New Frontiers in Wound Management Technologies – Expanding the Limits by Intensive Wound Care

Moris Topaz1, Oren Barzel2, Sigal Ezra2, Menachem Motiei3, Guy Topaz4, Neta Zilony3, Rona Katzengold5, Amit Gefen5, , Itzhak Ziev-Ner2, Rachela Popovtzer3

  1. Plastic Surgery Unit, Hillel Yaffe Medical Center, Hadera, Israel;
  2. Rehabilitation Center, Haim Sheba Medical Center, Ramat Gan, Israel;
  3. Faculty of Engineering & the Institute of Nanotechnology and Advanced Materials, Bar-Ilan University, Israel;
  4. Department of Internal Medicine G, Meir Medical Center Kfar Saba, Israel:
  5. Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Israel.

Abstract; Wound infection turns tissue repair a more complex, slow and fragile process. Time frame from injury to full wound closure is critical in multiple aspects; exposure to infection, morbidity and mortality, use of antibiotics, biofilm growth, development of bacterial resistance to antibiotics, costs and outcome functionality. The more rapidly skin wounds close, the less likely infection and scarring are to occur.

Regulated Negative Pressure-Assisted Wound Therapy (RNPT) utilizes sub-atmospheric pressure as a non-pharmaceutical technology to enhance wound healing. An inherent physical phenomenon is the reduced pO2 level in the wound’s atmosphere, limiting its use in suspected and apparent anaerobic infections. We have upgraded wound therapy by the simultaneous administration of irrigation & supplemental oxygen as Regulated Oxygen-Enriched & Irrigation Negative Pressure-Assisted Wound Therapy (ROI-NPT), to synergistically combat wound infection and promote wound healing. Irrigation may accelerate evacuation of infectious material from the wound and may provide a novel method for antibiotic administration. We maintain that ROI-NPT will provide a global platform technology for wound healing systems as well as an affordable, cost-effective alternative method to hyperbaric oxygen treatment (HBO) and reduced antibiotic usage. The TopClosure® Tension Relief System (TRS) is a novel device for stretching, and securing wound closure, applying stress relaxation and mechanical creep for primary closure of large skin defects which otherwise would have required closure by skin grafts, flaps or tissue expanders.

We will present multiple demonstrative cases of large skin defects customarily requiring extended period of vacuum treatment for granulation tissue growth followed by coverage by skin graft or flaps. TRS was applied during surgery serving as a tension-relief platform for tension sutures, to enable primary skin-defect closure by cycling of stress–relaxation, and mechanical creep until complete wound closure was achieved. Combined ROI-NPT and TRS may transform the traditional 3-phase text-book wound healing sequence into a short, more efficient 2-phase method.