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Influence of negative-pressure wound therapy on tissue oxygenation of the foot.

Shon YS, Lee YN, Jeong SH, Dhong ES, Han SK - Arch Plast Surg (2014)

Bottom Line: The readings obtained at the suction-on period were compared with the initial baseline (pre-suction) readings.TcpO2 decreased significantly immediately after applying NPWT, but gradually increased over time until reaching a steady plateau state.NPWT significantly decrease tissue oxygenation of the foot by 2.9 to 13.9 mm Hg.

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.

ABSTRACT

Background: Negative-pressure wound therapy (NPWT) is believed to accelerate wound healing by altering wound microvascular blood flow. Although many studies using laser Doppler have found that NPWT increases perfusion, recent work using other modalities has demonstrated that perfusion is reduced. The purpose of this study was to investigate the influence of NPWT on tissue oxygenation of the foot, which is the most sensitive region of the body to ischemia.

Methods: Transcutaneous partial pressure of oxygen (TcpO2) was used to determine perfusion beneath NPWT dressings of 10 healthy feet. The sensor was placed on the tarso-metatarsal area of the foot and the NPWT dressing was placed above the sensor. TcpO2 was measured until it reached a steady plateau state. The readings obtained at the suction-on period were compared with the initial baseline (pre-suction) readings.

Results: TcpO2 decreased significantly immediately after applying NPWT, but gradually increased over time until reaching a steady plateau state. The decrease in TcpO2 from baseline to the steady state was 2.9 to 13.9 mm Hg (mean, 9.3±3.6 mm Hg; 13.5±5.8%; P<0.01). All feet reached a plateau within 20 to 65 minutes after suction was applied.

Conclusions: NPWT significantly decrease tissue oxygenation of the foot by 2.9 to 13.9 mm Hg. NPWT should be used with caution on feet that do not have adequate tissue oxygenation for wound healing.

No MeSH data available.


Related in: MedlinePlus

NPWT dressing above the TcpO2 sensorNPWT with the TcpO2 sensor beneath the foam dressing. (A) TcpO2 sensor placed on the tarso-metatarsal area. (B) On one area of the foam dressing, a portion was cut out to fit the shape and size of the TcpO2 sensor. (C) The foam dressing was applied above the sensor. A drainage tube was connected to the foam dressing on the opposite side of the TcpO2 sensor location. Negative pressure was applied. NPWT, negative-pressure wound therapy; TcpO2, transcutaneous partial pressure of oxygen.
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Figure 1: NPWT dressing above the TcpO2 sensorNPWT with the TcpO2 sensor beneath the foam dressing. (A) TcpO2 sensor placed on the tarso-metatarsal area. (B) On one area of the foam dressing, a portion was cut out to fit the shape and size of the TcpO2 sensor. (C) The foam dressing was applied above the sensor. A drainage tube was connected to the foam dressing on the opposite side of the TcpO2 sensor location. Negative pressure was applied. NPWT, negative-pressure wound therapy; TcpO2, transcutaneous partial pressure of oxygen.

Mentions: On one area of the foam dressing, a portion was cut out to fit the shape and size of the TcpO2 sensor. The prepared foam dressing was then applied above the sensor so that the cut-out portion fit over the sensor. The overlying foam dressing was carefully sealed with an adhesive transparent film so as not to affect the baseline TcpO2 value by compressing the foam dressing. After confirming that the foam dressing did not change the TcpO2, a drainage tube was connected to the foam dressing on the opposite side of the TcpO2 sensor location to avoid direct compression of the sensor. This can minimize additional pressure at the sensor site while a vacuum pump delivers pressure. Suction pressure of 125 mm Hg was then applied until TcpO2 reached a steady plateau state. The patients were lying comfortably on their backs throughout the measurement (Fig. 1).


Influence of negative-pressure wound therapy on tissue oxygenation of the foot.

Shon YS, Lee YN, Jeong SH, Dhong ES, Han SK - Arch Plast Surg (2014)

NPWT dressing above the TcpO2 sensorNPWT with the TcpO2 sensor beneath the foam dressing. (A) TcpO2 sensor placed on the tarso-metatarsal area. (B) On one area of the foam dressing, a portion was cut out to fit the shape and size of the TcpO2 sensor. (C) The foam dressing was applied above the sensor. A drainage tube was connected to the foam dressing on the opposite side of the TcpO2 sensor location. Negative pressure was applied. NPWT, negative-pressure wound therapy; TcpO2, transcutaneous partial pressure of oxygen.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4228208&req=5

Figure 1: NPWT dressing above the TcpO2 sensorNPWT with the TcpO2 sensor beneath the foam dressing. (A) TcpO2 sensor placed on the tarso-metatarsal area. (B) On one area of the foam dressing, a portion was cut out to fit the shape and size of the TcpO2 sensor. (C) The foam dressing was applied above the sensor. A drainage tube was connected to the foam dressing on the opposite side of the TcpO2 sensor location. Negative pressure was applied. NPWT, negative-pressure wound therapy; TcpO2, transcutaneous partial pressure of oxygen.
Mentions: On one area of the foam dressing, a portion was cut out to fit the shape and size of the TcpO2 sensor. The prepared foam dressing was then applied above the sensor so that the cut-out portion fit over the sensor. The overlying foam dressing was carefully sealed with an adhesive transparent film so as not to affect the baseline TcpO2 value by compressing the foam dressing. After confirming that the foam dressing did not change the TcpO2, a drainage tube was connected to the foam dressing on the opposite side of the TcpO2 sensor location to avoid direct compression of the sensor. This can minimize additional pressure at the sensor site while a vacuum pump delivers pressure. Suction pressure of 125 mm Hg was then applied until TcpO2 reached a steady plateau state. The patients were lying comfortably on their backs throughout the measurement (Fig. 1).

Bottom Line: The readings obtained at the suction-on period were compared with the initial baseline (pre-suction) readings.TcpO2 decreased significantly immediately after applying NPWT, but gradually increased over time until reaching a steady plateau state.NPWT significantly decrease tissue oxygenation of the foot by 2.9 to 13.9 mm Hg.

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.

ABSTRACT

Background: Negative-pressure wound therapy (NPWT) is believed to accelerate wound healing by altering wound microvascular blood flow. Although many studies using laser Doppler have found that NPWT increases perfusion, recent work using other modalities has demonstrated that perfusion is reduced. The purpose of this study was to investigate the influence of NPWT on tissue oxygenation of the foot, which is the most sensitive region of the body to ischemia.

Methods: Transcutaneous partial pressure of oxygen (TcpO2) was used to determine perfusion beneath NPWT dressings of 10 healthy feet. The sensor was placed on the tarso-metatarsal area of the foot and the NPWT dressing was placed above the sensor. TcpO2 was measured until it reached a steady plateau state. The readings obtained at the suction-on period were compared with the initial baseline (pre-suction) readings.

Results: TcpO2 decreased significantly immediately after applying NPWT, but gradually increased over time until reaching a steady plateau state. The decrease in TcpO2 from baseline to the steady state was 2.9 to 13.9 mm Hg (mean, 9.3±3.6 mm Hg; 13.5±5.8%; P<0.01). All feet reached a plateau within 20 to 65 minutes after suction was applied.

Conclusions: NPWT significantly decrease tissue oxygenation of the foot by 2.9 to 13.9 mm Hg. NPWT should be used with caution on feet that do not have adequate tissue oxygenation for wound healing.

No MeSH data available.


Related in: MedlinePlus