Comparison of bacteria and fungus-binding mesh, foam and gauze as fillers in negative pressure wound therapy - pressure transduction, wound edge contraction, microvascular blood flow and fluid retention
M Malmsjö, MD, PhD, Department of Ophthalmology, Lund University, Lund, Sweden R Ingemansson, MD, PhD, Department of Cardiothoracic Surgery, Lund University, Lund, Sweden S Lindstedt, MD, PhD, Department of Cardiothoracic Surgery, Lund University, Lund, Sweden L Gustafsson, MD, PhD, Department of Ophthalmology, Lund University, Lund, Sweden. International Wound Journal
(Impact Factor: 2.15).
06/2012; 10(5). DOI: 10.1111/j.1742-481X.2012.01029.x
Bacteria- and fungus-binding mesh binds and inactivates bacteria and fungus, which makes it interesting, alternative, wound filler for negative pressure wound therapy (NPWT). This study was conducted to compare the performance of pathogen-binding mesh, foam and gauze as wound fillers in NPWT with regard to pressure transduction, fluid retention, wound contraction and microvascular blood flow. Wounds on the backs of 16 pigs were filled with pathogen-binding mesh, foam or gauze and treated with NPWT. The immediate effects of 0, -40, -60, -80 and -120 mmHg, on pressure transduction and blood flow were examined in eight pigs using laser Doppler velocimetry. Wound contraction and fluid retention were studied during 72 hours of NPWT at -80 and -120 mmHg in the other eight pigs. Pathogen-binding mesh, gauze and foam provide similar pressure transduction to the wound bed during NPWT. Blood flow was found to decrease 0·5 cm laterally from the wound edge and increase 2·5 cm from the wound edge, but was unaltered 5·0 cm from the wound edge. The increase in blood flow was similar with all wound fillers. The decrease in blood flow was more pronounced with foam than with gauze and pathogen-binding mesh. Similarly, wound contraction was more pronounced with foam, than with gauze and pathogen-binding mesh. Wound fluid retention was the same in foam and pathogen-binding mesh, while more fluid was retained in the wound when using gauze. The blood flow 0·5-5 cm from the wound edge and the contraction of the wound during NPWT were similar when using pathogen-binding mesh and gauze. Wound fluid was efficiently removed through the pathogen-binding mesh, which may explain previous findings that granulation tissue formation is more rapid under pathogen-binding mesh than under gauze. This, in combination with its pathogen-binding properties, makes this mesh an interesting wound filler for use in NPWT.
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Wound Healing: Cellular Mechanisms, Alternative Therapies and Clinical Outcomes, Edited by L.E. Wade, 01/2015: pages 49-104; Nova Science Publishers., ISBN: 978-1-63463-475-5
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ABSTRACT: Negative pressure wound therapy (NPWT) is becoming recognized in veterinary medicine as a viable option for the management of complex wounds. NPWT has many advantages over traditional wound care and results in quicker and improved wound healing in many instances. This article discusses the art and science of NPWT, as well as the many current indications, complications, advantages and disadvantages, and future directions of NPWT in small animal veterinary medicine. This therapy will likely have a growing role in veterinary medical practice for complicated wound management and other usages in coming years.
Copyright © 2015 Elsevier Inc. All rights reserved.
Veterinary Clinics of North America Small Animal Practice 03/2015; 45(3). DOI:10.1016/j.cvsm.2015.01.005 · 0.82 Impact Factor
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ABSTRACT: The aim of the study was to compare the efficacy of a microorganism-binding (MB) dressing with a silver-containing hydrofiber (SCH) dressing in controlling the bacterial loads of heavily colonised or locally infected chronic venous leg ulcers, before surgical management with homologous skin grafts.
A randomised comparative single centre study recruited patients presenting with hard-to-heal critically colonised or locally infected leg ulcers, who could be treated with skin grafting. Inclusion criteria included; ulcers of vascular aetiology, over 18 years old, a wound duration ≥6 months and ankle brachial index (ABPI) >0.6. Patients were randomly assigned to treatment with SCH dressings (Aquacel Ag) or MB dressing (Cutimed Sorbact). Dressings were changed daily over a four-day observation period, after which they were taken for a skin grafting procedure. Swab samples from ulcer beds were taken in order to quantify the bacterial load at inclusion (D0) and at the end of the observation period day 4 (D4). No antibiotics were administered before or during the evaluation period.
Both groups (n=20 SCH, n=20 MB) were similar in gender, age, pathophysiology (both had 15 patients with venous leg ulcers and 5 with arterial leg ulcers), ulcer surface, ulcer duration, treatment-related pain and initial bacterial load. Analysing bacterial load variation showed a significant reduction of bacterial burden at D4 in both groups. In the SCH group, we found an average bacterial load reduction of 41.6%, with an average reduction of 73.1% in the MB group (p< 0.00001). No serious adverse events were reported.
Our evaluation confirmed that MB and SCH dressings are effective in reducing the bacterial burden in critically colonised or locally infected chronic leg ulcers, without inducing adverse events, with MB dressings significantly more effective.
There were no external sources of funding for this study. The authors have no conflicts of interest to declare.
Journal of Wound Care 03/2015; 24(3):121-127. DOI:10.12968/jowc.2015.24.3.121 · 1.07 Impact Factor
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