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Topic: Current Concepts in Wound Healing

Histopathological study of chronic wounds

modulated by intermittent negative pressure

therapy under limited access dressing

Thittamaranahalli Muguregowda Honnegowda , Pramod Kumar , Rekha Singh ,
1,2
3
1
Swarna Shivakumar , Pragna Rao , Hemanth K. Prasad , Sudesh Kumar , Udaya Kumar ,
6
5
6
4
5
Echalasara Govindarama Padmanabha Udupa 5
1 Department of Plastic Surgery and Burns, Kasturba Medical College, Manipal 576104, Karnataka, India.
2 Department of Plastic Surgery, King Abdulaziz Specialist Hospital, Sakaka 42421, Al‑Jouf, Saudi Arabia.
3 Department of Pathology, Vydehi Institute of Medical Sciences and Research Center, Bengaluru 560066, Karnataka, India.
4 Department of Pathology, Apollo Hospitals, Bengaluru 560066, Karnataka, India.
5 Department of Biochemistry, Kasturba Medical College, Manipal 576104, Karnataka, India.
6 Department of Surgery, Government District Hospital, Udupi 576101, Karnataka, India.
Address for correspondence: Dr. Thittamaranahalli Muguregowda Honnegowda, Department of Plastic Surgery and Burns, Kasturba Medical
College, Manipal 576104, Karnataka, India. E‑mail: honnegowda33@gmail.com
ABSTRACT
Aim: Negative pressure wound therapy (NPWT) has achieved widespread success in the treatment of
chronic wounds. However, its effects have been only partially explored, and investigations have generally
concentrated on the wound‑dressing interface; a detailed histopathological description of the evolution
of wounds under NPWT is still lacking. The present study was performed to investigate the effect of
a limited access dressing (LAD) which exerts intermittent NPWT in a moist environment on chronic
wounds. Methods: A total of 140 patients were randomized into 2 groups: LAD group (n = 64) and
conventional dressing group (n = 76). By histopathological analysis of the granulation tissue, the amount
of inflammatory infiltrate, necrotic tissue, angiogenesis, and extracellular matrix (ECM) deposition was
studied and compared to determine healing between the 2 groups. Results: After 10 days of treatment,
histopathological analysis showed a significant decrease in necrotic tissue with LAD compared to the
conventional dressing group (mean ± standard error, 11.5 ± 0.48 vs. 10.1 ± 0.30, P = 0.007), the number
of inflammatory cells (12.6 ± 0.60 vs. 8.63 ± 0.35, P = 0.018), a significant increase in new blood vessels
(12.8 ± 0.58 vs. 9.3 ± 0.29, P = 0.005) and ECM deposit (13.3 ± 0.50 vs. 9.6 ± 0.24, P = 0.001). Conclusion:
LAD exerts its beneficial effects on chronic wound healing by decreasing the amount of necrotic tissue
and inflammatory cells while increasing the amount of ECM deposition and angiogenesis.

Key words:
Angiogenesis, chronic wounds, extracellular matrix, granulation tissue, inflammatory cell, limited
access dressing, necrotic tissue, negative pressure wound therapy

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Website: How to cite this article: Honnegowda TM, Kumar P, Singh R,
www.parjournal.net
Shivakumar S, Rao P, Prasad HK, Kumar S, Kumar U, Udupa EG.
Histopathological study of chronic wounds modulated by intermittent
negative pressure therapy under limited access dressing. Plast Aesthet
DOI: Res 2015;2:272-6.
10.4103/2347-9264.156993
Received: 20-11-2014; Accepted: 28-01-2015

272 © 2015 Plastic and Aesthetic Research | Published by Wolters Kluwer - Medknow