Structure-guided negative pressure wound therapy (NPWT): personalised tissue biomodulation with an NPWT system in adults and older adults.

IF 1.7 4区 医学 Q3 DERMATOLOGY
Leticia Vallejo-Carmona
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Abstract

Background: Negative pressure wound therapy (NPWT) has revolutionised the management of complex wounds via mechanisms such as microdeformation, angiogenesis and exudate control. However, its clinical effect has historically only been evaluated by qualitative and visual parameters. This study integrates near-infrared spectroscopy (NIRS) as a biofeedback tool to quantify physiological response to NPWT in real time.

Objective: This study aimed to quantitatively demonstrate the physiological and structural changes induced by an NPWT system in patients with complex wounds, measured using NIRS.

Methods: A prospective real-world observational study was conducted with a cohort of 23 patients with 33 wounds. Structural and physiological parameters were documented before and after NPWT treatment. Random-intercept mixed-effect statistical models and pre-post comparison tests were used to assess clinical and physiological significance.

Results: The data showed a progressive reduction in wound area and volume, accompanied by an increase in tissue oxygen saturation and a sustained decrease in deoxygenated haemoglobin. These findings, objectively quantified through NIRS as a real-time biofeedback tool, highlight the improvement in oxygenation and wound-bed perfusion and support the hypothesis of tissue biomodulation induced by NPWT.

Conclusion: The integration of NIRS redefines the clinical role of NPWT, allowing therapy to be customised based on specific physiological data. This combination represents a new frontier in precision wound medicine. The results of this study provide a foundation for a new generation of clinical decisions in advanced wound management.

结构引导负压伤口治疗(NPWT):在成人和老年人中使用NPWT系统进行个性化组织生物调节。
背景:负压伤口疗法(NPWT)通过微变形、血管生成和渗出控制等机制彻底改变了复杂伤口的管理。然而,其临床效果历来仅通过定性和视觉参数来评估。本研究将近红外光谱(NIRS)作为生物反馈工具,实时量化NPWT的生理反应。目的:本研究旨在定量证明NPWT系统在复杂伤口患者中引起的生理和结构变化,采用近红外光谱测量。方法:对23例33处伤口的患者进行前瞻性观察研究。记录NPWT治疗前后的结构和生理参数。采用随机截距混合效应统计模型和前后比较检验来评估临床和生理意义。结果:数据显示伤口面积和体积逐渐减少,伴随着组织氧饱和度的增加和缺氧血红蛋白的持续下降。这些发现通过近红外光谱作为实时生物反馈工具进行客观量化,突出了NPWT对氧合和伤床灌注的改善,并支持了NPWT诱导组织生物调节的假设。结论:NIRS的整合重新定义了NPWT的临床作用,允许根据特定的生理数据定制治疗。这种组合代表了精准伤口医学的新前沿。本研究结果为新一代晚期伤口处理的临床决策提供了基础。
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来源期刊
Journal of wound care
Journal of wound care DERMATOLOGY-
CiteScore
2.90
自引率
10.50%
发文量
215
期刊介绍: Journal of Wound Care (JWC) is the definitive wound-care journal and the leading source of up-to-date research and clinical information on everything related to tissue viability. The journal was first launched in 1992 and aimed at catering to the needs of the multidisciplinary team. Published monthly, the journal’s international audience includes nurses, doctors and researchers specialising in wound management and tissue viability, as well as generalists wishing to enhance their practice. In addition to cutting edge and state-of-the-art research and practice articles, JWC also covers topics related to wound-care management, education and novel therapies, as well as JWC cases supplements, a supplement dedicated solely to case reports and case series in wound care. All articles are rigorously peer-reviewed by a panel of international experts, comprised of clinicians, nurses and researchers. Specifically, JWC publishes: High quality evidence on all aspects of wound care, including leg ulcers, pressure ulcers, the diabetic foot, burns, surgical wounds, wound infection and more The latest developments and innovations in wound care through both preclinical and preliminary clinical trials of potential new treatments worldwide In-depth prospective studies of new treatment applications, as well as high-level research evidence on existing treatments Clinical case studies providing information on how to deal with complex wounds Comprehensive literature reviews on current concepts and practice, including cost-effectiveness Updates on the activities of wound care societies around the world.
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