Evaluation of closed incision management with negative pressure wound therapy (CIM): Hematoma/seroma and involvement of the lymphatic system

• Published in: Wound repair and regeneration 2011-09, Vol.19 (5), p.588-596
• Main Authors: Kilpadi, Deepak V., Cunningham, Mark R.
• Format: Article
• Language: English
• Subjects: Abdominal Wall - surgery; Animals; Bandages; Drainage; Female; Hematoma - pathology; Hematoma - prevention & control; Isotope Labeling; Lymph Nodes - chemistry; Lymph Nodes - pathology; Nanospheres - analysis; Negative-Pressure Wound Therapy; Seroma - pathology; Seroma - prevention & control; Skin - chemistry; Skin - pathology; Sus scrofa; Sutures; Viscera - chemistry; Viscera - pathology
• ISSN: 1067-1927; 1524-475X
• DOI: 10.1111/j.1524-475X.2011.00714.x

The objective of this porcine study was to evaluate the effect of closed incision management with negative pressure wound therapy (CIM) on hematoma/seroma formation, fluid removal into the CIM canister, and involvement of the lymphatic system. In each swine (n = 8), two sets of ventral contralateral subcutaneous dead spaces with overlying sutured incisions were created. Stable isotope‐labeled nanospheres were introduced into each subcutaneous dead space. Each contralateral incision was assigned to CIM (continuous −125 mmHg negative pressure) and control (semipermeable film dressing), respectively. Following 4 days of therapy, hematoma/seroma was weighed, total fluid volume in canisters was measured, five pre‐identified lymph nodes were harvested, and five key organs were biopsied. There was 25 ± 8 g (standard error [SE]) (63%) less hematoma/seroma in CIM sites compared to control sites (p = 0.002), without any fluid collection in the CIM canister. In lymph nodes, there were ∼60 μg (∼50%) more 30‐ and 50‐nm nanospheres from CIM sites than from control sites (p = 0.04 and 0.05, respectively). There was significantly greater nanosphere incidence from CIM sites than from control sites in lungs, liver, and spleen (p