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Σάββατο 29 Δεκεμβρίου 2018

Biomechanical Effects of Incisional Negative Wound Pressure Dressing: An Ex Vivo Model Using Human and Porcine Abdominal Walls

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.

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