Page 43 - Read Online

INTRODUCTION METHODS

Negative pressure wound therapy (NPWT) is a bio‑stimulating Ethical approval and informed consent
treatment for chronic wounds. In recent years, it has This prospective randomized study was carried out in
become one of the most frequently adopted treatments for the Department of Plastic Surgery and Burns, Kasturba
complex wounds worldwide. While it is generally believed Medical College and Hospital, Manipal, India. The
that NPWT improves wound healing and is cost‑effective, Institutional Ethics Committee reviewed and approved
there is a persistent demand for scientific evidence. the study protocol. Informed consent was obtained from
Several recent studies support the use of NPWT to all patients or their next of kin (as applicable) before
enhance wound healing by removing excess extracellular inclusion into the study.
fluid and decreasing tissue edema, which leads to Clinical study design
increased blood flow and stabilization of the wound Two hundred and fifteen patients with chronic wounds of
[1]
environment. A reduction in systemic (e.g. interleukins, more than 4 weeks duration were enrolled and assessed for
monocytes) and local mediators of inflammation has been eligibility. After examination of inclusion criteria (nonhealing
[2]
demonstrated in experimental models, while decreased chronic wounds, 12‑65 years of age) and exclusion criteria
[3]
matrix metalloproteinase activity and bacterial burden (collagen disorders, diabetes, leprosy, liver cirrhosis, HIV
have been documented clinically. In vivo, NPWT has been positive status, and pregnant women), 140 patients were
[4]
shown to increase fibroblast proliferation and migration, randomized into the LAD group (n = 64) or conventional
collagen organization, and to increase the expression of dressing group (n = 76) [Figure 1]. In the LAD group, the
vascular endothelial growth factor and fibroblast growth mean age was 38.3 ± 10.56 years (range: 12‑60 years),
factor‑2, thereby enhancing wound healing. [5] with a mean wound size at the time of admission of 19 cm
2
2
(range: 28‑40 cm ). In the conventional dressing group, the
Limited access dressings (LADs) have been shown to be
more effective in the treatment of chronic wounds. The mean age was 35.3 ± 14.0 years (range: 17‑65 years) with
[6]
2
present study evaluates the role of intermittent negative a mean wound size at the time of admission of 18 cm
2
pressure in a moist environment using LAD (cycle of (range: 26‑39 cm ) [Table 1].
30‑min suction and 3.5‑h rest) on chronic wounds by The LAD group was treated with intermittent negative
quantitative and comparative analysis of histopathological pressure in a moist environment. The conventional closed
parameters including the amount of necrotic tissue, the dressing group was treated with daily dressing changes
number of inflammatory cells, extent of angiogenesis, and using a squeezed 5% povidone‑iodine gauze which is a
the level of extracellular matrix (ECM) deposit. routine protocol in our burn unit. [7]

Figure 1: Consort flow chart

Plast Aesthet Res || Vol 2 || Issue 5 || Sep 15, 2015 273