Combination of negative pressure wound therapy with open bone grafting for bone and soft tissue defects

Deng,Kai; Yu,Ai-Xi; Xia,Cheng-Yan; Li,Zong-Huan; Wang,Wei-Yang

doi:10.3892/mmr.2013.1536

August 2013 Volume 8 Issue 2

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August 2013 Volume 8 Issue 2

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Article

Combination of negative pressure wound therapy with open bone grafting for bone and soft tissue defects

Authors:
- Kai Deng
- Ai-Xi Yu
- Cheng-Yan Xia
- Zong-Huan Li
- Wei-Yang Wang
View Affiliations / Copyright

Affiliations: Department of Micro-Orthopedics, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, P.R. China
Pages: 468-472
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Published online on: June 20, 2013

https://doi.org/10.3892/mmr.2013.1536
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Abstract

The aim of this study was to investigate the efficiency of negative pressure wound therapy (NPWT) combined with open bone graft (OBG; NPWT-OBG) for the treatment of bone and soft tissue defects with polluted wounds in an animal model. All rabbits with bone and soft tissue defects and polluted wounds were randomly divided into two groups, the experimental group (NPWT with bone graft) and the control group (OBG). The efficacy of the treatment was assessed by the wound conditions and healing time. Bacterial bioburdens and bony calluses were evaluated by bacteria counting and X-rays, respectively. Furthermore, granulation tissue samples from the wounds on days 0, 3, 7 and 14 of healing were evaluated for blood vessels and vascular endothelial growth factor (VEGF) levels. Wounds in the experimental group tended to have a shorter healing time, healthier wound conditions, lower bacterial bioburden, improvement of the bony calluses and an increased blood supply compared with those in the control group. With NPWT, wound infection was effectively controlled. For wounds with osseous and soft tissue defects, NPWT combined with bone grafting was demonstrated to be more effective than an OBG.

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1	Yazar S, Lin CH and Wei FC: One-stage reconstruction of composite bone and soft-tissue defects in traumatic lower extremities. Plast Reconstr Surg. 114:1457–1466. 2004. View Article : Google Scholar : PubMed/NCBI
2	Yu AX, Yu GR, Deng K, Tao SX, Pan ZY and Zhang JH: Combination of negative pressure wound therapy with tissue flap transplantation for severe infectious bone exposure. Chin J Microsurg. 29:219–220. 2006.(In Chinese).
3	Cabanela ME: Open cancellous bone grafting of infected bone defects. Orthop Clin North Am. 15:427–440. 1984.PubMed/NCBI
4	Lei H and Yi L: One-stage open cancellous bone grafting of infected fracture and nonunion. J Orthop Sci. 3:318–323. 1998. View Article : Google Scholar : PubMed/NCBI
5	Streubel PN, Stinner DJ and Obremskey WT: Use of negative-pressure wound therapy in orthopaedic trauma. J Am Acad Orthop Surg. 20:564–574. 2012. View Article : Google Scholar : PubMed/NCBI
6	Chen SZ, Li J, Li XY and Xu LS: Effects of vacuum-assisted closure on wound microcirculation: an experimental study. Asian J Surg. 28:211–217. 2005. View Article : Google Scholar : PubMed/NCBI
7	Vasconcelos MG, Alves PM, Vasconcelos RG, da Silveira EJ, Medeiros AM and de Queiroz LM: Expression of CD34 and CD105 as markers for angiogenesis in oral vascular malformations and pyogenic granulomas. Eur Arch Otorhinolaryngol. 268:1213–1217. 2011. View Article : Google Scholar : PubMed/NCBI
8	Barrientos S, Stojadinovic O, Golinko MS, Brem H and Tomic-Canic M: Growth factors and cytokines in wound healing. Wound Repair Regen. 16:585–601. 2008. View Article : Google Scholar : PubMed/NCBI
9	Papineau IJ, Alfageme A, Delcourt JP and Pilon BL: Chronic osteomyelitis of long bones - Resection and bone grafting with delayed skin closure. J Bone Joint Surg (Br). 58:138–141. 1976.
10	Freeland AE and Mutz SB: Posterior bone-grafting for infected ununited fracture of the tibia. J Bone Joint Surg Am. 58:653–657. 1976.PubMed/NCBI
11	Fleischmann W, Strecker W, Bombelli M and Kinzl L: Vacuum sealing as treatment of soft tissue damage in open fractures. Unfallchirurg. 96:488–492. 1993.(In German).
12	Zhengbao Z and Youping Y: The clinical significance of preventive use of antibiotics in polluted wound. J Pharm Pract. 17:131–133. 1999.
13	Borgquist O, Ingemansson R and Malmsjö M: Wound edge microvascular blood flow during negative-pressure wound therapy: examining the effects of pressures from −10 to −175 mmHg. Plast Reconstr Surg. 125:502–509. 2010.PubMed/NCBI
14	Zhou M, Yu A, Wu G, Xia C, Hu X and Qi B: Role of different negative pressure values in the process of infected wounds healing treated by vacuum-assisted closure: an experimental study. Int Wound J. May 29–2012.(Epub ahead of print). View Article : Google Scholar
15	Weed T, Ratliff C and Drake DB: Quantifying bacterial bioburden during negative pressure wound therapy: does the wound VAC enhance bacterial clearance? Ann Plast Surg. 52:276–280. 2004. View Article : Google Scholar : PubMed/NCBI
16	Baldwin C, Potter M, Clayton E, Irvine L and Dye J: Topical negative pressure stimulates endothelial migration and proliferation: a suggested mechanism for improved integration of Integra. Ann Plast Surg. 62:92–96. 2009. View Article : Google Scholar : PubMed/NCBI
17	Labler L, Rancan M, Mica L, Härter L, Mihic-Probst D and Keel M: Vacuum-assisted closure therapy increases local interleukin-8 and vascular endothelial growth factor levels in traumatic wounds. J Trauma. 66:749–757. 2009. View Article : Google Scholar : PubMed/NCBI
18	Peng H, Usas A, Olshanski A, et al: VEGF improves, whereas sFlt1 inhibits, BMP2-induced bone formation and bone healing through modulation of angiogenesis. J Bone Miner Res. 20:2017–2027. 2005. View Article : Google Scholar : PubMed/NCBI
19	Tarkin IS: The versatility of negative pressure wound therapy with reticulated open cell foam for soft tissue management after severe musculoskeletal trauma. J Orthop Trauma. 22:S146–S151. 2008. View Article : Google Scholar : PubMed/NCBI
20	Burchardt H: The biology of bone graft repair. Clin Orthop Relat Res. 174:28–42. 1983.PubMed/NCBI
21	Page JC, Newswander B, Schwenke DC, Hansen M and Ferguson J: Retrospective analysis of negative pressure wound therapy in open foot wounds with significant soft tissue defects. Adv Skin Wound Care. 17:354–364. 2004. View Article : Google Scholar : PubMed/NCBI

Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Combination of negative pressure wound therapy with open bone grafting for bone and soft tissue defects

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