The Management of Lower Extremity Wounds Using Topical Negative Pressure

Petrie, Nicola; Potter, Matthew; Banwell, Paul E.

doi:10.1177/1534734603261067

Cited by 17 publications

(7 citation statements)

References 68 publications

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“…The method also affects wound perfusion, growth factor, cytokine expression and cellular activity. These roles lead to enhanced granulation tissue formation and improved wound healing parameters (6)(7)(8). Therefore, the treatment should be focused on inducing osteogenesis through the effects of mechanical stimulation and growth factors in order to increase the early blood supply and restart bone healing (9).…”

Section: Discussionmentioning

confidence: 99%

Functions and mechanisms of intermittent negative pressure for osteogenesis in human bone marrow mesenchymal stem cells

Yang

Zhang

et al. 2014

Molecular Medicine Reports

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The present study aimed to determine the mechanism by which low‑intensity intermittent negative pressure affects the differentiation and proliferation of human mesenchymal stem cells (MSCs). Alkaline phosphatase (ALP) activity, type I collagen and vascular endothelial growth factor (VEGF) were detected to analyze differentiation. MTT and flow cytometry were employed to measure proliferation and apoptosis. Western blot analysis was used to examine endoplasmic reticulum (ER) stress‑associated factors. This study was divided into two groups, including a normal group (without any treatment) and vacuum group (treated with a vacuum). There was a significant decrease in the proliferation of cells in the vacuum group. The number of cells in S phase was reduced significantly, while the rate of apoptosis and the activity of ALP were markedly increased under vacuum conditions. Expression of collagen type I and VEGF was significantly increased, and the ratio of osteoprotegrin to osteoprotegrin ligand was decreased significantly in the vacuum group. ER stress‑associated proteins, p‑PRKR‑like ER kinase, inositol‑requiring enzyme 1 and cleaved activating transcription factor 6, as well as the downstream factors, were activated when treated with negative pressure. In conclusion, treatment with low‑intensity and intermittent negative pressure may inhibit the proliferation of MSCs and trigger ER stress‑associated cellular apoptosis, further enhancing osteogenesis activity and inducing differentiation to osteoblasts.

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Section: Discussionmentioning

confidence: 99%

Functions and mechanisms of intermittent negative pressure for osteogenesis in human bone marrow mesenchymal stem cells

Yang

Zhang

et al. 2014

Molecular Medicine Reports

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“…[119][120][121][122][123] Since the early studies of Morykwas et al and Argenta and Morykwas that demonstrated the numerous attributes of NPWT, a very large body of evidence has been published supporting the clinical efficacy of this very important biophysical modality. 121,[124][125][126][127][128][129] Clinical trials have been conducted in the ensuing years that have proven the superiority of NPWT over standard therapy for managing open amputation wounds, DFUs, VLUs, and other wounds.…”

Section: Negative Pressure Wound Therapymentioning

confidence: 99%

Challenges in the Treatment of Chronic Wounds

Frykberg

Banks

2015

Advances in Wound Care

1,823

1,429

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Significance: Chronic wounds include, but are not limited, to diabetic foot ulcers, venous leg ulcers, and pressure ulcers. They are a challenge to wound care professionals and consume a great deal of healthcare resources around the globe. This review discusses the pathophysiology of complex chronic wounds and the means and modalities currently available to achieve healing in such patients.Recent Advances: Although often difficult to treat, an understanding of the underlying pathophysiology and specific attention toward managing these perturbations can often lead to successful healing.Critical Issues: Overcoming the factors that contribute to delayed healing are key components of a comprehensive approach to wound care and present the primary challenges to the treatment of chronic wounds. When wounds fail to achieve sufficient healing after 4 weeks of standard care, reassessment of underlying pathology and consideration of the need for advanced therapeutic agents should be undertaken. However, selection of an appropriate therapy is often not evidence based.Future Directions: Basic tenets of care need to be routinely followed, and a systematic evaluation of patients and their wounds will also facilitate appropriate care. Underlying pathologies, which result in the failure of these wounds to heal, differ among various types of chronic wounds. A better understanding of the differences between various types of chronic wounds at the molecular and cellular levels should improve our treatment approaches, leading to better healing rates, and facilitate the development of new more effective therapies. More evidence for the efficacy of current and future advanced wound therapies is required for their appropriate use.

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“…The NPWT device was originally developed with the goal of providing a moist wound-healing environment while protecting the wound from outside bacteria. [17][18][19] However, the first model did not sufficiently address wound bioburden. Wound irrigation with the goal of decreasing bioburden is a fundamental next step in the management of open wounds.…”

Section: Introductionmentioning

confidence: 99%

Negative Pressure Wound Therapy With Instillation (NPWTi) Better Reduces Post-debridement Bioburden in Chronically Infected Lower Extremity Wounds Than NPWT Alone

Goss

Schwartz

Facchin

et al. 2012

Journal of the American College of Clinical Wound Specialists

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It has long been realized that NPWT does not make its greatest impact by bioburden reduction. Other work has demonstrated that debridement alone does not reduce wound bioburden by more than 1 Log. Wounds treated with NPWTi (in this case with quarter strength bleach instillation solution) had a statistically significant reduction in bioburden, while wounds treated with NPWT had an increase in bioburden over the 7 days.

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The Management of Lower Extremity Wounds Using Topical Negative Pressure

Cited by 17 publications

References 68 publications

Functions and mechanisms of intermittent negative pressure for osteogenesis in human bone marrow mesenchymal stem cells

Functions and mechanisms of intermittent negative pressure for osteogenesis in human bone marrow mesenchymal stem cells

Challenges in the Treatment of Chronic Wounds

Negative Pressure Wound Therapy With Instillation (NPWTi) Better Reduces Post-debridement Bioburden in Chronically Infected Lower Extremity Wounds Than NPWT Alone

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