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Biological effects and clinical application of negative pressure wound therapy: a review

02 October 2017
Volume 1 · Issue 4

Abstract

Negative pressure wound therapy (NPWT) has shown great advantages in the management of a wide range of clinical problems such as wound or chronic wound healing; open wounds with exposed bone, nerve, or tendon; and orthopaedic implants and related infection in the orthopaedics field. Even though it has shown positive efficacy in treating infection (wound infection or orthopaedic implant infection), its molecular mechanisms of action remain unclear and require further exploration. Since NPWT is widely used in the clinical setting, a comprehensive understanding of its biological effect will assist in appropriate clinical application. This review summarises the biological effect of NPWT on bacteria and cell growth as well as the possible mechanisms associated with NPWT applied in wound healing. We also highlight novel antibacterial dressings for NPWT. PubMed, and Web of Science database searches were conducted. Several search terms were used including negative pressure wound therapy, bacterial growth, growth factor, wound healing, dressing. All databases were searched from inception to 2015, references that lacked original resarch were eliminated.

Negative pressure wound therapy (NPWT), based on the use of sub-atmospheric pressure, has revolutionised clinical wound management and has been widely used for traumatic wounds (including soft tissue defects, open fractures, and burns) and achieving good outcomes.1,2 It plays an increasingly important role in clinical practice, usually consisting of an open-cell foam dressing covered with an adhesive drape that is connected to a vacuum pump to create and maintain negative pressure. NPWT has shown great advantages in the management of wound or chronic wound healing and has recently been used in the orthopaedic field for the treatment of open wounds with exposed bone, nerve, or tendon, orthopaedic implants, and related infection in the orthopedics field.3,4,5

The clinical application of NPWT mainly relies on the biological effects of negative pressure and mechanical effects on cells, tissues, and bacteria that direct the wound or chronic wound through the healing process.6,7 The negative pressure can be transduced to the wound bed, and the drainage system can influence the transduction of negative pressure to the wound site.8 However, the biological effects of NPWT on wound healing and bacteria remain under debate, as does it's application in infection.

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