Negative Pressure Wound Therapy and its Application to Orthopaedics. Part I: Literature Review

Abstract

Negative pressure wound therapy (NPWT) is a technique that converts an open wound into a controlled closed environment by applying intermittent or continuous sub-atmospheric pressure to a specialized wound dressing in order to stimulate healing. The available literature which has set the standard for the care of acute and chronic orthopaedic wounds using this technique, especially for the lower extremities, is reviewed. Original studies by Morykwas and Argenta are discussed as well as the current basic science and clinical studies related to care for the orthopaedic patient. Finally, complications reported in the literature are addressed.

Key words

NPWT - wound VAC - basic science - history

References

• 1 Argenta L C, Morykwas M J. Vacuum-assisted closure: a new method for wound control and treatment: clinical experience.  Ann Plast Surg. 1997;  38 563-577
• 2 Armstrong D G, Lavery L A. Diabetic foot study consortium. Negative pressure wound therapy after partial diabetic foot amputation: a multicenter, randomised controlled trial.  Lancet. 2005;  336 (9498) 1704-1710
• 3 Barringer C B, Gorse S J, Burge T S. The VAC dressing - cautionary tale.  Br J Plast Surg. 2004;  57 482
• 4 Bonham P A. Surgical wound case studies with the Versatile 1 wound vacuum system for negative pressure wound therapy.  J Wound Ostomy Continence Nurs. 2006;  33 185-190
• 5 Burdette-Taylor S R. Use of the Versatile One (V1) for closed suction drainage to stimulate closure in chronic wounds in home care. Poster supported by Blue Sky Medical of San Diego, CA and Genesis Medical of Indianapolis, IN
• 6 Clare M P, Fitzgibbons T C, McMullen S T, Stice R C, Hayes D F, Henkel L. Experience with the vacuum assisted closure negative pressure technique in the treatment of non-healing diabetic and dysvascular wounds.  Foot and Ankle International. 2002;  23 896-901
• 7 Campbell P E. Surgical wound case studies with the Versatile 1 wound vacuum system for negative pressure wound therapy.  J Wound Ostomy Continence Nurs. 2006;  33 176-185
• 8 Davydov Y A, Larichev K G. The bacteriological and cytological assessment of vacuum therapy of purulent wound.  Vestnik Khirugii. 1988;  10 48-52 ,  Translation by Blue Sky Medical, 2004
• 9 Davydov Y A, Larichev K G, Abramov A Y. Concepts for clinical biological management of the wound process in the treatment of purulent wounds using vacuum therapy.  Vestnik Khirugii. 1991;  2 132-135 ,  Translation by Blue Sky Medical, 2004
• 10 Davydov Y A, Malafeeva A P, Smirnov A P. Vacuum therapy in the treatment of purulent lactation mastitis.  Vestnik Khirurgii. 1986;  9 66-70 ,  Translation by Blue Sky Medical, 2004
• 11 DeFranzo A J, Argenta L C, Marks M W, Molnar J A, David L R, Webb L X, Ward W G, Teasdall R G. The use of vacuum-assisted closure therapy for the treatment of lower-extremity wounds with exposed bone.  Plast Reconst Surg. 2001;  108 1184-1191
• 12 Eginton M T, Brown K R, Seabrook G R, Towne J B, Cambria R A. A prospective randomized evaluation of negative-pressure wound dressings for diabetic foot wounds.  Ann Vasc Surg. 2003;  17 645-649
• 13 Fleischmann W, Lang E, Kinzl L. Vacuum assisted wound closure after dermatofasciotomy of the lower extremity.  Unfallchirurg. 1996;  99 283-287 ,  [in German]
• 14 Fleischmann W, Lang E, Russ M. Treatment of infection by vacuum sealing.  Unfallchirurg. 1997;  100 301-304 ,  [in German]
• 15 Fleischmann W, Russ M, Marquardt C. Closure of defect wounds by combined vacuum sealing with instrumental skin expansion.  Unfallchirurg. 1996;  99 970-974 ,  [in German]
• 16 Fleischmann W, Strecker W, Bombelli M, Kinzl L. Vacuum sealing as treatment of soft tissue damage in open fractures.  Unfallchirurg. 1993;  96 488-492 ,  [in German]
• 17 Green A K, Puder M, Roy R, Arsenault D, Kwei S, Moses M A, Orgill D P. Microdeformational wound therapy: Effects on angiogenesis and matrix metalloproteinases in chronic wounds of 3 debilitated patients.  Ann Plast Surg. 2006;  56 418-422
• 18 Gwan-Nulla D N, Casal R S. Toxic shock syndrome associated with the use of the vacuum assisted closure device.  Ann Plast Surg. 2001;  47 552-554
• 19 Herscovici D, Sanders R W, Scaduto J M, Infante A, DiPasquale T. Vacuum-assisted wound closure (VAC therapy) for the management of patients with high-energy soft tissue injuries.  J Orthop Trauma. 2003;  17 683-688
• 20 Ilizarov G A. The tension-stress effect on the genesis and growth of tissues. Part I. The influence of stability of fixation and soft tissue preservation.  Clin Orthop Rel Res. 1989;  238 249-281
• 21 Ilizarov G A. The tension-stress effect on the genesis and growth of tissues. Part II. The influence of the rate and frequency of distraction.  Clin Orthop Rel Res. 1989;  239 263-285
• 22 Joseph E, Hamori C A, Bergman S, Roaf E, Swann N F, Anastasi G W. A prospective randomized trial of vacuum-assisted closure versus standard therapy of chronic nonhealing wounds.  Wounds. 2000;  12 60-67
• 23 Kostiuchenok I I, Kolker V A, Karlov V A. The vacuum effect in the surgical treatment of purulent wounds.  Vestnik Khirurgii. 1986;  9 18-21 ,  Translation by Blue Sky Medical, 2004
• 24 Mendonca D A, Cosker T, Makwana N K. Vacuum-assisted closure to aid wound healing in foot and ankle surgery.  Foot and Ankle International. 2005;  26 761-766
• 25 Miller M S, McDaniel C. Treating wound dehiscence with an alternative system of delivering topical negative pressure.  J Wound Care. 2006;  17 321-324
• 26 Morykwas M J, Argenta L C, Shelton-Brown E I, McGuirt W. Vacuum-assisted closure: a new method for wound control and treatment: animal studies and basic foundation.  Ann Plast Surg. 1997;  38 553-562
• 27 Morykwas M J, Faler B J, Pearce D J, Argenta L C. Effects of varying levels of subatmospheric pressure on the rate of granulation tissue formation in experimental wounds in swine.  Ann Plast Surg. 2001;  47 547-551
• 28 Müllner T, Mrkonjic L, Kwasny O, Vécsei V. The use of negative pressure to promote healing of tissue defects: a clinical trial using vacuum sealing technique.  Br J Plast Surg. 1997;  50 194-199
• 29 Parrett B M, Matros E, Pribaz J J, Orgill D P. Lower extremity trauma: trends in the management of soft-tissue reconstruction of open tibia-fibula fractures.  Plast Reconstr Surg. 2006;  117 1315-1322
• 30 Saxena V, Hwang C, Huang S, Eichbaum Q, Inber D, Orgill D. Vacuum-assisted closure: microdeformations of wounds and cell proliferation.  Plast Reconstr Surg. 2004;  114 1086-1096
• 31 Shi B, Chen S Z, Zhang P, Li J Q. Effects of vacuum assisted closure on the expression of MMP-1, 2, 13 in human granulation wounds.  Zhongua Sheng Wai Ke Ka Zhi. 2003;  19 279-281
• 32 Sumpio B E, Banes A J, Levin L G. et al . Mechanical stress stimulates aortic endothelial cells to proliferate.  J Vasc Surg. 1987;  6 252-256
• 33 Thoma R. Über die Histomechanik des Gefäßsystems und die Pathogenese der Angiosklerose.  Virchows Archiv Path Anat. 1911;  204 1-74
• 34 Usupov Y N, Yepifanov M V. Active wound drainage.  Vestnik Khirugii. 1987;  4 42-45 ,  Translation by Blue Sky Medical, 2004
• 35 Wackenfors A, Sjogren J, Gustafsson R, Algotsson L, Ingemansson R, Malmsjo M. Effects of vacuum-assisted closure therapy on inguinal wound edge microvascular blood flow.  Wound Repair and Regeneration. 2004;  12 600-606
• 36 Wirtz H RW, Dobbs L G. Calcium mobilization and exocytosis after one mechanical stretch of lung epithelial cells.  Science. 1990;  250 1266-1269
• 37 Yang C C, Chang D S, Webb L X. Vacuum-assisted closure for fasciotomy wounds following compartment syndrome of the leg.  J Surg Orthop Adv. 2006;  15 19-23