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Wound Edge Microvascular Blood Flow during Negative-Pressure Wound Therapy: Examining the Effects of Pressures from –10 to –175 mmHg

Borgquist, Ola M.D.; Ingemansson, Richard M.D., Ph.D.; Malmsjö, Malin M.D., Ph.D.

Plastic and Reconstructive Surgery: February 2010 - Volume 125 - Issue 2 - p 502-509
doi: 10.1097/PRS.0b013e3181c82e1f
Experimental: Original Articles

Background: Negative-pressure wound therapy is believed to accelerate wound healing by altered wound edge microvascular blood flow. The current standard negative pressure is –125 mmHg. However, this pressure may cause pain and ischemia and often has to be reduced. The aim of the present study was to examine the blood flow effects of different levels of negative pressures (–10 to –175 mmHg).

Methods: Wound edge microvascular blood flow was studied in a peripheral wound model in eight 70-kg pigs on application of negative-pressure wound therapy. Blood flow was examined, using laser Doppler velocimetry, in subcutaneous and muscle tissue at 0.5, 2.5, and 5 cm from the wound edge.

Results: Blood flow changed gradually with increasing negative pressure until reaching a steady state. Blood flow decreased close to the wound edge (0.5 cm) and increased farther from the wound edge (2.5 cm). At 0.5 cm, blood flow decreased 15 percent at –10 mmHg, 64 percent at –45 mmHg, and 97 percent at –80 mmHg. At 2.5 cm, blood flow increased 6 percent at –10 mmHg, 32 percent at –45 mmHg, and 90 percent at –80 mmHg. Higher levels of negative pressure did not have additional blood flow effects (p > 0.30). No blood flow effects were seen 5 cm from the wound edge.

Conclusions: Blood flow changes gradually when the negative pressure is increased. The levels of pressure for negative-pressure wound therapy may be tailored depending on the wound type and tissue composition, and this study implies that –80 mmHg has similar blood flow effects as the clinical standard, –125 mmHg.

Lund, Sweden

From the Departments of Ophthalmology and Cardiothoracic Surgery, Lund University Hospital.

Received for publication March 24, 2009; accepted July 29, 2009.

Disclosure: The study was supported by Prospera. None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this article.

Malin Malmsjö, M.D., Ph.D.; Vascular Research; BMC A13; SE-221 84 Lund, Sweden;

©2010American Society of Plastic Surgeons