Advanced

Wound contraction and macro-deformation during negative pressure therapy of sternotomy wounds.

Torbrand, Christian LU ; Ugander, Martin LU ; Engblom, Henrik LU ; Arheden, Håkan LU ; Ingemansson, Richard LU and Malmsjö, Malin LU (2010) In Journal of Cardiothoracic Surgery 5.
Abstract
ABSTRACT: BACKGROUND: Negative pressure wound therapy (NPWT) is believed to initiate granulation tissue formation via macro-deformation of the wound edge. However, only few studies have been performed to evaluate this hypothesis. The present study was performed to investigate the effects of NPWT on wound contraction and wound edge tissue deformation. METHODS: Six pigs underwent median sternotomy followed by magnetic resonance imaging in the transverse plane through the thorax and sternotomy wound during NPWT at 0, -75, -125 and -175 mmHg. The lateral width of the wound and anterior-posterior thickness of the wound edge was measured in the images. RESULTS: The sternotomy wound decreased in size following NPWT. The lateral width of the... (More)
ABSTRACT: BACKGROUND: Negative pressure wound therapy (NPWT) is believed to initiate granulation tissue formation via macro-deformation of the wound edge. However, only few studies have been performed to evaluate this hypothesis. The present study was performed to investigate the effects of NPWT on wound contraction and wound edge tissue deformation. METHODS: Six pigs underwent median sternotomy followed by magnetic resonance imaging in the transverse plane through the thorax and sternotomy wound during NPWT at 0, -75, -125 and -175 mmHg. The lateral width of the wound and anterior-posterior thickness of the wound edge was measured in the images. RESULTS: The sternotomy wound decreased in size following NPWT. The lateral width of the wound, at the level of the sternum bone, decreased from 39 ± 7 mm to 30 ± 6 mm at -125 mmHg (p = 0.0027). The greatest decrease in wound width occurred when switching from 0 to -75 mmHg. The level of negative pressure did not affect wound contraction (sternum bone: 32 ± 6 mm at -75 mmHg and 29 ± 6 mm at -175 mmHg, p = 0.0897). The decrease in lateral wound width during NPWT was greater in subcutaneous tissue (14 ± 2 mm) than in sternum bone (9 ± 2 mm), resulting in a ratio of 1.7 ± 0.3 (p = 0.0423), suggesting macro-deformation of the tissue. The anterior-posterior thicknesses of the soft tissue, at 0.5 and 2.5 cm laterally from the wound edge, were not affected by negative pressure. CONCLUSIONS: NPWT contracts the wound and causes macro-deformation of the wound edge tissue. This shearing force in the tissue and at the wound-foam interface may be one of the mechanisms by which negative pressure delivery promotes granulation tissue formation and wound healing. (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
Journal of Cardiothoracic Surgery
volume
5
publisher
BioMed Central
external identifiers
  • wos:000283292200001
  • pmid:20920290
  • scopus:77957194792
ISSN
1749-8090
DOI
10.1186/1749-8090-5-75
language
English
LU publication?
yes
id
a1bc1c68-297d-43d7-8fab-a841aeefc4bd (old id 1711404)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/20920290?dopt=Abstract
date added to LUP
2010-11-05 12:28:43
date last changed
2017-01-01 07:46:40
@article{a1bc1c68-297d-43d7-8fab-a841aeefc4bd,
  abstract     = {ABSTRACT: BACKGROUND: Negative pressure wound therapy (NPWT) is believed to initiate granulation tissue formation via macro-deformation of the wound edge. However, only few studies have been performed to evaluate this hypothesis. The present study was performed to investigate the effects of NPWT on wound contraction and wound edge tissue deformation. METHODS: Six pigs underwent median sternotomy followed by magnetic resonance imaging in the transverse plane through the thorax and sternotomy wound during NPWT at 0, -75, -125 and -175 mmHg. The lateral width of the wound and anterior-posterior thickness of the wound edge was measured in the images. RESULTS: The sternotomy wound decreased in size following NPWT. The lateral width of the wound, at the level of the sternum bone, decreased from 39 ± 7 mm to 30 ± 6 mm at -125 mmHg (p = 0.0027). The greatest decrease in wound width occurred when switching from 0 to -75 mmHg. The level of negative pressure did not affect wound contraction (sternum bone: 32 ± 6 mm at -75 mmHg and 29 ± 6 mm at -175 mmHg, p = 0.0897). The decrease in lateral wound width during NPWT was greater in subcutaneous tissue (14 ± 2 mm) than in sternum bone (9 ± 2 mm), resulting in a ratio of 1.7 ± 0.3 (p = 0.0423), suggesting macro-deformation of the tissue. The anterior-posterior thicknesses of the soft tissue, at 0.5 and 2.5 cm laterally from the wound edge, were not affected by negative pressure. CONCLUSIONS: NPWT contracts the wound and causes macro-deformation of the wound edge tissue. This shearing force in the tissue and at the wound-foam interface may be one of the mechanisms by which negative pressure delivery promotes granulation tissue formation and wound healing.},
  articleno    = {75},
  author       = {Torbrand, Christian and Ugander, Martin and Engblom, Henrik and Arheden, Håkan and Ingemansson, Richard and Malmsjö, Malin},
  issn         = {1749-8090},
  language     = {eng},
  publisher    = {BioMed Central},
  series       = {Journal of Cardiothoracic Surgery},
  title        = {Wound contraction and macro-deformation during negative pressure therapy of sternotomy wounds.},
  url          = {http://dx.doi.org/10.1186/1749-8090-5-75},
  volume       = {5},
  year         = {2010},
}