Changes of perfusion patterns of surgical wounds under application of closed incision negative pressure wound therapy in postbariatric patients¹

Article type: Research Article

Authors: Renno, Isabell^a | Boos, Anja M.^{a; b} | Horch, Raymund E.^a | Ludolph, Ingo^{a; *}

Affiliations: [a] Department of Plastic and Hand Surgery University Hospital of Erlangen, Friedrich-Alexander-University of Erlangen-Nürnberg (FAU), Erlangen, Germany | [b] Department of Plastic Surgery, Hand and Burn Surgery University Hospital of Aachen, RWTH University of Aachen, Aachen, Germany

Correspondence: [*] Corresponding author: Ingo Ludolph, Krankenhausstrasse 12, Erlangen, Bavaria, 91054, Germany. E-mail: [email protected].

Note: [1] This is a prospective randomized controlled clinical study.

Abstract: BACKGROUND:Negative pressure wound therapy applied over closed incisions (ciNPT) has been shown to influence wound healing. Therefore, the aim of this study was to examine the short-term effects of ciNPT on skin perfusion patterns in postbariatric wounds. METHODS:17 patients were included. Patients from the study group received a ciNPT dressing with a continuous negative pressure of – 125 mmHg for five days. Two intra- and two postoperative measurements were performed using both a combined laser Doppler spectrophotometry and an ICG angiography system to determine oxygen saturation (sO2), hemoglobin content (rHb) and perfusion patterns. RESULTS:Three days postoperatively the sO2 was significantly higher in the study group compared to the control group and also compared to the end of the operation. Concerning the rHb, there was no statistical significant alteration in or between the groups, but a trend towards a correlated alteration of sO2 and rHb. ICG angiography showed an earlier and stronger enhancement of perfusion parameters in the study group. CONCLUSION:CiNPT has a positive effect on oxygen saturation and tissue perfusion, which are both associated with the wound healing process. The use of ciNPT could therefore possibly reduce the risk of wound healing complications in this high-risk patient group.

Keywords: Skin perfusion patterns, combined laser Doppler spectrophotometry, ICG angiography, oxygen saturation, relative hemoglobin content, wound healing, O2C, SPY, weight loss, obesity, maintenance of weight loss, body contouring surgery, abdominoplasty, postoperative complications, closed incisional negative pressure wound therapy, ciNPWT, ciNPT, NPWT, postbariatric surgery, postoperative wound care, high-risk patients

DOI: 10.3233/CH-180450

Journal: Clinical Hemorheology and Microcirculation, vol. 72, no. 2, pp. 139-150, 2019