The effect of NPWT in wound healing and bacterial count on deep dermal burn injury model: An experimental study

Reagan Resadita; M Rosadi Seswandhana; Eko Purnomo; Sharfan Anzhari; Gita Christy Gabriela; Ishandono Dachlan; Teguh Aryandono; Yohanes Widodo Wirohadidjojo

doi:10.1016/j.amsu.2022.103367

The effect of NPWT in wound healing and bacterial count on deep dermal burn injury model: An experimental study

Ann Med Surg (Lond). 2022 Feb 12:75:103367. doi: 10.1016/j.amsu.2022.103367. eCollection 2022 Mar.

Authors

Reagan Resadita¹, M Rosadi Seswandhana¹, Eko Purnomo², Sharfan Anzhari¹, Gita Christy Gabriela¹, Ishandono Dachlan¹, Teguh Aryandono³, Yohanes Widodo Wirohadidjojo⁴

Affiliations

¹ Division of Plastic, Reconstruction and Aesthetic Surgery, Department of Surgery, Faculty of Medicine, Public Health and Nursing/Dr. Sardjito Hospital, Yogyakarta, 55281, Indonesia.
² Division of Pediatric Surgery, Department of Surgery, Faculty of Medicine, Public Health and Nursing/Dr. Sardjito Hospital, Yogyakarta, 55281, Indonesia.
³ Division of Surgical Oncology, Department of Surgery, Faculty of Medicine, Public Health and Nursing/Dr. Sardjito Hospital, Yogyakarta, 55281, Indonesia.
⁴ Department of Dermatovenerology, Faculty of Medicine, Public Health and Nursing/Dr. Sardjito Hospital, Yogyakarta, 55281, Indonesia.

Abstract

Background: Sepsis is one of the main causes in burn victim's mortality. The use of negative pressure wound therapy (NPWT) provides an ideal environment to accelerate wound healing. We compare the use of normal saline (NS), intermittent NPWT, continuous NPWT and silver sulfadiazine in wound healing process.

Method: This study involved 6 Yorkshire pigs; each pig was induced with 20 burns on the flank area. Burns were divided into 4 treatment groups: NS gauze, intermittent NPWT, continuous NPWT, and silver sulfadiazine dressing. Burns were evaluated on day 1,3,7,14, and 21 for its morphology and bacterial colonization and on day 14 and 21 for the remaining burn surface area.

Result: Wound that received NPWT therapy appeared better in both granulation and crust formation. Remaining burn surface area (mm²) on day 14 in NS group, intermittent NPWT, continuous NPWT, and silver sulfadiazine were 107.43 ± 83.43, 178.07 ± 74.83, 146.10 ± 69.1, 126.03 ± 83.22, respectively(p = 0.457); on day 21 in NS group, intermittent NPWT, continuous NPWT, and silver sulfadiazine were 13.16 ± 16.86, 59.49 ± 20.72, 54.79 ± 46.59, 48.95 ± 39.84, respectively(p=0.169). There were no significant differences in each treatment group bacterial colonization(p>0.05). There were no significant correlation between bacterial colonization and remaining burn surface area (p>0.05).

Conclusion: While morphologically, the wound in NPWT treatment groups appeared better in granulation and crust formation, the remaining wound surface area and the number of bacterial colonization were not significantly difference compared to standard therapy (silver sulfadiazine and NS gauze). There were no significant correlation between the amount of bacterial colonization and remaining wound surface area on every treatment group.

Keywords: Bacterial colonization; Bacterial count; Burn injury; Continuous NPWT; Intermittent NPWT; Negative pressure wound therapy; Wound surface area.