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Molecular mechanisms of action of negative pressure wound therapy: a systematic review

Published online by Cambridge University Press:  19 October 2023

Bharadhwaj Ravindhran Open the ORCID record for Bharadhwaj Ravindhran [Opens in a new window] ,
Nicole Schafer ,
Annabel Howitt ,
Daniel Carradice ,
George Smith  and
Ian Chetter
Bharadhwaj Ravindhran*
Affiliation:
Academic Vascular Surgical Unit, Hull Royal Infirmary, Hull, UK Department of Health Sciences, University of York, York, UK
Nicole Schafer
Affiliation:
Academic Vascular Surgical Unit, Hull Royal Infirmary, Hull, UK
Annabel Howitt
Affiliation:
Academic Vascular Surgical Unit, Hull Royal Infirmary, Hull, UK
Daniel Carradice
Affiliation:
Academic Vascular Surgical Unit, Hull Royal Infirmary, Hull, UK
George Smith
Affiliation:
Academic Vascular Surgical Unit, Hull Royal Infirmary, Hull, UK
Ian Chetter
Affiliation:
Academic Vascular Surgical Unit, Hull Royal Infirmary, Hull, UK
*
Corresponding author: Bharadhwaj Ravindhran; Email: bharadhwaj.ravindhran@nhs.net
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Abstract

Negative pressure wound therapy (NPWT) has significantly advanced wound care and continues to find new applications. Its effects at a molecular level however, remain a subject of debate. The aim of this systematic review is to summarize the current evidence regarding the molecular mechanisms of action of NPWT. Medline, Embase, EBSCO databases and clinical trial registries were searched from inception to January 2023. Clinical studies, animal models or in-vitro studies that quantitatively or semi-quantitatively evaluated the influence of NPWT on growth factors, cytokine or gene-expression in the circulation or wound-bed were included. Risk of Bias assessment was performed using the RoBANS tool for non-randomized studies, the COCHRANE's Risk of Bias 2(ROB-2) tool for randomized clinical studies, OHAT tool for in-vitro studies or the SYRCLE tool for animal model studies. A descriptive summary was collated and the aggregated data is presented as a narrative synthesis. This review included 19 clinical studies, 11 animal studies and 3 in-vitro studies. The effects of NPWT on 43 biomarkers and 17 gene expressions were studied across included studies. NPWT stimulates modulation of numerous local and circulating cytokines and growth factor expressions to promote an anti-inflammatory profile. This is most likely achieved by downregulation of TNFα, upregulation of VEGF, TGF-β and fibronectin.

Keywords

biomarkersmolecular mechanismsnegative-pressure wound therapywound carewound healing
Type
Review
Information
Expert Reviews in Molecular Medicine , Volume 25 , 2023 , e29
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Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press

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