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The influence of low and high pressure levels during negative pressure wound therapy on wound contraction and fluid evacuation.

Borgquist, Ola LU ; Ingemansson, Richard LU and Malmsjö, Malin LU (2011) In Plastic and Reconstructive Surgery 127(2). p.551-559
Abstract
BACKGROUND: Negative pressure wound therapy (NPWT) promotes healing by drainage of excessive fluid and debris and also by mechanical deformation of the wound edge tissue. The most commonly used negative pressure is -125 mmHg. However, this pressure may cause pain and ischemia, and the pressure often needs to be reduced. The aim of the present study was to examine wound contraction and fluid removal during low and increasing levels of negative pressures. METHODS: A peripheral wound was created in 70 kg pigs. The immediate effects of NPWT (-10 to -175 mmHg) on wound contraction and fluid removal was studied in eight pigs. The long-term effects on wound contraction were studied in eight additional pigs during 72 hours of NPWT at -75 mmHg.... (More)
BACKGROUND: Negative pressure wound therapy (NPWT) promotes healing by drainage of excessive fluid and debris and also by mechanical deformation of the wound edge tissue. The most commonly used negative pressure is -125 mmHg. However, this pressure may cause pain and ischemia, and the pressure often needs to be reduced. The aim of the present study was to examine wound contraction and fluid removal during low and increasing levels of negative pressures. METHODS: A peripheral wound was created in 70 kg pigs. The immediate effects of NPWT (-10 to -175 mmHg) on wound contraction and fluid removal was studied in eight pigs. The long-term effects on wound contraction were studied in eight additional pigs during 72 hours of NPWT at -75 mmHg. RESULTS: The wound contraction and fluid removal increased gradually with increasing levels of negative pressure until reaching a steady state. Maximum wound contraction was observed at -75 mmHg. When NPWT was discontinued, after 72 hours of therapy, the wound surface area was smaller than before therapy. Maximum wound fluid removal was observed at -125 mmHg. Higher pressures did not further reduce wound surface area or fluid volume. The time required for evacuation of 50% of the maximal fluid drained for a specific pressure level was longer for low negative pressures (∼45 s for pressures below -50 mmHg) than for high negative pressures (∼15-20 s for pressures above -50 mmHg). CONCLUSIONS: NPWT facilitates drainage of wound fluid and exudates and results in mechanical deformation of the wound edge tissue which is known to stimulate granulation tissue formation. Maximum wound contraction is achieved already at -75 mmHg, and this may be a suitable pressure for most wounds. In wounds with large volumes of exudate, higher pressure levels may be needed for the initial treatment period. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Plastic and Reconstructive Surgery
volume
127
issue
2
pages
551 - 559
publisher
Lippincott Williams & Wilkins
external identifiers
  • wos:000286928100009
  • pmid:20966819
  • scopus:79951681875
ISSN
0032-1052
DOI
10.1097/PRS.0b013e3181fed52a
language
English
LU publication?
yes
id
6cbac821-166c-48c5-9147-5d185717dcfe (old id 1710886)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/20966819?dopt=Abstract
date added to LUP
2010-11-05 15:21:37
date last changed
2017-11-19 03:09:19
@article{6cbac821-166c-48c5-9147-5d185717dcfe,
  abstract     = {BACKGROUND: Negative pressure wound therapy (NPWT) promotes healing by drainage of excessive fluid and debris and also by mechanical deformation of the wound edge tissue. The most commonly used negative pressure is -125 mmHg. However, this pressure may cause pain and ischemia, and the pressure often needs to be reduced. The aim of the present study was to examine wound contraction and fluid removal during low and increasing levels of negative pressures. METHODS: A peripheral wound was created in 70 kg pigs. The immediate effects of NPWT (-10 to -175 mmHg) on wound contraction and fluid removal was studied in eight pigs. The long-term effects on wound contraction were studied in eight additional pigs during 72 hours of NPWT at -75 mmHg. RESULTS: The wound contraction and fluid removal increased gradually with increasing levels of negative pressure until reaching a steady state. Maximum wound contraction was observed at -75 mmHg. When NPWT was discontinued, after 72 hours of therapy, the wound surface area was smaller than before therapy. Maximum wound fluid removal was observed at -125 mmHg. Higher pressures did not further reduce wound surface area or fluid volume. The time required for evacuation of 50% of the maximal fluid drained for a specific pressure level was longer for low negative pressures (∼45 s for pressures below -50 mmHg) than for high negative pressures (∼15-20 s for pressures above -50 mmHg). CONCLUSIONS: NPWT facilitates drainage of wound fluid and exudates and results in mechanical deformation of the wound edge tissue which is known to stimulate granulation tissue formation. Maximum wound contraction is achieved already at -75 mmHg, and this may be a suitable pressure for most wounds. In wounds with large volumes of exudate, higher pressure levels may be needed for the initial treatment period.},
  author       = {Borgquist, Ola and Ingemansson, Richard and Malmsjö, Malin},
  issn         = {0032-1052},
  language     = {eng},
  number       = {2},
  pages        = {551--559},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Plastic and Reconstructive Surgery},
  title        = {The influence of low and high pressure levels during negative pressure wound therapy on wound contraction and fluid evacuation.},
  url          = {http://dx.doi.org/10.1097/PRS.0b013e3181fed52a},
  volume       = {127},
  year         = {2011},
}