Closed incision management with negative pressure wound therapy (CIM): biomechanics

Surg Innov. 2012 Mar;19(1):67-75. doi: 10.1177/1553350611414920. Epub 2011 Aug 25.

Abstract

A novel closed incision management with negative pressure wound therapy (CIM) has been developed for convenient use with closed incisions that has the potential to be beneficial for patients at risk for postoperative complications. Incisions are typically under lateral tension. This study explored the biomechanical mechanisms by which integrity of the incisional closure is enhanced by CIM. CIM was hypothesized to affect local stresses around closed incisions in a beneficial manner. Finite element analyses (FEA) indicated that application of CIM decreased the lateral stresses ~50% around the incision and changed the direction of the stresses to a distribution that is typical of intact tissue. Bench evaluations corroborated findings that CIM significantly increased the force required to disrupt the closed incision by ~50% as compared with closure alone. In conclusion, using 2 FEAs and bench modeling, CIM was shown to reduce and normalize tissue stresses and bolster appositional forces at the incision.

MeSH terms

  • Analysis of Variance
  • Biomechanical Phenomena
  • Comorbidity
  • Computer Simulation
  • Finite Element Analysis
  • Humans
  • Models, Anatomic
  • Negative-Pressure Wound Therapy*
  • Statistics, Nonparametric
  • Surgical Wound Dehiscence / physiopathology*
  • Surgical Wound Dehiscence / prevention & control*
  • Suture Techniques
  • Wound Healing / physiology