Micro-Negative Pressure Drainage Dressing: A Substitute for Surgical Treatment of Refractory Wounds after Burns

Background: Clinical observation suggested that micro-negative pressure drainage dressing (MNPDD) can promote refractory wound healing. This study explored the effect of MNPDD on refractory wound. Methods: Human keratinocytes (HaCat) and human fibroblasts (HF) were used to evaluate cell migration ability with micro-negative pressure. MNPDD promotion of cell migration in vivo was reflected by the vimentin content in rat. A multi-centre retrospective cohort study evaluated the effect of MNPDD by comparing skin grafting rate. Findings: Cell experiments revealed that with micro-negative pressure, HaCat and HF had higher migration capacity at 24 h (22·10±4·24% vs 1·26±1·65% for HaCat and 26·08±4·30% vs 1·98±1·82% for HF, P<·001). Animal experiments revealed that the  wounds with MNPDD had higher vimentin concentration (43·8±4·6 vs 22·5±4·0 per field of view at day 9, P<·001). MNPDD reduced the rate of skin graft (15·10% vs 77·36%, P<0·001) without extending treatment time (22·74±11·58 vs 22·16±13·56 days, P=·792). Interpretation: MNPDD is a novel effective treatment for refractory wounds; the mechanism may involve cell migration. Funding Statement: This work was funded by the National Nature Science Foundation of China (81120108015), National Nature Science Foundation of China (81772125), National Basic Research Program of China (2012CB518100), ‘Twelfth Five-Year’ Scientific Program of China (AWS11J008, AWS14C001), Clinical Key Discipline Project of Shanghai and China, Young Talents Training Program of Shanghai Health System (XYQ2013079), Shanghai “priority” for clinical key discipline and Joint Research Program of important diseases of Shanghai Health System (2013ZYJB0008), and Creativity and Innovation Training Program of Second Military Medical University, Shanghai, China (FH2016186). Declaration of Interests: There are no competing interests or conflicts in the present paper. Ethics Approval Statement: All animal experiments were approved by the Ethics Committee of Animal Center of Second Military Medical University. The retrospective cohort study was approved by the Ethics Committee of Changhai Hospital Affiliated to Second Military Medical University. All experiments and the retrospective study were conducted according to the appropriate ethical requirements. The experimental animals were treated in strict accordance with animal ethics standards. The experiments were conducted in strict accordance to ethics standards; the need for informed consent was waived owing to the retrospective nature of the study.