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Title: Topical negative pressure therapy in wound healing : a research tool to study neutrophil-mediated wound pathophysiology in acute dermal wounds
Author: Adams, Titus Sam Turner
ISNI:       0000 0001 3397 7932
Awarding Body: University of Bristol
Current Institution: University of Bristol
Date of Award: 2003
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Topical Negative Pressure therapy is in widespread use in the management of acute and chronic cutaneous wounds. The mechanisms of action are not fully understood, but are likely to be multifactorial. Experience of this therapy is based on a number of clinical series, case reports and some animal studies. There is a lack of direct evidence to determine its mechanisms of action and to support its clinical efficacy in human wound healing. This problem stems partly from difficulties in applying selective negative pressure to open exudative wounds. A new approach was required in applying this technology to wound surfaces in consenting patients. This thesis describes the design and validation of 'standard' and 'irrigation' devices that were used to apply Topical Negative Pressure to one part of a wound thus allowing intra-patient control. As a novel research tool, the irrigation device provided an opportunity to collect wound fluid from the surface of the wound for biochemical analysis. Paired wound biopsies of Topical Negative Pressure treated and control wounds were obtained. This thesis has demonstrated that Topical Negative Pressure (with intermittent suction) modulated the acute donor site wound and partial thickness burn wound during the first 48 hours of injury, by altering the distribution of inflammatory neutrophils in the dermis. Using a cycle of periods of suction-on and suction-off, Topical Negative Pressure increased the removal of Neutrophil Elastase from the wound during suction, in addition to its endogenous plasma-derived inhibitor, a1-Protease Inhibitor. Using this new device on human wounds has provided a means of understanding mechanisms in Topical Negative Pressure therapy, and has demonstrated its use as a research tool in the collection and analysis of wound fluid
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available