title: Negative pressure therapy for closed spine incisions: a pilot study.
abstract: ﻿Negative pressure therapy (NPT), used on open wounds or postoperative infections, has not been evaluated on closed spinal incisions. This was analyzed after 3 days and 5 days of NPT application using biomechanics and histology in a porcine model.
  
  
  METHODS
  In 8 mature miniature pigs, 2 end-to-end midline spine incisions were closed in a standard fashion. Negative pressure (Prevena™ Incision Management System, KCI, San Antonio,TX) was applied to one incision (NPT group) while standard dry dressings were used on the other (control group). After 3 days or 5 days, all incisions underwent biomechanical (eg, failure load, failure energy, and stress), histological, and scar scale evaluation.
  
  
  METHODS
  ANOVAs compared the groups (3-day vs 5-day, NPT vs control, P < 0.05). Negative pressure therapy demonstrated a significantly improved scar scale height grade than the control (P = 0.026). Failure load (4.9 ± 4.0 vs 16.5 ± 14.6 N), energy absorbed (8.0 ± 9.0 vs. 26.9 ± 23.0 mJ), and ultimate stress (62 ± 53 vs. 204 ± 118 N/mm2) were lower in the control group. Histological analysis revealed no differences in incision scar width.
  
  
  CONCLUSIONS
  Negative pressure therapy application on closed incisions presented a trend toward improved early healing strength, and in significantly improved incision appearance. Clinically, NPT may improve incision integrity, minimizing the risk of dehiscence or subsequent infection. Patients at high risk of postoperative incision site complications may benefit from primary application of NPT.
authors: Rady Children's Hospital, Orthopedic Biomechanics Research Center, San Diego, CA.
authors: Diana A
authors: DA
authors: Glaser
authors: Rady Children's Hospital, Orthopedic Biomechanics Research Center, San Diego, CA; email: cfarnsworth@rchsd.org.
authors: Christine L
authors: CL
authors: Farnsworth
authors: Department of Orthopaedic Surgery, University of California, San Diego.
authors: Eric S
authors: ES
authors: Varley
authors: Rady Children's Hospital, Orthopedic Biomechanics Research Center, San Diego, CA.
authors: Thomas A
authors: TA
authors: Nunn
authors: Department of Orthopaedic Surgery, University of California, San Diego.
authors: Mehria
authors: M
authors: Sayad-Shah
authors: Rady Children's Hospital, Orthopedic Biomechanics Research Center, San Diego, CA.
authors: Eric A
authors: EA
authors: Breisch
authors: Rady Children's Hospital, Orthopedic Biomechanics Research Center, San Diego, CA.
authors: Burt
authors: B
authors: Yaszay