负压伤口治疗(NPWT)广泛用于手术伤口管理和最近的烧伤护理;然而,组织压力变化和最佳敷料应用技术仍然未知。这项研究是为了帮助了解在负压下改变输送压力时组织压力的变化,敷料厚度和敷料分布。这项研究于2021年在一家四级儿科烧伤医院完成。利用尸体猪模型,使用颅内压监测器和传感器评估血压.将换能器放置在表皮上或在超声引导下通过插管插入真皮,皮下或肌肉层。Mepitel™,ACTICOAT™,然后周向或非周向施加不同层的Kerlix™(10、20或30层)和NPWT。当NPWT以-40、-60、-80、-100和-120mmHg递送时,每组结果指示颅内压探头读数。中位数和四分位压记录为表皮:-42(-42.5--41),-60.5(-62.5--60),-80.5(-82--80),-99(-99--98)mmHg(p<0.001);真皮:1(0-2),2(1-3.5),3(2-5.5),4(3-7),5.5(4-7.5)mmHg(p<0.001)(当施加圆周敷料(p<0.001)或更多层Kerlix时,压力增加较小(p<0.001));皮下组织:1.5(-4.5-1),-2.5(-7.5-1.5),-3.5(-11-1.5),-5(-14-1.5)和-6(-16-2)mmHg(p=006)(随着Kerlix层(0.047)和肌肉层的增加,压力降低较小:0(-0.5-0),0(-1-0.5),0(-1-1),00(-1-1),00(-1.5-1)mmHg(p=0.55)。这些数据表明负压矛盾地对真皮施加正压。周向和多层敷料降低了这种正压力。这些知识影响了我们的烧伤负压伤口治疗敷料的选择。这项研究的局限性在于尸体模型,一个活的模型是建议未来的研究。
Negative Pressure Wound Therapy (
NPWT) is broadly used in surgical wound management and more recently burn care; however, the tissue pressure changes and best dressing application technique remains unknown. This study was done to help understand the tissue pressure changes beneath negative pressure when varying the delivered pressures, dressing thickness and distribution of dressings. This study was done in 2021 at a quaternary paediatric burns hospital. Utilising a cadaveric porcine model, an intracranial pressure monitor and transducer were used to assess pressure. The transducer was placed on the epidermis or inserted under ultrasound guidance via cannulation to the dermis, subcutaneous or muscular layer. Mepitel™, ACTICOAT™, varying layers of Kerlix™ (10, 20 or 30 layers) and
NPWT were then applied either circumferentially or non-circumferentially. Each set of results is indicative of the intracranial pressure probe reading when
NPWT was delivered at -40, -60, -80, -100 and -120 mmHg. The median and interquartile pressure recordings were epidermis: -42 (-42.5 - -41), -60.5 (-62.5 - -60), -80.5 (-82 - -80), - 99 (-99 - -98)mmHg (p < 0.001); dermis: 1 (0 - 2), 2 (1 - 3.5), 3 (2 - 5.5), 4 (3 - 7), 5.5 (4 - 7.5)mmHg (p < 0.001) (the increase in pressure was less when circumferential dressings (p < 0.001) or more layers of Kerlix were applied (p < 0.001)); subcutis: 1.5 (-4.5-1), -2.5 (-7.5 - 1.5), -3.5 (-11 - 1.5), -5 (-14 - 1.5) and -6 (-16 - 2)mmHg (p = 006) (the decrease in pressure was less with increased layers of Kerlix (0.047) and muscular: 0 (-0.5 - 0), 0 (-1 - 0.5), 0 (-1 - 1), 0 0 (-1 - 1), 00 (-1.5 - 1)mmHg (p = 0.55). These data suggest negative pressure paradoxically exerts a positive pressure on the dermis. Circumferential and multi-layer dressings reduce this positive pressure. This knowledge has impacted our burn negative pressure wound therapy dressing selection. The limitation of this study is the cadaveric model, a live model is suggested for future studies.