Poster CS-21

Early Elastic Compression Improves Traumatic Limb Wound Healing: textile compression delivers static force that signals cell DNA expression to enhance regenerative healing

Presented at Symposium on Advanced Wound Care 2021

Problem Negative pressure wound therapy (NPWT) delivers negative hydrostatic pressure delivered via open cell foam to stabilize and transfer battle field soft tissue injury.1 The physiology of NPWT and elastic textile compression, both signal cell DNA to make proteins, is not well understood but evidence is growing to suggest ‘All lower extremity wounds benefit from elastic compression.2 Rubin describes how vibration therapy induces bone micro-strain signaling of bone marrow osteoblasts preventing osteoporosis in space.3,4 * Ennis demonstrated this vibration improves murine wound healing presumably by stimulating regenerative marrow stem cells, e.g. circulating epithelial precursors.5,6 In light of NPWT for trauma, we ask, can early elastic compression improve healing of traumatic wounds. Methods Photos document presentation, therapy, and outcomes of four injuries (auto roll over with blunt knee skin disruption, tractor vs. corrugated steel, and blunt contusions) treated with early fuzzy wale stockinet compression.7,8 ** Results Early textile compression of traumatic wounds anecdotally appears to decrease pain, enhance eschar separation, enable home care including frequent wound shower sprays, and decrease clinic visits. Conclusions Four traumatic leg wounds anecdotally appear to have a regenerative response to early elastic textile compression, opening a promising research avenue.

Sponsor

Sponsor name

Compression Dynamics, LLC, Omaha, NE

References

1.Elster, Eric A., Glaser, JJ. Warfare-related Complex Abdominal Wall Reconstruciton Using a Bioprosthetic Regenerate Template and Negative Pressure Therapy. Open Access Journal of Plastic Surgery, May 2016, Accessed 11/24/2019 http://www.eplasty.com/images/PDF/eplasty09e17.pdf Alavi, A. Is It Vasculitis, Stop and Think. PowerPoint presentation, personal comment from podium, Wounds Canada, Fall Conference Mississauga, Ontario, November 18, 2017. Rubin, J., Rubin, C., Jacobs, CR. Molecular pathways mediating mechanical signaling in bone. Gene,2006/2/15 v367, p 1-16 Gilsanz, V., Rubin, C, et al. Low_amplitude, high_frequency mechanical signals enhance musculoskeletal development of young women with low Bone Marrow Density. Journal of Bone and Mineral Research, Volume 21, Issue 9, 1464-1474, September 2006. Ennis, WJ, Koh, TJ. Low-Intensity Vibration Improves Angiogenesis and Wound Healing in Diabetic Mice. (2014). PLoS ONE 9(3): e91355. doi:10.1371/journal.pone.0091355 6. Tamaia, Katsuto. PDGFR_-positive cells in bone marrow are mobilized by high mobility group box 1 (HMGB1) to regenerate injured epithelia. Proceedings of the National Academy of Sciences, USA, PNAS April 19, 2011 108 (16) 6609-6614; https://doi.org/10.1073/pnas.10167531087. Sibbald, R Gary et al. Comparative Clinical Effectiveness Evaluation of Two Elasticized Compression Devices (Longitudinal & Tubular) for the Treatment of Lower Limb Edema. In press December 2019, Advances in Skin and Wound Care.8.Ostler, Marta. Compression is Key: Silver, Elastic Compression Stockinet, and Hyper-absorbent Felt in Direct Contact with VLU Granulation Tissue Reverses Comorbid Inflammation, Pain and Exudate that Delays Effective Compression Therapy. Symposium of Advanced Wound Care, October 2019, Case Study Science poster, Accessed November 22, 2019. https://compressiondynamics.com/wp-content/uploads/2019/10/PosterCompression-is-Key-Silver-Elastic-Compression-Stockinet-and-Hyper-absorbent-Felt-in-Direct-Contact-with-VLU-Granulation-Tissue.pdf

Product Information

* LivMD™ Vibration Plate: Rx, Amplitude, 5 to 10 microns 10-9 M, (for scale, human hair diameter is 30- 50 microns), force 0.6G, (60% of the force of gravity 9.8 meters per second2), frequency 30Hz, (30/second). Marodyne, BT Health Care, Inning am Ammersee, Germany. ** EdemaWear®, EdemaWear® LITE™, Fuzzy wale elastic compression stockinet, Compression Dynamics LLC, Omaha, Nebraska.