Arch Plast Surg.  2014 Nov;41(6):668-672. 10.5999/aps.2014.41.6.668.

Influence of Negative-Pressure Wound Therapy on Tissue Oxygenation of the Foot

• Shon YS
• Lee YN
• Jeong SH
• Dhong ES
• Han SK

• KMID: 2267616
• DOI: http://doi.org/10.5999/aps.2014.41.6.668

Abstract

BACKGROUND
Negative-pressure wound therapy (NPWT) is believed to accelerate wound healing by altering wound microvascular blood flow. Although many studies using laser Doppler have found that NPWT increases perfusion, recent work using other modalities has demonstrated that perfusion is reduced. The purpose of this study was to investigate the influence of NPWT on tissue oxygenation of the foot, which is the most sensitive region of the body to ischemia.
METHODS
Transcutaneous partial pressure of oxygen (TcpO2) was used to determine perfusion beneath NPWT dressings of 10 healthy feet. The sensor was placed on the tarso-metatarsal area of the foot and the NPWT dressing was placed above the sensor. TcpO2 was measured until it reached a steady plateau state. The readings obtained at the suction-on period were compared with the initial baseline (pre-suction) readings.
RESULTS
TcpO2 decreased significantly immediately after applying NPWT, but gradually increased over time until reaching a steady plateau state. The decrease in TcpO2 from baseline to the steady state was 2.9 to 13.9 mm Hg (mean, 9.3+/-3.6 mm Hg; 13.5+/-5.8%; P<0.01). All feet reached a plateau within 20 to 65 minutes after suction was applied.
CONCLUSIONS
NPWT significantly decrease tissue oxygenation of the foot by 2.9 to 13.9 mm Hg. NPWT should be used with caution on feet that do not have adequate tissue oxygenation for wound healing.

Keyword

Negative-pressure wound therapy; Oxygen partial pressure determination, Transcutaneous; Foot

MeSH Terms

Bandages
Blood Gas Monitoring, Transcutaneous
Foot*
Ischemia
Negative-Pressure Wound Therapy*
Oxygen*
Partial Pressure
Perfusion
Reading
Suction
Wound Healing
Wounds and Injuries
Oxygen