Negative-pressure wound therapy in skin grafts: A systematic review and meta-analysis of randomized controlled trials

Jiang, Zhengying; Yu, Xuan; Liao, Xincheng; Liu, Mingzhuo; Fu, Zhonghua; Min, Dinghong; Guo, Guang-hua

doi:10.1016/j.burns.2021.02.012

Cited by 28 publications

(19 citation statements)

References 25 publications

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“…Negative pressure is a medical treatment that uses vacuum dressings to strengthen and promote the healing of acute, chronic, and burn wounds. The therapy involves the use of a closed wound dressing connected to a pump to create a negative pressure environment around the wound 26 . We aimed to investigate whether negative pressure therapy can regulate the body's antibacterial defenses by affecting the expression of these noncoding RNAs.…”

Section: Resultsmentioning

confidence: 99%

“…The therapy involves the use of a closed wound dressing connected to a pump to create a negative pressure environment around the wound. 26 We aimed to investigate whether negative pressure therapy can regulate the body's antibacterial defenses by affecting the expression of these noncoding RNAs.…”

Section: Mir-125b-5p Is Downregulated In Cells and Mice After Mtb Inf...mentioning

confidence: 99%

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Negative pressure promotes macrophage M1 polarization after Mycobacterium tuberculosis infection via the lncRNA XIST/microRNA–125b–5p/A20/NF–κB axis

Luo

et al. 2022

Annals of the New York Academy of Sciences

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Experiments have demonstrated the regulation of long noncoding RNA (lncRNA) in tuberculosis (TB), and negative pressure treatment has been associated with the alleviation of TB. Here, we investigated the interaction of negative pressure and the lncRNA X‐inactive specific transcript (XIST) in modulating Mycobacterium tuberculosis (MTB) infection. Initially, we established an in vitro cell model of MTB infection and an in vivo mouse model of MTB infection, followed by treatment with negative pressure. Then, we examined the expression of XIST, followed by analysis of the downstream miRNA of XIST. XIST was overexpressed or underexpressed through cell transfection to examine its effects on macrophage polarization via the miR–125b–5p/A2 axis. The MTB models were characterized by upregulated XIST and downregulated miR‐125b‐5p. XIST bound to miR‐125b‐5p, leading to its downregulation, and thus causing higher MTB survival in an ESAT‐6–dependent manner. Additionally, negative pressure treatment decreased MTB‐driven XIST expression through downregulation of A20 (an NF‐κB repressor) via miR‐125b‐5 expression, promoting the M1 polarization program in macrophages through activation of the NF‐κB pathway. In summary, negative pressure treatment after MTB infection can promote the polarization of macrophages to the proinflammatory M1 phenotype by regulating the XIST/miR–125b–5p/A20/NF–κB axis.

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Section: Resultsmentioning

confidence: 99%

Section: Mir-125b-5p Is Downregulated In Cells and Mice After Mtb Inf...mentioning

confidence: 99%

Negative pressure promotes macrophage M1 polarization after Mycobacterium tuberculosis infection via the lncRNA XIST/microRNA–125b–5p/A20/NF–κB axis

Luo

et al. 2022

Annals of the New York Academy of Sciences

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“…Next, the wounds were completely sealed with transparent breathable films and the suction tubes were then connected to the intelligent negative pressure wound therapy instruments (ZN100, Shandong Chuangkang Biotechnology Co., Ltd). We applied the intermittent negative pressure drainage where the pump of −80 to −100 mmHg was conducted for 5 min and the positive pressure was set to 2 min 18‐21 . The wound dressing and negative pressure drainage tubes were changed every 7 days for a total of 14 days of treatment.…”

Section: Methodsmentioning

confidence: 99%

Autologous wound margin point columnar full‐thickness skin grafting combined with negative pressure wound therapy improves wound healing in refractory diabetic foot ulcers

Huang

Wang

et al. 2022

International Wound Journal

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Diabetic lower extremity ulcers (DLEUs) are a severe complication of diabetes mellitus (DM) and are difficult to heal. This study aimed to explore the efficacy of autologous point columnar full‐thickness skin graft taken from the ulcer wound margin combined with negative pressure wound therapy (NPWT) in refractory DLEUs. This is a prospective cohort study. A total of 40 inpatients with refractory DLEUs were recruited in the Diabetes Foot Center of Guangxi Zhuang Autonomous Region People's Hospital from October 2019 to November 2021. According to the doctors' professional suggestions and the patients' personal wishes, these enrolled patients were divided into two groups based on different topical wound management: the graft group (n = 18) and the conventional wound therapeutic (CWT) group (n = 22). The efficacy evaluations included the time to complete re‐epithelialization of the wound and healing speed within 14 days of graft treatment or after 14 days of graft treatment in the two groups. Before the treatment, the graft group had a significantly larger ulcer area than the CWT group [27.22 (15.28, 46.59) versus 10.92 (7.00, 24.93) cm2, P < .01]. However, the time to complete wound re‐epithelialization in the graft group was shorter than in the CWT group [58.22 ± 30.60 versus 86.09 ± 49.54 d, P < .05]. Meanwhile, the healing speed in graft group was markedly faster than in CWT group, whether within 14 days [0.60 (0.40, 0.92) versus 0.16 (0.07, 0.34) cm2/d, P < .01] or after 14 days of graft treatment [0.57 (0.45, 0.91) versus 0.13 (0.08, 0.27) cm2/d, P < .01]. However, the total treatment cost in the graft group was lower than in the CWT group [419.59 ± 137.20 versus 663.97 ± 497.02 $, P < .05]. The novel treatment modality of autologous full‐thickness skin graft taken from the ulcer wound margin combined with NPWT has hereby proposed for the first time, and is a safe, effective, and reliable method with a good performance‐to‐cost ratio to promote wound healing and shorten the healing time for DLEUs.

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“…Negative-pressure wound therapy (NPWT) has largely proven to be an effective method for facilitating integration of skin grafts. 38,39 In their recent systematic review, Jiang et al reported that NPWT resulted in increased graft take, reduced hospital stay, and lower risk of reoperation compared with non-NPWT for patients with skin grafts. 39 Few studies have also assessed the effectiveness of NPWT in patients with Integra placement.…”

Section: Operative Techniquementioning

confidence: 99%

“…38,39 In their recent systematic review, Jiang et al reported that NPWT resulted in increased graft take, reduced hospital stay, and lower risk of reoperation compared with non-NPWT for patients with skin grafts. 39 Few studies have also assessed the effectiveness of NPWT in patients with Integra placement. 40,41 Stiefel et al established a 94.5% (17 of 18 children) success rate for Integra fixation following wound VAC therapy.…”

Section: Operative Techniquementioning

confidence: 99%

Technical Refinements with the Use of Biologic Healing Agents

2022

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Soft tissue defects resulting from trauma, vascular disease, burns, and postoncologic resections require reconstructive surgery for appropriate wound coverage and support. Dermal substitutes have been applied to a vast array of reconstructive settings across nearly all anatomical areas with demonstrable success. However, they require meticulous handling and operative technical expertise to optimize management of these soft tissue defects. In this review, we will address three dermal substitutes, their operative techniques, and their surgical applications.

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Negative-pressure wound therapy in skin grafts: A systematic review and meta-analysis of randomized controlled trials

Cited by 28 publications

References 25 publications

Negative pressure promotes macrophage M1 polarization after Mycobacterium tuberculosis infection via the lncRNA XIST/microRNA–125b–5p/A20/NF–κB axis

Negative pressure promotes macrophage M1 polarization after Mycobacterium tuberculosis infection via the lncRNA XIST/microRNA–125b–5p/A20/NF–κB axis

Autologous wound margin point columnar full‐thickness skin grafting combined with negative pressure wound therapy improves wound healing in refractory diabetic foot ulcers

Technical Refinements with the Use of Biologic Healing Agents

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