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Comparison of tissue damage, cleansing and cross-contamination potential during wound cleansing via two methods: lavage and negative pressure wound therapy with instillation.
MedLine Citation:
PMID:  22905800     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
The use of lavage was compared to negative pressure wound therapy (NPWT) with instillation (NPWTi) to assess extent of soft tissue damage, debris removal and environmental cross-contamination susceptibility in three distinct models. Scanning electron microscopy in an ex vivo model showed increased visible tissue trauma from lavage treatment at low and high pressures versus NPWTi with the degree of trauma relative to the pressure of the irrigant. These results were corroborated in granulating full-thickness excisional swine wounds coated with dextran solution to simulate wound debris. Both low-pressure lavage and NPWTi demonstrated effective cleansing in this model, reducing debris by >90%. However, using three-dimensional photography to evaluate tissue damage by measuring immediate tissue swelling (changes in wound volume and depth) showed significantly greater (P < 0.05) swelling in low-pressure lavage-treated wounds compared with NPWTi-treated wounds. Lastly, bench top wound models were inoculated with fluorescent bacterial particles to assess environmental cross-contamination potential and collected at measured distances after treatment with low-pressure lavage and NPWTi. No evidence of cross-contamination was found with NPWTi, whereas one half of the particles became 'aerosolised' during low-pressure lavage (P < 0.05). Collectively, these studies demonstrate the effective wound cleansing capabilities of NPWTi without the tissue damage and environmental contamination associated with lavage.
Authors:
Diwi Allen; Lori A Labarbera; Ioana L Bondre; Marcus C Lessing; Anthony M Rycerz; Deepak V Kilpadi; Barbara A Collins; Joanna Perkins; Amy K McNulty
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-21
Journal Detail:
Title:  International wound journal     Volume:  -     ISSN:  1742-481X     ISO Abbreviation:  Int Wound J     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101230907     Medline TA:  Int Wound J     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 Kinetic Concepts. International Wound Journal © 2011 Blackwell Publishing Ltd and Medicalhelplines.com Inc.
Affiliation:
D Allen, MS, Active Healing Solutions-Applied Sciences, Kinetic Concepts, Inc., San Antonio, TX, USA LA LaBarbera, BS, Active Healing Solutions-Applied Sciences, Kinetic Concepts, Inc., San Antonio, TX, USA IL Bondre, BS, Active Healing Solutions-Applied Sciences, Kinetic Concepts, Inc., San Antonio, TX, USA MC Lessing, PhD, Active Healing Solutions-Applied Sciences, Kinetic Concepts, Inc., San Antonio, TX, USA AM Rycerz Jr, PhD, Active Healing Solutions-Applied Sciences, Kinetic Concepts, Inc., San Antonio, TX, USA DV Kilpadi, PhD, Active Healing Solutions-Applied Sciences, Kinetic Concepts, Inc., San Antonio, TX, USA BA Collins, BS, RVT, Active Healing Solutions-Applied Sciences, Kinetic Concepts, Inc., San Antonio, TX, USA J Perkins, BS, Active Healing Solutions-Applied Sciences, Kinetic Concepts, Inc., San Antonio, TX, USA AK McNulty, PhD, Active Healing Solutions-Applied Sciences, Kinetic Concepts, Inc., San Antonio, TX, USA.
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