Negative Pressure Wound Therapy in Maxillofacial Applications

Abstract

Negative pressure wound therapy has greatly advanced the field of wound healing for nearly two decades, by providing a robust surgical adjunct technique for accelerating wound closure in acute and chronic wounds. However, the application of negative pressure wound therapy in maxillofacial applications has been relatively under utilized as a result of the physical articulations and contours of the head and neck that make it challenging to obtain an airtight seal for different negative pressure wound therapy systems. Adapting negative pressure wound therapies for maxillofacial applications could yield significant enhancement of wound closure in maxillofacial applications. The current review summarizes the basic science underlying negative pressure wound therapy, as well as specific maxillofacial procedures that could benefit from negative pressure wound therapy.

How influential is the stiffness of the foam dressing on soft tissue loads in negative pressure wound therapy?

“…The most important and perhaps unexpected finding of the present study is that the periwound skin stresses, which are considered to be physiologically important for stimulating healing by NPWT (e.g. through angiogenesis, proliferation and migration of phagocyte and fibroblast cells, and synthesis of collagen [8,9,42,43]) were only slightly affected by the stiffness of the foam dressing (around an order of magnitude with respect to measured commercial product stiffnesses) (Figures 5b, 6b).…”

Cellulose: a fascinating biopolymer for hydrogel synthesis

“…129,130 A wound is an injury to living tissue caused by a cut, burn, accident, etc., to the skin tissue. Wound healing is a biological process that happens mainly in four stages: hemostasis, inflammation, proliferation, and tissue remodeling 131,132 (Fig. 11).…”

Enhancing wound healing dressing development through interdisciplinary collaboration

“…• Brings wound edges together 57 • Stimulates fibroblasts 57 • Stimulates granulation, particularly angiogenesis 57 • Stimulates epithelial proliferation when used with liner (Prevena™) 57 • Various contraindications 59 Antimicrobial dressings • Prevents wound contamination 54 Abbreviation: NPWT, negative pressure wound therapy.…”

“…NPWT devices consist of a semipermeable film covering a wound filler, most commonly polyurethane foam though gauze and polyvinyl foam can also be used, which either directly contacts the wound bed or rests on top of a low adherent contact layer. 57,58 The dressing is connected to a drainage tube which is also connected to a device responsible for generating the negative pressure. 58 Figure 6 demonstrates an example of a NPWT system.…”

“…NPWT pulls wound edges together, removes edematous fluid, stimulates fibroblast proliferation, and, with the use of a liner or contact layer, stimulates epithelial cell proliferation. 57 Some contraindications of NPWT include malignancy, osteomyelitis, and the presence of necrotic tissue. 59 Another wound management technique is shock wave therapy, which is hypothesized to utilize external deformations to the cytoskeleton via mechanotransduction.…”