Negative Pressure Wound Therapy (NPWT)

Recent Developments

Despite widespread use of NPWT in recent years, questions have remained about pressure intensity levels, duration of treatment, and treatment intervals. Two studies published by Wackenfors, et al, in 2004 and 2005, respectively, explored the effects of NPWT on microvascular blood flow using laser Doppler in pig wound models. Both studies shed light on the questions above.

The first, a study of inquinal wounds using pressures of -50 to -200 mmHg, noted increased blood flow closer to the wound in muscular versus subcutaneous tissue. A hypoperfused area where blood flow decreased was found in the immediate proximity of the wound edge. The area of hypoperfusion increased with the use of higher negative pressures, and was especially prominent in subcutaneous tissue. The results suggested negative pressures of -100 mmHg be used in muscular tissue and -75 mmHg in softer subcutaneous tissue, to "minimize possible ischemic events." Blood flow increased multifold when therapy was terminated, suggesting that intermittent therapy may provide additional benefits in blood flow and wound healing.

The second study examined the effects of NPWT on peristernal soft tissue blood flow and metabolism (pressures of -50 to -200 mmHg) in an uninfected porcine sternotomy wound model. As in the first study, the peak increase in blood flow occurred closer to the wound edge in muscular versus subcutaneous tissue. In immediate proximity to the wound, a zone of relative hypoperfusion increased with increasing negative pressure. Wound fluid partial pressure of oxygen and lactate levels (in combination considered important to healing) increased when NPWT was applied.

The Wackenfor studies suggest that lower negative pressures than traditionally applied in NPWT may strike the best balance between optimizing perfusion and preventing ischemia. In addition, they clearly point out the importance of being able to adjust negative pressure to the type of tissue. They also point to benefits of intermittent therapy.

 

 

 

 

NPWT
Overview
Historical Milestones
Recent Developments
Goals of NPWT
The Prospera PRO Series
 
Wound Healing 101
Overview
Phases of Wound Healing
Assesment/Classification
Wound Treatment
Optimizing the Host
Wound Closure
Ecomonic Considerations

 

Wackenfor Studies
Full Prospera Video

 

 

 

 

 
           
 
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