Experimental Study Of Negative Pressure Wound Therapy With Instillation(NPWTi) Treating Infected Wound

BackgroundInfectious wound is one of the problematic issues in clinical surgery treatment and also one important subject in medical study.Negative Pressure Wound Therapy with Instillation(NPWTi)is a physical wound treatment technology that combines liquid instillation and negative pressure suction,which can better promote the growth of granulation tissue and wound healing compared to simple NPWT.NPWTi is an automatic and controllable real-time technology,which has been used in wounds with a large volume of seepage and tissue necrosis,acute wounds and infectious wounds.Studies show that various wound treatment solution can be applied in NPWTi,including sanitizer,antibiotics and anesthetics.This study is to discuss the curative effect difference of different instillation liquid in NPWTi technology treating infectious wound infected by different bacteria by establishing pig back skin soft tissue infectious models.ObjectiveLavage and medication for the infective wound are important factors determining the skin healing.In this study,we aimed to treat the infected soft tissue wound in the porcine model by introducing negative pressure wound therapy with instillation(NPWTi).We compared different antibacterial lavage fluids in different dressing techniques.MethodsInfected soft tissue defect on porcine model was constructed by “partial skin excision-heavy impact” method,and infected either staphylococcus aureus or pseudomonas aeruginosa.Through our novelly developed three-dimensional scanning technique,the wound area and volume were measured.Besides,the differences in pathomorphology,capillary density,myeloperoxidase(MPO)activity,inflammatory factor(TNF-α,IL-1β and IL-6)levels and angiogenesis related factor(VEGF and ICAM)levels were observed.ResultsFor pseudomonas aeruginosa infection,the effect of polyhexamethylene biguanidine hydrochloride on wound repair was the best;for staphylococcus aureus infection,the effect of chlorine dioxide compound was the best.The effects of antibacterial instillation fluids were significantly better than the saline control group,on the wound area and volume,physiological improvement,attenuating the MPO activity,down-regulation of inflammatory factor expression and promotion of angiogenesis.Moreove,the NPWTi technique showed a significant contribution compared with the conventional dressing technique.ConclusionNPWTi has a unique advantage,especially when combined with the suitable antibacterial instillation fluids,on accelerating the wound contraction and healing.