Use of subatmospheric pressure to prevent progression of partial-thickness burns in a swine model

Abstract

The poorly understood, complex series of events that follows thermal injury frequently results in progressive loss of tissue. The concept of reversing this distinctive series of events has focused on the zone of stasis. Tissues in the zone of stasis that surround burn injuries usually die over a period of 48 to 72 hours postinjury, resulting in a more severe injury. Application of a controlled subatmospheric pressure (125 mm Hg) in an artificially closed space to partial-thickness burns in pigs significantly decreased the maximum depth of cellular death under the burn when the pressure was applied within 12 hours after burn creation (depth of control burns = 0.885 +/- 0.115 mm; subatmospheric pressure treated burns (0-hour delay) = 0.095 +/- 0.025 mm). A decrease in the depth of cell death was noted when subatmospheric pressure was applied for as little as 6 hours. In summary, the application of the negative pressure to partial-thickness burn injuries prevented progression of the wound to a deeper injury in this experimental pig model. A 12-hour working window exists between injury and treatment with reduced pressure, with an application time of as little as 6 hours for successful prevention of injury progression. This technique may represent a new, inexpensive, 'low tech' method for the treatment of partial-thickness burn injuries.