AUTHOR=Tingting Sun , Xinyue Feng , Tiantian Yang , xiao An , Rui Li , Feng Lin , Daohong Liu , Zhirui Li , Guoqi Wang 

TITLE=Comparison of the effects of negative pressure wound therapy and negative pressure wound therapy with instillation on wound healing in a porcine model

JOURNAL=Frontiers in Surgery

VOLUME=10

YEAR=2023

URL=https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2023.1080838

DOI=10.3389/fsurg.2023.1080838

ISSN=2296-875X

ABSTRACT=<sec><title>Background</title><p>Negative pressure wound therapy with instillation (NPWTi) is a novel method based on standard negative pressure wound therapy (NPWT). This study aimed to compare the effects of standard NPWT and NPWTi on bioburden and wound healing in a <italic>Staphylococcus aureus</italic> (<italic>S.aureus</italic>) infected porcine model.</p></sec><sec><title>Methods</title><p>Green fluorescent protein-labeled <italic>S.aureus</italic> infected wounds were created on the back of porcine. Wounds were treated with NPWT or NPWT with instillation (saline). The tissue specimens were harvested on days 0 (12 h after bacterial inoculation), 2, 4, 6, and 8 at the center of wound beds. Viable bacterial counts, laser scanning confocal microscopy, PCR, western blot, and histological analysis were performed to assess virulence and wound healing.</p></sec><sec><title>Results</title><p>The bacterial count in the NPWTi group was lower than that of the NPWT group and the difference was statistically significant on day 2, day 4, day 6, and day 8 (<italic>P</italic> &lt; 0.05). The expression levels of agrA, <italic>Eap</italic>, <italic>Spa,</italic> and <italic>Hla</italic> genes of the NPWTi group were significantly lower than that of the NPWT group on day 8 (<italic>P</italic> &lt; 0.05). The bacterial invasion depth of the NPWTi group was significantly lower than that of the NPWT group on day 2, day 4, day 6, and day 8 (<italic>P</italic> &lt; 0.05). Though the NPWTi group showed a significantly increased expression of <italic>bFGF</italic> and <italic>VEGF</italic> than that of the NPWT group in the early time (<italic>P</italic> &lt; 0.05), NPWTi cannot lead to better histologic parameters than the NPWT group (<italic>P</italic> &gt; 0.05).</p></sec><sec><title>Conclusion</title><p>Our results demonstrated that NPWTi induced a better decrease in bacterial burden and virulence compared with standard NPWT. These advantages did not result in better histologic parameters on the porcine wound model.</p></sec>