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Scientific Principles and Clinical Application of Negative Pressure Wound Therapy (NPWT)

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Pearls and Pitfalls in Skin Ulcer Management

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Abstract

Since its introduction in the 1990s, the negative pressure therapy has become one of the most popular treatments for many pathologies and in particular both for acute and recalcitrant/chronic wounds. During these last years, to better understand its abilities, the scientific community studied its mechanism of actions both in vitro and in vivo and proposed different clinical applications, and with the aim of increasing wound healing, there have been many technological evolutions, which have been associated with this treatment, for example, the development of different interfaces. In this chapter, we will analyze the mechanism of action and the possible application of this treatment for stimulating wound healing in recalcitrant wounds.

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References

  1. Miller C. The history of negative pressure wound therapy (NPWT): from “lip service” to the modern vacuum system. J Am Coll Clin Wound Spec. 2013;4(3):61–2.

    PubMed  PubMed Central  Google Scholar 

  2. Galea E. The evolution of negative pressure wound therapy. Wounds Middle East. 2016;3(2):34–7.

    Google Scholar 

  3. Argenta LC, Morykwas MJ. Vacuum-assisted closure: a new method for wound control and treatment: clinical experience. Ann Plast Surg. 1997;38:563–76.

    Article  CAS  PubMed  Google Scholar 

  4. Ingber DE. Tensegrity: the architectural basis of cellular mechanotransduction. Annu Rev Physiol. 1997;59:575–99.

    Article  CAS  PubMed  Google Scholar 

  5. Ingber DE, Tensegrity II. How structural networks influence cellular information processing networks. J Cell Sci. 2003;116:1397–408.

    Article  CAS  PubMed  Google Scholar 

  6. Ingber DE. Cellular mechanotransduction: putting all the pieces together again. FASEB J. 2006;20(7):811–27.

    Article  CAS  PubMed  Google Scholar 

  7. Huang S, Ingber DE. Shape-dependent control of cell growth, differentiation, and apoptosis: switching between attractors in cell regulatory networks. Exp Cell Res. 2000;261:91–103.

    Article  CAS  PubMed  Google Scholar 

  8. Saxena W, et al. Vacuum -assisted closure: microdeformations of wounds and cell proliferation. Plast Reconstr Surg. 2004;114:1086–96.

    Article  PubMed  Google Scholar 

  9. Pietramaggiori G, et al. Tensile forces stimulate vascular remodeling and epidermal cell proliferation in living skin. Ann Surg. 2007;246(5):896–902.

    Article  PubMed  Google Scholar 

  10. Scherer SS, et al. The mechanism of action of the vacuum-assisted closure device. Plast Reconstr Surg. 2008;122(3):786–97.

    Article  CAS  PubMed  Google Scholar 

  11. Scherer SS, et al. Short periodic applications of the vacuum assisted closure device cause an extended tissue response in diabetic mouse model. Plast Reconstr Surg. 2009;124:1458–65.

    Article  CAS  PubMed  Google Scholar 

  12. Bassetto F, et al. Histological evolution of chronic wounds under negative pressure therapy. J Plasti Reconstr Aesthet Surg. 2012;65(1):91–9.

    Article  Google Scholar 

  13. Labanaris AP, et al. The effect of vacuum-assisted closure on lymph vessels in chronic wounds. J Plast Reconstr Aesthet Surg. 2009;62:1068–75.

    Article  PubMed  Google Scholar 

  14. Panayi AC, Leavitt T, Orgill DP. Evidence based review of negative pressure wound therapy. Wound J Dermatol. 2017;6(1):1–16.

    Google Scholar 

  15. Urschel JD, et al. The effect of mechanical stress on soft and hard tissue repair; a review. Br J Plast Surg. 1988;41:182–6.

    Article  CAS  PubMed  Google Scholar 

  16. Orgill DP, et al. The mechanism of action of vacuum assisted closure: more to learn. Surgery. 2009;146:40–51.

    Article  PubMed  Google Scholar 

  17. Younan G, et al. Analysis of nerve and neuropeptide patterns in vacuum-assisted closure-treated diabetic murine wounds. Plast Reconstr Surg. 2010;126:87–96.

    Article  CAS  PubMed  Google Scholar 

  18. Erba P, et al. Angiogenesis in wounds treated by microdeformational wound therapy. Ann Surg. 2011;253:402–9.

    Article  PubMed  Google Scholar 

  19. Labler L, et al. Vacuum-assisted closure therapy increases local interleukin-8 and vascular endothelial growth factor levels in traumatic wounds. J Trauma. 2009;66:749–57.

    CAS  PubMed  Google Scholar 

  20. Lancerotto L, et al. Mechanism of action of microdeformational wound therapy. Semin Cell Dev Biol. 2012;23:987–92.

    Article  PubMed  Google Scholar 

  21. Giatsidis G, et al. Noninvasive induction of angiogenesis in tissues by external suction: sequential optimization for use in reconstructive surgery. Angiogenesis. 2018;21(1):61–78.

    Article  CAS  PubMed  Google Scholar 

  22. Rhodius P, et al. Noninvasive flap preconditioning by foam-mediated external suction improves the survival of fasciocutaneous axial-pattern flaps in a type 2 diabetic murine model. Plast Reconstr Surg. 2018;142(6):872e–83e.

    Article  CAS  PubMed  Google Scholar 

  23. Lujan-Hernandez J, et al. Induction of adipogenesis by external volume expansion. Plast Reconstr Surg. 2016;137(1):122–31.

    Article  CAS  PubMed  Google Scholar 

  24. Kim PJ, et al. Negative pressure wound therapy with instillation: international consensus guidelines update. Int Wound J. 2020;17:174–86.

    Article  PubMed  Google Scholar 

  25. Scarpa C, et al. Efficacy of negative pressure wound therapy with instillation and dwell time for the treatment of a complex chronic venous leg ulcer. Wounds. 2020;3(12):372–4.

    Google Scholar 

  26. Teot L, Boissiere F, Fluieraru S. Novel foam dressing using negative pressure wound therapy with instillation to remove thick exudate. Int Wound J. 2017;14:842–8.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Apelqvist J, et al. EWMA document: negative pressure wound therapy. Overview, challenges and perspectives. J Wound Care. 2017;26(Sup 3):S1–S154.

    Article  PubMed  Google Scholar 

  28. Rohrich RJ. The "soft-tissue wound management: current applications of negative-pressure wound therapy with instillation" supplement. Plast Reconstr Surg. 2021;147:1S–76S.

    PubMed  Google Scholar 

  29. Gabriel A, et al. Effects of negative-pressure wound therapy with instillation versus standard of care in multiple wound types: systematic literature review and meta-analysis. Plast Reconstr Surg. 2021;147(1S-1):68S–76S.

    Article  CAS  PubMed  Google Scholar 

  30. Novah A, et al. The evidence-based principles of negative pressure wound therapy in trauma & orthopedics. Open Orthop J. 2014;8(Suppl 1:M6):168–77.

    Google Scholar 

  31. Iheozor-Ejiofor Z, et al. Negative pressure wound therapy for open traumatic wounds. Cochrane Database Syst Rev. 2018;7(7):CD012522.

    PubMed  Google Scholar 

  32. Helito CP, et al. The use of negative-pressure wound therapy after total knee arthroplasty is effective for reducing complications and the need for reintervention. BMC Musculoskelet Disord. 2020;21:490.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Lee HJ, et al. Negative pressure wound therapy for soft tissue injuries around the foot and ankle. J Orthop Surg Res. 2009;4:14.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Gupta S, et al. Clinical recommendations and practical guide for negative pressure wound therapy with instillation. Int Wound J. 2016;13:159–74.

    Article  PubMed  Google Scholar 

  35. Alkhateep Y, et al. Negative pressure wound therapy for chronic venous ulcer. Egyptian J Surg. 2018;37(2):196–9.

    Article  Google Scholar 

  36. Hasan MY, et al. Negative-pressure wound therapy for management of diabetic foot wounds: a review of the mechanism of action, clinical applications, and recent developments. Diabet Foot Ankle. 2015;6:27618.

    Article  PubMed  Google Scholar 

  37. Chen L, et al. A systematic review and meta-analysis of efficacy and safety of negative pressure wound therapy in the treatment of diabetic foot ulcer. Ann Palliat Med. 2021;10(10):10830–9.

    Article  PubMed  Google Scholar 

  38. Song YP, et al. Negative-pressure wound therapy for III/IV pressure injuries: a meta-analysis. Wound Repair Regen. 2021;29(1):20–33.

    Article  PubMed  Google Scholar 

  39. Jiang ZY, et al. Negative-pressure wound therapy in skin grafts: a systematic review and meta-analysis of randomized controlled trials. Burns. 2021;47(4):747–55.

    Article  PubMed  Google Scholar 

  40. Fleck T, Fleck M. Negative pressure wound therapy for the treatment of sternal wound infections after cardiac surgery. Int Wound J. 2014;11(3):240–5.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. University of Padova, Padua, Italy

    Franco Bassetto & Scarpa Carlotta

Authors
  1. Franco Bassetto
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  2. Scarpa Carlotta
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Corresponding author

Correspondence to Scarpa Carlotta .

Editor information

Editors and Affiliations

  1. Unit of Plastic and Reconstructive Surgery, Department of Precision and Regenerative Medicine and Jonic Area, University of Bari, Bari, Italy

    Michele Maruccia

  2. Plastic Surgery Unit, University of Trieste, Cattinara Hospital, Trieste, Italy

    Giovanni Papa

  3. Difficult Wound Healing Unit, Policlinico di Monza, Vercelli, Italy, Italy

    Elia Ricci

  4. Plastic and Reconstructive Surgery, University of Bari Aldo Moro, Bari, Italy

    Giuseppe Giudice

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Bassetto, F., Carlotta, S. (2023). Scientific Principles and Clinical Application of Negative Pressure Wound Therapy (NPWT). In: Maruccia, M., Papa, G., Ricci, E., Giudice, G. (eds) Pearls and Pitfalls in Skin Ulcer Management. Springer, Cham. https://doi.org/10.1007/978-3-031-45453-0_13

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  • DOI: https://doi.org/10.1007/978-3-031-45453-0_13

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-45452-3

  • Online ISBN: 978-3-031-45453-0

  • eBook Packages: MedicineMedicine (R0)

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