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Negative Pressure Wound Therapy of Chronically Infected Wounds Using 1% Acetic Acid Irrigation

BACKGROUND: Negative-pressure wound therapy (NPWT) induces angiogenesis and collagen synthesis to promote tissue healing. Although acetic acid soaks normalize alkali wound conditions to raise tissue oxygen saturation and deconstruct the biofilms of chronic wounds, frequent dressing changes are requi...

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Autores principales: Jeong, Hii Sun, Lee, Byeong Ho, Lee, Hye Kyung, Kim, Hyoung Suk, Moon, Min Seon, Suh, In Suck
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society of Plastic and Reconstructive Surgeons 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4297808/
https://www.ncbi.nlm.nih.gov/pubmed/25606491
http://dx.doi.org/10.5999/aps.2015.42.1.59
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author Jeong, Hii Sun
Lee, Byeong Ho
Lee, Hye Kyung
Kim, Hyoung Suk
Moon, Min Seon
Suh, In Suck
author_facet Jeong, Hii Sun
Lee, Byeong Ho
Lee, Hye Kyung
Kim, Hyoung Suk
Moon, Min Seon
Suh, In Suck
author_sort Jeong, Hii Sun
collection PubMed
description BACKGROUND: Negative-pressure wound therapy (NPWT) induces angiogenesis and collagen synthesis to promote tissue healing. Although acetic acid soaks normalize alkali wound conditions to raise tissue oxygen saturation and deconstruct the biofilms of chronic wounds, frequent dressing changes are required. METHODS: Combined use of NPWT and acetic acid irrigation was assessed in the treatment of chronic wounds, instilling acetic acid solution (1%) beneath polyurethane membranes twice daily for three weeks under continuous pressure (125 mm Hg). Clinical photographs, pH levels, cultures, and debrided fragments of wounds were obtained pre- and posttreatment. Tissue immunostaining (CD31, Ki-67, and CD45) and reverse transcription-polymerase chain reaction (vascular endothelial growth factor [VEGF], vascular endothelial growth factor receptor [VEGFR]; procollagen; hypoxia-inducible factor 1 alpha [HIF-1-alpha]; matrix metalloproteinase [MMP]-1,-3,-9; and tissue inhibitor of metalloproteinase [TIMP]) were also performed. RESULTS: Wound sizes tended to diminish with the combined therapy, accompanied by drops in wound pH (weakly acidic or neutral) and less evidence of infection. CD31 and Ki-67 immunostaining increased (P<0.05) post-treatment, as did the levels of VEGFR, procollagen, and MMP-1 (P<0.05), whereas the VEGF, HIF-1-alpha, and MMP-9/TIMP levels declined (P<0.05). CONCLUSIONS: By combining acetic acid irrigation with negative-pressure dressings, both the pH and the size of chronic wounds can be reduced and infections be controlled. This approach may enhance angiogenesis and collagen synthesis in wounds, restoring the extracellular matrix.
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spelling pubmed-42978082015-01-20 Negative Pressure Wound Therapy of Chronically Infected Wounds Using 1% Acetic Acid Irrigation Jeong, Hii Sun Lee, Byeong Ho Lee, Hye Kyung Kim, Hyoung Suk Moon, Min Seon Suh, In Suck Arch Plast Surg Original Article BACKGROUND: Negative-pressure wound therapy (NPWT) induces angiogenesis and collagen synthesis to promote tissue healing. Although acetic acid soaks normalize alkali wound conditions to raise tissue oxygen saturation and deconstruct the biofilms of chronic wounds, frequent dressing changes are required. METHODS: Combined use of NPWT and acetic acid irrigation was assessed in the treatment of chronic wounds, instilling acetic acid solution (1%) beneath polyurethane membranes twice daily for three weeks under continuous pressure (125 mm Hg). Clinical photographs, pH levels, cultures, and debrided fragments of wounds were obtained pre- and posttreatment. Tissue immunostaining (CD31, Ki-67, and CD45) and reverse transcription-polymerase chain reaction (vascular endothelial growth factor [VEGF], vascular endothelial growth factor receptor [VEGFR]; procollagen; hypoxia-inducible factor 1 alpha [HIF-1-alpha]; matrix metalloproteinase [MMP]-1,-3,-9; and tissue inhibitor of metalloproteinase [TIMP]) were also performed. RESULTS: Wound sizes tended to diminish with the combined therapy, accompanied by drops in wound pH (weakly acidic or neutral) and less evidence of infection. CD31 and Ki-67 immunostaining increased (P<0.05) post-treatment, as did the levels of VEGFR, procollagen, and MMP-1 (P<0.05), whereas the VEGF, HIF-1-alpha, and MMP-9/TIMP levels declined (P<0.05). CONCLUSIONS: By combining acetic acid irrigation with negative-pressure dressings, both the pH and the size of chronic wounds can be reduced and infections be controlled. This approach may enhance angiogenesis and collagen synthesis in wounds, restoring the extracellular matrix. The Korean Society of Plastic and Reconstructive Surgeons 2015-01 2015-01-14 /pmc/articles/PMC4297808/ /pubmed/25606491 http://dx.doi.org/10.5999/aps.2015.42.1.59 Text en Copyright © 2015 The Korean Society of Plastic and Reconstructive Surgeons http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Jeong, Hii Sun
Lee, Byeong Ho
Lee, Hye Kyung
Kim, Hyoung Suk
Moon, Min Seon
Suh, In Suck
Negative Pressure Wound Therapy of Chronically Infected Wounds Using 1% Acetic Acid Irrigation
title Negative Pressure Wound Therapy of Chronically Infected Wounds Using 1% Acetic Acid Irrigation
title_full Negative Pressure Wound Therapy of Chronically Infected Wounds Using 1% Acetic Acid Irrigation
title_fullStr Negative Pressure Wound Therapy of Chronically Infected Wounds Using 1% Acetic Acid Irrigation
title_full_unstemmed Negative Pressure Wound Therapy of Chronically Infected Wounds Using 1% Acetic Acid Irrigation
title_short Negative Pressure Wound Therapy of Chronically Infected Wounds Using 1% Acetic Acid Irrigation
title_sort negative pressure wound therapy of chronically infected wounds using 1% acetic acid irrigation
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4297808/
https://www.ncbi.nlm.nih.gov/pubmed/25606491
http://dx.doi.org/10.5999/aps.2015.42.1.59
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