title: Closed incision management with negative pressure wound therapy (CIM): biomechanics.
abstract: A novel closed incision management with negative pressure wound therapy (CIM) has been developed for convenient use with closed incisions that has the potential to be beneficial for patients at risk for postoperative complications. Incisions are typically under lateral tension. This study explored the biomechanical mechanisms by which integrity of the incisional closure is enhanced by CIM. CIM was hypothesized to affect local stresses around closed incisions in a beneficial manner. Finite element analyses (FEA) indicated that application of CIM decreased the lateral stresses ~50% around the incision and changed the direction of the stresses to a distribution that is typical of intact tissue. Bench evaluations corroborated findings that CIM significantly increased the force required to disrupt the closed incision by ~50% as compared with closure alone. In conclusion, using 2 FEAs and bench modeling, CIM was shown to reduce and normalize tissue stresses and bolster appositional forces at the incision.
authors.affiliation: Global Research and Development, Kinetic Concepts, Inc, San Antonio, TX 78249, USA. robert.wilkes@kci1.com
authors.forename: Robert Peyton
authors.initials: RP
authors.lastname: Wilkes
authors.forename: Deepak V
authors.initials: DV
authors.lastname: Kilpad
authors.forename: Yabin
authors.initials: Y
authors.lastname: Zhao
authors.forename: Richard
authors.initials: R
authors.lastname: Kazala
authors.forename: Amy
authors.initials: A
authors.lastname: McNulty
mesh_terms: D000704:Analysis of Variance; D001696:Biomechanical Phenomena; D015897:Comorbidity; D003198:Computer Simulation; D020342:Finite Element Analysis; D006801:Humans; D008953:Models, Anatomic; D054843:Negative-Pressure Wound Therapy; D018709:Statistics, Nonparametric; D013529:Surgical Wound Dehiscence / Q000503:physiopathology* / Q000517:prevention & control*; D013536:Suture Techniques; D014945:Wound Healing / Q000502:physiology