title: Negative-pressure wound therapy after fasciotomy reduces muscle-fiber regeneration in a pig model.
abstract: BACKGROUND
  Negative-pressure wound therapy (NPWT) can improve fasciotomy wound closure, but its effects on skeletal muscle are largely unknown. The purpose of this study was to evaluate NPWT effects on skeletal muscle after fasciotomy for compartment syndrome in an animal model and to assess regional variability in muscle fiber regeneration.
  
  
  METHODS
  Compartment syndrome was induced in the hindlimb of twenty-two adult female pigs with use of a continuous intracompartmental serum-infusion model. Fasciotomy was performed after six hours, and animals were randomized to receive either wet-to-dry gauze dressings (control group) or NPWT dressings (-125 mm Hg, continuous suction) for seven days. Delayed primary wound closure was attempted at seven days, and the peroneus tertius was harvested for analysis seven days or twenty-one days after fasciotomy. Muscles were weighed, and hematoxylin and eosin-stained samples from four regions of the muscle (superficial central, deep central, lateral, and proximal) were mapped for different cellular morphologies.
  
  
  RESULTS
  Muscle weight was greater in the affected limb at all time points with no difference between treatment groups. At seven days, only the deep central samples in the NPWT group had a significantly greater cross-sectional area containing normal fibers as compared with that found in the controls. By twenty-one days, the deep central, lateral, and proximal regions of the NPWT-treated muscles had a smaller cross-sectional area containing normal fiber morphology and a greater cross-sectional area containing only mononucleated cells as compared with the controls.
  
  
  CONCLUSIONS
  NPWT did not decrease muscle weight. At twenty-one days, the extent of muscle fiber regeneration after fasciotomy for compartment syndrome was reduced in muscles treated with NPWT for seven days compared with the values in the control group treated with wet-to-dry gauze dressings.
  
  
  CONCLUSIONS
  NPWT may be harmful to skeletal muscle after compartment syndrome requiring fasciotomy and local wound care.
authors.affiliation: Division of Orthopaedic Surgery, University of Ottawa, The Ottawa Hospital-Civic Campus, 1053 Carling Avenue, Ottawa, ON K1Y 4E9, Canada. E-mail address for G. Wilkin: geoff.wilkin@gmail.com.
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Wilkin
authors.affiliation: Department of Cellular and Molecular Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON K1H 8M5, Canada.
authors.forename: Shiemaa
authors.initials: S
authors.lastname: Khogali
authors.affiliation: Division of Orthopaedic Surgery, North York General Hospital, 4001 Leslie Street, Toronto, ON M2K 1E1, Canada.
authors.forename: Shawn
authors.initials: S
authors.lastname: Garbedian
authors.affiliation: Division of Orthopaedic Surgery, Sault Area Hospital, 240 McNabb Street, Sault Ste. Marie, ON P6B 1Y5, Canada.
authors.forename: Bradley
authors.initials: B
authors.lastname: Slagel
authors.affiliation: Department of Cellular and Molecular Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON K1H 8M5, Canada.
authors.forename: Simon
authors.initials: S
authors.lastname: Blais
authors.affiliation: Division of Orthopaedic Surgery, University of Ottawa, The Ottawa Hospital-Civic Campus, 1053 Carling Avenue, Ottawa, ON K1Y 4E9, Canada. E-mail address for G. Wilkin: geoff.wilkin@gmail.com.
authors.forename: Wade
authors.initials: W
authors.lastname: Gofton
authors.affiliation: Division of Orthopaedic Surgery, University of Ottawa, The Ottawa Hospital-Civic Campus, 1053 Carling Avenue, Ottawa, ON K1Y 4E9, Canada. E-mail address for G. Wilkin: geoff.wilkin@gmail.com.
authors.forename: Allan
authors.initials: A
authors.lastname: Liew
authors.affiliation: Department of Cellular and Molecular Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON K1H 8M5, Canada.
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Renaud
authors.affiliation: Division of Orthopaedic Surgery, University of Ottawa, The Ottawa Hospital-Civic Campus, 1053 Carling Avenue, Ottawa, ON K1Y 4E9, Canada. E-mail address for G. Wilkin: geoff.wilkin@gmail.com.
authors.forename: Steven
authors.initials: S
authors.lastname: Papp
mesh_terms: D000818:Animals; D003161:Compartment Syndromes / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D004195:Disease Models, Animal; D000071938:Fasciotomy; D005260:Female; D006614:Hindlimb; D018485:Muscle Fibers, Skeletal / Q000502:physiology*; D054843:Negative-Pressure Wound Therapy / Q000379:methods*; D009929:Organ Size; D012038:Regeneration / Q000502:physiology*; D034421:Sus scrofa