The objective of this porcine study was to evaluate the effect of closed incision management with negative pressure wound therapy (CIM) on hematoma/seroma formation, fluid removal into the CIM canister, and involvement of the lymphatic system. In each swine (n = 8), two sets of ventral contralateral subcutaneous dead spaces with overlying sutured incisions were created. Stable isotope-labeled nanospheres were introduced into each subcutaneous dead space. Each contralateral incision was assigned to CIM (continuous -125 mmHg negative pressure) and control (semipermeable film dressing), respectively. Following 4 days of therapy, hematoma/seroma was weighed, total fluid volume in canisters was measured, five pre-identified lymph nodes were harvested, and five key organs were biopsied. There was 25 ± 8 g (standard error [SE]) (63%) less hematoma/seroma in CIM sites compared to control sites (p = 0.002), without any fluid collection in the CIM canister. In lymph nodes, there were ∼60 μg (∼50%) more 30- and 50-nm nanospheres from CIM sites than from control sites (p = 0.04 and 0.05, respectively). There was significantly greater nanosphere incidence from CIM sites than from control sites in lungs, liver, and spleen (p < 0.05); no nanospheres were detected in kidney biopsies. Thus, in this porcine model, application of CIM significantly decreased hematoma/seroma levels without fluid collection in the canister, which may be explained by increased lymph clearance.

Osteointegration is dependent on a variety of biomechanical and biochemical factors. One factor is the wettability of an implant surface that is directly influenced by its surface energy. This investigation used the Zisman plot to determine critical surface tension as one representative measurement of surface energy. The effects of surface treatment, bulk grain size, and surface roughness on the critical surface tension of unalloyed titanium (Ti) were examined. Radio frequency glow discharge-treated Ti had the highest critical surface tension, followed by the passivated and heat-sterilized conditions. Titanium with no surface treatment had the lowest critical surface tension. The surface energy of Ti with an average grain size of 23 microns was not significantly different from that with a grain size of 70 microns. Surface roughness was shown to cause significant difference in measurements and definitely should be considered in studies of this kind.