Effects of negative pressure wound therapy on cellular energetics in fibroblasts grown in a provisional wound (fibrin) matrix.

Negative pressure wound therapy (NPWT) using reticulated open cell foam dressing (ROCF) is effective for treatment of recalcitrant wounds; however, the effects of this therapy on cellular metabolism remain to be elucidated. The effect of two different subatmospheric pressure applications on the cell energetics of human fibroblasts grown in a 3D fibrin matrix was studied using two different pressure-manifolding materials, an ROCF or gauze under suction (GUS). It was found that levels of cytochrome c oxidase, energy charge, and adenosine triphosphate/adenosine diphosphate were significantly increased following the application of NPWT using ROCF vs. GUS (p<0.05). Increases in these parameters likely reflect an improved energetic status. In addition, levels of transforming growth factor-beta and platelet-derived growth factor (alpha and beta isoforms) were significantly increased (80 and 53%, respectively; p<0.05) over static control cultures following treatment with NPWT using ROCF but not following GUS. These growth factors are known to be important during wound healing. Clearly, both the material used as the dressing to manifold the subatmospheric pressure and the pressure used have a dramatic effect on cellular response.