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. 2022 Aug 31;11(17):5133.
doi: 10.3390/jcm11175133.

Effects of Different Pressure Levels in Topical Negative Pressure Application-Analysis of Perfusion Parameters in a Clinical Skin Model Using Multimodal Imaging Techniques

Emine Ceylan Aslan-Horch  1 , Raymund E Horch  1 , Andreas Arkudas  1 , Wibke Müller-Seubert  1 , Ingo Ludolph  1
Affiliations

Effects of Different Pressure Levels in Topical Negative Pressure Application-Analysis of Perfusion Parameters in a Clinical Skin Model Using Multimodal Imaging Techniques

Emine Ceylan Aslan-Horch et al. J Clin Med. .

Abstract

The effects of topical negative pressure therapy (TNP) have been a subject of research for many years. In this study, we investigated new imaging devices to detect clinical changes that TNP causes on healthy tissue and identified differences in microcirculation created by different pressure levels. We used near-infrared spectroscopy (NIS), thermography, and a vein illuminator to measure the differences in oxygen saturation, tissue temperature, and vein pattern. A control group (-125 mmHg) and three comparison groups with only TNP dressing (Group 1), -25 mmHg (Group 2), and -175 mmHg (Group 3) were established. Thirty minutes of TNP on intact skin was followed by 30 min of resting. A total of 24 participants were measured by all imaging devices at predetermined time points. Oxygen saturation and skin temperature increased by 8.07% and 1.67 °C for the control group, 4.00% and 1.65 °C for Group 2, and 8.45% and 1.68 °C for Group 3. Group 1 showed a slight increase in oxygen saturation and a 2.7 °C increase in skin temperature. Over the 30 min following removal of TNP, oxygen saturation and temperature decreased gradually for all groups. The vein illuminator did not show significant differences in the venous pattern or flow. Our study showed that higher negative pressure values resulted in higher oxygen saturation and higher tissue temperature.

Keywords: imaging; near infrared spectroscopy; negative pressure wound therapy; perfusion; pressure level; thermography.

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Conflict of interest statement

R. E. Horch has received third-party funding for scientific research on NPWT from KCI—an Acelity company—in the past and has served as a member of a Scientific Advisory Board of KCI—Acelity in the past. R. E. Horch and A. Arkudas served as speakers on scientific symposia of KCI—Acelity in the past. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. The other authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Potential projection of direct perforator vessels at the skin (spotted rings) as they could be detected by thermography as so-called hot spots. (A) “Hot spot” projection: circled areas show enhanced heat pattern over perforating vessels and can be visualized by thermography. (B) Subcutaneous perforator vessels branching into skin. (C) Axial submuscular blood vessels.
Figure 2
Figure 2
Timeline of the study. Different colors representing different devices used at certain timepoints.
Figure 3
Figure 3
Differences of the means in the oxygen saturation compared to t0 over study timeline for near-infrared spectroscopy images.
Figure 4
Figure 4
Differences of the means in the oxygen saturation percentage compared to t0 at t1 and t6 measured by near-infrared spectroscopy.
Figure 5
Figure 5
Near-infrared spectroscopy images from the control group, taken at t0 (left), t1 (middle), and t6 (right).
Figure 6
Figure 6
Differences of the means for the temperature in Celsius degrees compared to t0 at t1 and t6, measured by thermography.
Figure 7
Figure 7
Thermography images from the control group, taken at t0 (left), t1 (middle), and t6 (right).
Figure 8
Figure 8
Vein illuminator images, showing patterns of superficial veins, captured by a digital camera at t0 (0’) (left), t1 (30’) (middle), and t6 (60’) (right).
Figure 9
Figure 9
Comparison of the images captured by all devices used in the study at t0; elliptic areas represent the location of topical negative pressure (TNP). (A) Image captured by near-infrared spectroscopy. (B,C) Images captured by thermography, in representative color spectrum and original image. (D) Live image created by vein illuminator, captured with digital camera. The white elliptic area represents the location of TNP.
Figure 10
Figure 10
Correlation between the means resulting from different TNP values at t1 and t6.
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