PDF(Pubmed)
Abstract：
Negative Pressure Wound Therapy (NPWT) has been widely adopted in wound healing strategies due to its multimodal mechanism of action. While NPWT\'s positive impression on wound healing is well-established, its effect on bacterial load reduction remains equivocal. This study investigates NPWT\'s efficacy in reducing bioburden using an in vitro porcine skin model, focusing on the impact of Staphylococcus aureus and Staphylococcus epidermidis. Custom-made negative pressure chambers were employed to apply varying negative pressures. Porcine skin was cut into 5 × 5 cm squares and three standardized wounds of 6 mm each were created using a biopsy punch. Then, wounds were infected with S. aureus and S. epidermidis bacterial suspensions diluted 1:10,000 to obtain a final concentration of 1.5 × 104 CFU/ml and were placed in negative pressure chambers. After incubation, bacterial counts were expressed as colony-forming units (CFU) per ml. For S. aureus at 120 hours, the median CFU, mean area per colony, and total growth area were notably lower at -80 mmHg when compared to -250 mmHg and -50 mmHg, suggesting an optimal negative pressure for the pressure-dependent inhibition of the bacterial proliferation. While analyzing S. epidermidis at 120 hours, the response to the negative pressure was similar but less clear, with the minor CFU at -100 mmHg. The influence of intermittent negative pressure on the S. epidermidis growth showed notably lower median CFU with the interval therapy every hour compared to the S. aureus control group. This study contributes valuable insights into NPWT\'s influence on the bacterial load, emphasizing the need for further research to reformulate its role in managing contaminated wounds.
摘要：
负压伤口治疗（NPWT）由于其多模式作用机制而被广泛用于伤口愈合策略。虽然NPWT对伤口愈合的积极印象是公认的，它对减少细菌负荷的影响仍然模棱两可。本研究使用体外猪皮肤模型调查NPWT在减少生物负载方面的功效，重点对金黄色葡萄球菌和表皮葡萄球菌的影响。采用定制的负压室来施加变化的负压。将猪皮肤切成5X5cm的正方形,并使用活检穿孔器产生三个各自6mm的标准化伤口。然后，用稀释为1:10,000的金黄色葡萄球菌和表皮葡萄球菌细菌悬浮液感染伤口,以获得1.5×104CFU/ml的终浓度,并置于负压室中。孵化后,细菌计数表示为每毫升菌落形成单位(CFU)。对于金黄色葡萄球菌在120小时，CFU中位数，每个殖民地的平均面积，与-250mmHg和-50mmHg相比，-80mmHg的总生长面积明显较低，提示压力依赖性抑制细菌增殖的最佳负压。在120小时分析表皮葡萄球菌时，对负压的反应相似，但不太清楚，次要CFU为-100mmHg。与金黄色葡萄球菌对照组相比,间歇性负压对表皮葡萄球菌生长的影响显示每小时间隔治疗的中值CFU显著较低。这项研究为NPWT对细菌负荷的影响提供了有价值的见解，强调需要进一步研究以重新制定其在管理受污染伤口中的作用。
