Abstract
Introduction Incisional negative pressure wound therapy (iNPWT) has been of recent interest in different surgical fields as beneficial outcomes on high-risk wounds have been reported. Nevertheless, its mechanisms of function are not widely studied to date. Methods We established two ex vivo setups of iNPWT in porcine and human abdominal wall for measuring pressures within the wound which result from iNPWT application. For pressure measurements, a high-resolution manometry catheter and a balloon catheter probe were used in a wound sealed with either a commercially available PREVENA VAC kit or a self-made iNPWT kit. Furthermore, we evaluated seroma evacuation by iNPWT. Results Both setups showed similar characteristics of pressure curves within the wound when applying increasing negative pressures. Application of high pressures did not result in a similar increase in wound pressure. Only subtotal evacuation of seroma by iNPWT application (about 75% of volume) could be detected. Conclusion Our ex vivo model of iNPWT in porcine and human abdominal wall could show reproducible measurements of pressures within the wounds in both types of tissue. As intrawound pressures did not increase in the same way as the applied negative pressure, we suggest that our results do not advocate the idea of using iNPWT for wound care especially as seroma evacuation remains insufficient.
Highlights
Incisional negative pressure wound therapy has been of recent interest in different surgical fields as beneficial outcomes on high-risk wounds have been reported
A 3-channel high-resolution manometry (HRM) probe (Unisensor, Attikon, Switzerland) for manometry was placed on the bottom of the wound and diverted subcutaneously to the side (Figures 2(b) and 2(e))
The initial pressure difference is caused by the strength with which the foil was stuck onto the skin
Summary
Incisional negative pressure wound treatment (iNPWT) has emerged as a useful tool to reduce surgical site infections (SSIs) [1]. In patients after arthroplasty, iNPWT decreases the rate of wound seroma and inflammation postoperatively [2, 3]. In a silicone wound model, iNPWT could reduce lateral tension and approximate wound edges even in the wound bed [4]. Others demonstrated increased vascularisation along wound edges when using negative pressure [5, 6]. Very little is known about the specific biomechanical effects of negative pressure on closed incisions/wounds in real tissue. We developed an abdominal wall model to investigate pressure ratios and fluid drainage within closed wounds during negative pressure treatment. We compared a commercially available iNPWT dressing kit with a self-made iNPWT dressing
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