wound environment, and relatively high treatment costs. In LAD a definite intermittent negative pressure regimen is followed. The intermittent negative pressure (cycle of 30 minutes suction and 3 1 / 2 hours rest) is effective. Overall, the LAD is a safe and effective alternative to conventional dressing methods. LAD is an excellent research tool for wound healing as frequent/continuous record of wound healing is possible without disturbing the wound healing process. LAD is an effective dressing for limb salvage in cases of acute and chronic complex wounds. Leech effect prevents wound related systematic response syndrome and sepsis. Suction-assisted dressing (SAD) is a combination of semiocclusive dressing with negative pressure. It works by removal of fluids by intermittent (like LAD) negative pressure and preventing bacterial invasion. SAD is especially advantageous where soakage is less, there is no dead tissue covering the wound (e.g., following skin grafting), superficial skin wounds (e.g., donor area) and also where LAD is technically difficult to apply over circumferential trunk and neck dressings under anesthesia.

scholarly journals Histopathological study of chronic wounds modulated by intermittent negative pressure therapy under limited access dressing

2015 ◽  
Vol 2 (5) ◽  
pp. 272
Author(s):  
ThittamaranahalliHonnegowda Muguregowda ◽  
Pramod Kumar ◽  
Rekha Singh ◽  
Swarna Shivakumar ◽  
Pragna Rao ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Chronic Wounds ◽  
Histopathological Study ◽  
Negative Pressure Therapy ◽  
Pressure Therapy ◽  
Limited Access

scholarly journals Microplasma Treatment versus Negative Pressure Therapy for Promoting Wound Healing in Diabetic Mice

2021 ◽  
Vol 22 (19) ◽  
pp. 10266
Author(s):  
Pei-Lin Shao ◽  
Jiunn-Der Liao ◽  
Shun-Cheng Wu ◽  
Yu-Hsing Chen ◽  
Tak-Wah Wong
Keyword(s):  
Wound Healing ◽  
Negative Pressure ◽  
Chronic Wounds ◽  
Transforming Growth Factor ◽  
Treatment Time ◽  
Proliferation Index ◽  
Diabetic Mice ◽  
Pressure Therapy ◽  
Wound Area ◽  
Diabetic Wounds

The delayed healing response of diabetic wounds is a major challenge for treatment. Negative pressure wound therapy (NPWT) has been widely used to treat chronic wounds. However, it usually requires a long treatment time and results in directional growth of wound healing skin tissue. We investigated whether nonthermal microplasma (MP) treatment can promote the healing of skin wounds in diabetic mice. Splint excision wounds were created on diabetic mice, and various wound healing parameters were compared among MP treatment, NPWT, and control groups. Quantitative analysis of the re-epithelialization percentage by detecting Ki67 and DSG1 expression in the extending epidermal tongue (EET) of the wound area and the epidermal proliferation index (EPI) was subsequently performed. Both treatments promoted wound healing by enhancing wound closure kinetics and wound bed blood flow; this was confirmed through histological analysis and optical coherence tomography. Both treatments also increased Ki67 and DSG1 expression in the EET of the wound area and the EPI to enhance re-epithelialization. Increased Smad2/3/4 mRNA expression was observed in the epidermis layer of wounds, particularly after MP treatment. The results suggest that the Smad-dependent transforming growth factor β signaling contributes to the enhancement of re-epithelialization after MP treatment with an appropriate exposure time. Overall, a short-term MP treatment (applied for 30 s twice a day) demonstrated comparable or better efficacy to conventional NPWT (applied for 4 h once a day) in promoting wound healing in diabetic mice. Thus, MP treatment exhibits promise for treating diabetic wounds clinically.

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

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.

scholarly journals EFFECTS OF PROBIOTICS SUPPLEMENTATION ON SKIN WOUND HEALING IN DIABETIC RATS

2020 ◽  
Vol 33 (1) ◽  
Author(s):  
Letícia Fuganti CAMPOS ◽  
Eliane TAGLIARI ◽  
Thais Andrade Costa CASAGRANDE ◽  
Lúcia de NORONHA ◽  
Antônio Carlos L. CAMPOS ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Wound Healing ◽  
Type I Collagen ◽  
Chronic Wounds ◽  
Skin Wound ◽  
Diabetic Rats ◽  
Control Group ◽  
Type I ◽  
Collagen Deposition ◽  
Skin Wound Healing

ABSTRACT Background: Chronic wounds in patients with Diabetes Mellitus often become incurable due to prolonged and excessive production of inflammatory cytokines. The use of probiotics modifies the intestinal microbiota and modulates inflammatory reactions. Aim: To evaluate the influence of perioperative supplementation with probiotics in the cutaneous healing process in diabetic rats. Methods: Forty-six rats were divided into four groups (C3, P3, C10, P10) according to the treatment (P=probiotic or C=control, both orally administered) and day of euthanasia, 3rd or 10th postoperative days. All rats were induced to Diabetes Mellitus 72 h before starting the experiment with alloxan. Supplementation was initiated five days before the incision and maintained until euthanasia. Scalpel incision was guided by a 2x2 cm mold and the wounds were left to heal per second-intention. The wounds were digitally measured. Collagen densitometry was done with Picrosirius Red staining. Histological parameters were analyzed by staining by H&E. Results: The contraction of the wound was faster in the P10 group which resulted in a smaller scar area (p=0.011). There was an increase in type I collagen deposition from the 3rd to the 10th postoperative day in the probiotic groups (p=0.016), which did not occur in the control group (p=0.487). The histological analysis showed a better degree of healing in the P10 group (p=0.005), with fewer polymorphonuclear (p<0.001) and more neovessels (p=0.001). Conclusions: Perioperative supplementation of probiotics stimulates skin wound healing in diabetic rats, possibly due to attenuation of the inflammatory response and increased neovascularization and type I collagen deposition.

scholarly journals Overweight induced by high-fat diet delays rat cutaneous wound healing

2006 ◽  
Vol 96 (6) ◽  
pp. 1069-1077 ◽  
Author(s):  
Adriana P. Nascimento ◽  
Andréa M. A. Costa
Keyword(s):  
Blood Pressure ◽  
Wound Healing ◽  
High Fat Diet ◽  
Inflammatory Infiltrate ◽  
Cellular Proliferation ◽  
Chronic Wounds ◽  
Wound Contraction ◽  
Cutaneous Wound Healing ◽  
High Fat ◽  
Cutaneous Wound

Prolonged wound healing is a complication that contributes to morbidity and mortality. Overweight people regularly undergo surgery and trauma, and often develop chronic wounds, but the effects of the adipose tissue excess on cutaneous wound healing are not well understood. This study tested the hypothesis that overweight induced by a high-fat diet impairs rat cutaneous wound healing. Male Wistar rats were fed with either a high-fat or a standard (control) diet. After 15 weeks, an excisional lesion was done and the animals were killed 21 d later. Wound contraction and re-epithelialization, blood pressure, glucose and retroperitoneal fat were evaluated. After killing, lesion and adjacent normal skin were formol-fixed and paraffin-embedded. Inflammatory infiltrate, myofibroblasts, collagen fibres and cellular proliferation were analysed and blood vessels were evaluated using stereological methods. There was no difference in blood pressure and glucose, but retroperitoneal fat increased in the high-fat diet group. Animals fed with the high-fat diet presented delayed wound contraction and re-epithelialization. It was found that 21 d after wounding, overweight induced by a high-fat diet increased the inflammatory infiltrate and delayed myofibroblastic differentiation, collagen deposition, epithelial and connective tissue cell proliferation, and angiogenesis. These findings support the hypothesis that a high-fat diet exerts negative effects on rat cutaneous wound healing, due mainly to the prolongation of the inflammatory phase.

Efficacy of Negative Pressure Therapy (NPWT) in the Management of Wounds of Different Etiologies

2018 ◽  
Vol 69 (8) ◽  
pp. 1980-1986
Author(s):  
Mihaela Pertea ◽  
Natalia Velenciuc ◽  
Vladimir Poroch ◽  
Petru Ciobanu ◽  
Mihaela Boanca ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Chronic Wounds ◽  
Length Of Hospital Stay ◽  
Soft Tissue Defect ◽  
Lower Limbs ◽  
Adhesive Tape ◽  
Subatmospheric Pressure ◽  
Pressure Therapy ◽  
Application Frequency ◽  
Hospital Days

The objective was to assess the role of negative pressure wound therapy (NPWT) in the management of wounds of various etiologies, infected or not, acute or chronic. The study was conducted in a group of 37 patients (24 men and 13 women) aged 26 to 86 years with acute or chronic wounds, posttraumatic or due to chronic diseases located on the lower limbs or following oncological abdominal surgery. In all cases a Vacuum Assisted Closure (VAC) system was continuously applied using a subatmospheric pressure ranging from 90 to 120 mmHg. Beside sex, age and etiology of soft tissue defect the following parameters were studied: surgical treatment performed prior to NPWT application, frequency of dressing changes, duration of NPWT, level of subatmospheric pressure used in each case, number of hospital days, complications arising from NPWT use. The outcome was favorable in all cases without such complications as infection or bleeding, a perilesional erythema (contact dermatitis caused by the used adhesive tape) being noted in only 13.51% of cases. The average duration of NPWT was 8.1 days. The frequency of dressing changes was in most cases of 3 days (89.18%) with a group mean of 3.05 days, and the average applied negative pressure was -110.83 mmHg, range -90mmHg to -120 mm Hg. No complications requiring the interruption of NPWT use were recorded. NPWT, by stimulating wound constriction and granulation tissue formation is an option in the management of acute or chronic wounds of various etiologies, whether infected or not, resulting in a decrease in the number of surgeries and their complexity, length of hospital stay and, last but not least, reduced patient suffering.

Sign in / Sign up

Export Citation Format

Share Document