The influence of vacuum assisted closure therapy on bacterial growth and biofilm development in the wounds

master's thesis

• Title (croatian): Utjecaj terapije za zatvaranje rana vakuumom na rast bakterija i nastanak biofilma u ranama
• Author: Viviana Wahl
• Mentor: Krešimir Bulić (mentor)
• Committee member: Davor Mijatović (predsjednik povjerenstva)
• Committee member: Krešimir Bulić (član povjerenstva)
• Committee member: Tomislav Meštrović (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Surgery); Zagreb
• Defense date and country: 2021-07-16, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Surgery

Abstract

Vacuum assisted closure therapy was developed for the needs of plastic surgery in the 90s. Primarily used for the treatment of patients with large chronic wounds, the usage nowadays extends to area of medicine and veterinary, for all types of large, chronic and infected wounds, where increased drainage of the exudate and help with wound closure is needed. Vacuum assisted closure therapy uses sub-atmospheric pressure between 50 and 200 mmHg which facilitates drainage of fluids, reduces swelling, mechanically removes bacteria and increases blood flow. Precaution is needed with poorly debrided wounds, with irradiated tissue, with fragile blood vessels and with patients on anticoagulation therapy. The foam with 400 to 600 micrometer pores, covers the wound area completely, over which protective seal is placed. Tubing connects the seal with the vacuum pump, on which continuous, variable or intermittent mode of action and level of negative pressure are set. Since the early nineties numerous research articles were written on the topic of negative pressure and vacuum therapy and they mostly agree, that utilisation of negative pressure improves rate of granulation tissue formation, decreases time of healing and assists with infectious process in the wound. In-vitro and in-vivo research shows good clinical results. Additionally, gene testing and microbiological results are encouraging.

Abstract (croatian)

Terapija kroničnih rana uz pomoć vakuuma razvijena je za potrebe plastične kirurgije u početku 90-ih godina. Primarno korišten za liječenje bolesnika s velikim kroničnim ranama, danas se koristi na području medicine i veterine, za sve vrste velikih, kroničnih i zaraženih rana, gdje je potrebna povećana drenaža eksudata i pomoć pri zatvaranju rana. Terapija negativnim tlakom koristi subatmosferski tlak između 50 i 200 mmHg što olakšava drenažu tekućina, smanjuje oticanje, mehanički uklanja bakterije i povećava protok krvi. Potreban je oprez sa loše očišćenim ranama, s ozračenim tkivom, krhkim krvnim žilama i s pacijentima na antikoagulacijskoj terapiji. Pjena s porama od 400 do 600 mikrometara u potpunosti pokriva područje rane preko koje se postavlja zaštitna folija. Cijev spaja zaštitnu foliju s vakuumskom pumpom, na kojoj se kontroliraju kontinuirani, promjenjivi ili isprekidani način djelovanja i razina negativnog tlaka. Od početka devedesetih na temu negativnog tlaka i vakuumske terapije napisani su brojni istraživački članci, koji se uglavnom slažu da korištenje negativnog tlaka poboljšava brzinu stvaranja granulacijskog tkiva, smanjuje vrijeme zacjeljivanja i pomaže kod zaraznog procesa u rani. In-vitro i in-vivo istraživanja pokazuju dobre kliničke rezultate. Također ohrabruju rezultati genetskog ispitivanja i mikrobiološki rezultati.

• Keywords: vacuum assisted closure therapy; negative pressure; chronic wound treatment; biofilms
• Keywords (croatian): terapija negativnim tlakom; negativni tlak; liječenje kronične rane; biofilmi
• Language: english
• URN:NBN: urn:nbn:hr:105:338196
• Study programme: Title: Medicine (in English language); Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2021-12-22 10:52:24