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Negative Pressure Wound Therapy-associated Tissue Trauma and Pain: A Controlled In vivo Study Comparing Foam and Gauze Dressing Removal by Immunohistochemistry for Substance P and Calcitonin Gene-related Peptide in the Wound Edge.

Malmsjö, Malin LU ; Gustafsson, Lotta LU ; Lindstedt Ingemansson, Sandra LU and Ingemansson, Richard LU (2011) In Ostomy - Wound Management 57(12). p.30-35
Abstract
Pain upon negative pressure wound therapy (NPWT) dressing removal has been reported and is believed to be associ- ated with the observation that granulation tissue grows into foam. Wound tissue damage upon removal of the foam may cause the reported pain. Calcitonin gene-related peptide (CGRP) and substance P are neuropeptides that cause inflam- mation and signal pain and are known to be released when tissue trauma occurs. The aim of this controlled in vivo study was to compare the expression of CGRP and substance P in the wound bed in control wounds and following NPWT and foam or gauze dressing removal. Eight pigs with two wounds each were treated with open-pore structure polyurethane foam or AMD gauze and NPWT of 0 (control) or -80 mm Hg... (More)
Pain upon negative pressure wound therapy (NPWT) dressing removal has been reported and is believed to be associ- ated with the observation that granulation tissue grows into foam. Wound tissue damage upon removal of the foam may cause the reported pain. Calcitonin gene-related peptide (CGRP) and substance P are neuropeptides that cause inflam- mation and signal pain and are known to be released when tissue trauma occurs. The aim of this controlled in vivo study was to compare the expression of CGRP and substance P in the wound bed in control wounds and following NPWT and foam or gauze dressing removal. Eight pigs with two wounds each were treated with open-pore structure polyurethane foam or AMD gauze and NPWT of 0 (control) or -80 mm Hg for 72 hours. Following removal of the wound filler, the ex- pression of CGRP and substance P was measured, using arbitrary units, in sections of biopsies from the wound bed using immunofluorescence techniques. Substance P and CGRP were more abundant in the wound edge following the removal of foam than of gauze dressings and least abundant in control wounds. The immunofluorescence staining of the wound edge for CGRP was 52 ± 3 au after the removal of gauze and 97 ± 5 au after the removal of foam (P <0.001). For substance P, the staining was 55 ± 3 au after gauze removal and 95 ± 4 au after foam removal (P <0.001). CGRP and substance P staining was primarily located to nerves and leukocytes. The increase in CGRP and substance P immuno- fluorescence was especially prominent in the dermis but also was seen in subcutaneous and muscle tissue. Using gauze may be one way of reducing NPWT dressing change-related pain. New wound fillers designed to optimize granulation tissue formation and minimize pain issues presumably will be developed in the near future. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
controlled study, animal model, negative pressure wound therapy, pain, dressing
in
Ostomy - Wound Management
volume
57
issue
12
pages
30 - 35
publisher
HMP Communications
external identifiers
  • wos:000298771500007
  • pmid:22156176
  • scopus:84865765614
ISSN
0889-5899
language
English
LU publication?
yes
id
0d2e7b88-a700-4e8b-9296-c21b7003e243 (old id 2274203)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/22156176?dopt=Abstract
date added to LUP
2012-01-03 18:44:21
date last changed
2017-08-27 04:33:00
@article{0d2e7b88-a700-4e8b-9296-c21b7003e243,
  abstract     = {Pain upon negative pressure wound therapy (NPWT) dressing removal has been reported and is believed to be associ- ated with the observation that granulation tissue grows into foam. Wound tissue damage upon removal of the foam may cause the reported pain. Calcitonin gene-related peptide (CGRP) and substance P are neuropeptides that cause inflam- mation and signal pain and are known to be released when tissue trauma occurs. The aim of this controlled in vivo study was to compare the expression of CGRP and substance P in the wound bed in control wounds and following NPWT and foam or gauze dressing removal. Eight pigs with two wounds each were treated with open-pore structure polyurethane foam or AMD gauze and NPWT of 0 (control) or -80 mm Hg for 72 hours. Following removal of the wound filler, the ex- pression of CGRP and substance P was measured, using arbitrary units, in sections of biopsies from the wound bed using immunofluorescence techniques. Substance P and CGRP were more abundant in the wound edge following the removal of foam than of gauze dressings and least abundant in control wounds. The immunofluorescence staining of the wound edge for CGRP was 52 ± 3 au after the removal of gauze and 97 ± 5 au after the removal of foam (P &lt;0.001). For substance P, the staining was 55 ± 3 au after gauze removal and 95 ± 4 au after foam removal (P &lt;0.001). CGRP and substance P staining was primarily located to nerves and leukocytes. The increase in CGRP and substance P immuno- fluorescence was especially prominent in the dermis but also was seen in subcutaneous and muscle tissue. Using gauze may be one way of reducing NPWT dressing change-related pain. New wound fillers designed to optimize granulation tissue formation and minimize pain issues presumably will be developed in the near future.},
  author       = {Malmsjö, Malin and Gustafsson, Lotta and Lindstedt Ingemansson, Sandra and Ingemansson, Richard},
  issn         = {0889-5899},
  keyword      = {controlled study,animal model,negative pressure wound therapy,pain,dressing},
  language     = {eng},
  number       = {12},
  pages        = {30--35},
  publisher    = {HMP Communications},
  series       = {Ostomy - Wound Management},
  title        = {Negative Pressure Wound Therapy-associated Tissue Trauma and Pain: A Controlled In vivo Study Comparing Foam and Gauze Dressing Removal by Immunohistochemistry for Substance P and Calcitonin Gene-related Peptide in the Wound Edge.},
  volume       = {57},
  year         = {2011},
}