title: Simultaneous irrigation and negative pressure wound therapy enhances wound healing and reduces wound bioburden in a porcine model.
abstract: Infected foot wounds are one of the most common reasons for hospitalization and amputation among persons with diabetes. The objective of the study was to investigate a new wound therapy system that employs negative pressure wound therapy (NPWT) with simultaneous irrigation therapy. For this study, we used a porcine model with full-thickness excisional wounds, inoculated with Pseudomonas aeruginosa. Wounds were treated for 21 days of therapy with either NPWT, NPWT with simultaneous irrigation therapy using normal saline or polyhexanide biguanide (PHMB) at low or high flow rates, or control. Data show that NPWT with either irrigation condition improved wound healing rates over control-treated wounds, yet did not differ from NPWT alone. NPWT improved bioburden over control-treated wounds. NPWT with simultaneous irrigation further reduced bioburden over control and NPWT-treated wounds; however, flow rate did not affect these outcomes. Together, these data show that NPWT with simultaneous irrigation therapy with either normal saline or PHMB has a positive effect on bioburden in a porcine model, which may translate clinically to improved wound healing outcomes.
authors.affiliation: Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Davis
authors.forename: Jessica
authors.initials: J
authors.lastname: Bills
authors.forename: Jenny
authors.initials: J
authors.lastname: Barker
authors.forename: Paul
authors.initials: P
authors.lastname: Kim
authors.forename: Lawrence
authors.initials: L
authors.lastname: Lavery
mesh_terms: D000818:Animals; D058491:Bacterial Load; D003646:Debridement; D017719:Diabetic Foot / Q000382:microbiology / Q000473:pathology / Q000628:therapy*; D005260:Female; D054843:Negative-Pressure Wound Therapy / Q000379:methods*; D011552:Pseudomonas Infections / Q000628:therapy*; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D013552:Swine; D007507:Therapeutic Irrigation; D014945:Wound Healing; D014946:Wound Infection / Q000382:microbiology / Q000473:pathology / Q000628:therapy*