Novel imaging methods reveal positive impact of topical negative pressure application on tissue perfusion in an in vivo skin model

Abstract

The influence of topical negative pressure application (TNPA) on tissue perfusion still remains controversial. TNPA was applied for 30 minutes on intact skin of 21 healthy participants. Measurements of tissue oxygen saturation and tissue temperature as signs of tissue perfusion were performed before application of the TNPA, directly after removal of the TNPA and 5, 10, 15, 20, and 30 minutes after removal of the dressing using the near infrared imaging (NIRI) and a thermal imaging camera. Tissue oxygen saturation showed an increase from 67.7% before applying the TNPA to 76.1% directly after removal of TNPA, followed by a decrease of oxygen saturation 30 minutes after removal of TNPA. The measured temperature of the treated skin area increased from 32.1 C to 36.1 C after removal of TNPA with a consecutive decrease of the temperature 30 minutes after removal. TNPA resulted in both a higher tissue oxygen saturation and a higher skin temperature after 30 minutes compared to the beginning. TNPA increases both tissue oxygen saturation and skin temperature as sign of an increase of tissue perfusion. NIRI and thermal imaging proved to be useful for measuring changes in tissue perfusion.

Intra- and Early Postoperative Evaluation of Malperfused Areas in an Irradiated Random Pattern Skin Flap Model Using Indocyanine Green Angiography and Near-Infrared Reflectance-Based Imaging and Infrared Thermography

“…This study evaluates the different imaging modalities-infrared thermography, indocyanine green angiography and near-infrared reflectance-based imaging [16,17]-to predict malperfused areas in an irradiated random pattern fasciocutaneous flap model.…”

Response to the letter to the editor ‘Novel imaging methods reveal positive impact of topical negative pressure application on tissue perfusion in an in‐vivo skin model’

“…We thank the authors for their valuable and interesting feedback on our study "Novel imaging methods reveal positive impact of topical negative pressure application on tissue perfusion in an in vivo skin model." 1 They point out that the impact of topical negative pressure application (TNPA) on the local perfusion of tissue is still not fully understood and that this would result in an ongoing discussion if TNPA increases or decreases tissue perfusion. Questions of altering the skin circulation have been investigated for a long time and have been discussed controversially when controlled clinical tissue expansion, a then popular technique of providing donor tissue, showed to result in an increase in surface area of expanded skin.…”

“…We thank the authors for their valuable and interesting feedback on our study “Novel imaging methods reveal positive impact of topical negative pressure application on tissue perfusion in an in vivo skin model.” 1 …”

Comment on “Novel imaging methods reveal positive impact of topical negative pressure application on tissue perfusion in an in vivo skin model”

“…Dear Editors, To this day, the mechanism of action of negative-pressure wound therapy (NPWT) continues to elude us. 1,2 Whether NPWT increases or reduces tissue pressure during suction and how this affects perfusion are the most basic, yet critically important, physiological concepts that need to be clearly elucidated. In this regard, we would like to put forward three concerns regarding the interesting article by Muller-Seubert et al 1 We applaud the authors on a well-conducted study.…”

“… 1 , 2 Whether NPWT increases or reduces tissue pressure during suction and how this affects perfusion are the most basic, yet critically important, physiological concepts that need to be clearly elucidated. In this regard, we would like to put forward three concerns regarding the interesting article by Muller‐Seubert et al 1 …”