Blood Flow Responses in the Peristernal Thoracic Wall During Vacuum-Assisted Closure Therapy Angelica Wackenfors, MS, Ronny Gustafsson, MD, Johan Sjögren,

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Presentation transcript:

Blood Flow Responses in the Peristernal Thoracic Wall During Vacuum-Assisted Closure Therapy Angelica Wackenfors, MS, Ronny Gustafsson, MD, Johan Sjögren, MD, Lars Algotsson, MD, PhD, Richard Ingemansson, MD, PhD, Malin Malmsjö, MD, PhD The Annals of Thoracic Surgery Volume 79, Issue 5, Pages 1724-1730 (May 2005) DOI: 10.1016/j.athoracsur.2004.10.053 Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 A schematic illustration of the experimental setup showing a cross-section of the open wound with the vacuum-assisted closure (VAC) pump unit to the right and the laser Doppler velocimetry equipment to the left. A polyurethane foam dressing was placed between the sternal edges. Two noncollapsible drainage tubes were inserted into the foam. The open wound was sealed with a transparent adhesive drape. The drainage tubes were connected to a purpose-built vacuum source (vacuum-assisted closure pump unit), which delivered a continuous negative pressure. A canister in the pump unit collected exudates from the wound. Microvascular blood flow was measured by laser Doppler velocimetry. Filament probes (0.5 mm) were inserted into subcutaneous or the deep muscular tissue of the wound edge, and recordings were made with three parallel probes. A skin probe was placed 10 cm from the wound. Wound fluid from the vacuum-assisted closure–treated pigs was sampled from the vacuum-assisted closure drainage tube, close to the wound edge. The Annals of Thoracic Surgery 2005 79, 1724-1730DOI: (10.1016/j.athoracsur.2004.10.053) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Representative example of microvascular blood flow changes after application of vacuum-assisted closure therapy (−125 mm Hg) in subcutaneous tissue at 3.0 cm (A), 0.5 cm (B), and 4.5 cm (C) from the sternal wound edge. The Annals of Thoracic Surgery 2005 79, 1724-1730DOI: (10.1016/j.athoracsur.2004.10.053) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Representative example of microvascular blood flow changes after application of vacuum-assisted closure therapy (−125 mm Hg) in muscular tissue at 2.0 cm (A), 0.5 cm (B), and 4.5 cm (C) from the sternal wound edge. The Annals of Thoracic Surgery 2005 79, 1724-1730DOI: (10.1016/j.athoracsur.2004.10.053) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Microvascular blood flow in subcutaneous (○) and muscular tissue (●), at increasing distance from the sternal wound edge in 6 domestic pigs after application of subatmospheric pressures of −50 to −200 mm Hg. Changes in blood flow were calculated as percent of baseline flow and are presented as mean ± standard error of the mean. The Annals of Thoracic Surgery 2005 79, 1724-1730DOI: (10.1016/j.athoracsur.2004.10.053) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions