Laboratory Research
Ensuring a sufficient seal is critical to successful Negative Pressure Wound Therapy (NPWT). Applying NPWT drapes over fragile skin can be problematic. A cyanoacrylate based polymeric barrier film (CASP*) has been used to attachment to wet, weepy, damaged skin in clinical practice.1 The current preclinical study assesses benefits of CASP when used on healthy versus damaged periwound skin in conjunction with acrylate based NPWT drape**.
In this n= 6 porcine study, CASP was applied to intact skin or a partial thickness (3cm by 18cm by 500um deep) wound, simulating damaged periwound skin. CASP was applied according to manufacturer’s instructions
Methods: A contact layer*** was placed in the center of the simulated wound and a piece of NPWT foam^ was placed on top of the contact layer. An 14cm by 14cm piece of NPWT drape was placed over the surrogate wound on top of the CASP. The NPWT set up was attached to an NPWT unit and either continuous -50mmHg or -200mmHg was delivered to the surrogate wounds for 72h. The same surrogate wound assembly without the use of CASP served as the control. At 72h, the percentage of drape lift for each surrogate wound was recorded.
Results:
Drapes were removed from the surrogate wounds. For CASP treated sites, an adhesive remover was used per manufacturer’s instruction. Drapes removed from intact skin were stained to assess corneocyte coverage. Tissue samples from sites having a partial thickness wound were sent for histology to assess epithelialization, bacterial and necrotic tissue presence as well as inflammation.
Discussion:
Initial results show that for skin with partial thickness wounds, NPWT drape had a higher percent lift when CASP was not used. NPWT drapes removed less skin cells when CASP was used and the partial thickness wounds were cleaner as evidenced by the presence of less cellular and necrotic debris and bacteria. Results presented here indicate that CASP may serve as a good alternative to crusting and other methods used to obtain a secure seal for NPWT dressings over damaged tissue.
Trademarked Items: * 3M™ Cavilon™ Advanced Skin Protectant, 3M, St. Paul, MN
** V.A.C.® Drape, KCI, San Antonio, TX
*** Adaptic Contact Dressing
^ 3M™ V.A.C.® Granufoam™ Dressing
References: Brennan MR, Milne CT, Grell-Kann M, et al. J of Wound, Ostomy Continence Nursing. 2017; 44(2): 172-180.