Finite Element Modeling and Ease of Use Assessment of a Novel Longer-Wear, Peel and Place Negative Pressure Wound Therapy (NPWT) Dressing

Introduction: Negative pressure wound therapy (NPWT)* with reticulated open cell foam (ROCF)^ has evolved the practice of wound care. To date, ROCF has not been utilized as an extended wear dressing due to the potential for tissue ingrowth that may occur if left in place for >72 hours. A novel peel and place† dressing for use with NPWT has been developed to address this challenge.Methods: Finite element analysis (FEA) was conducted using computer simulation to evaluate the effects of NPWT on tissue deformations produced by the peel and place dressing compared to ROCF. Wound models were developed, with clinical input, incorporating dimensional specifications and material properties for the relevant tissue layers (epidermis, dermis, subcutaneous fat, muscle, and bone). Simulations in this environment were completed for ROCF and the peel and place NPWT dressings under -125 mmHg. Also, user testing comparing ROCF to the peel and place dressing was conducted to determine if participants could successfully complete dressing application and sealing under NPWT. Time for dressing application was recorded for each participant for each dressing. The users were also surveyed regarding the ease of use of each dressing.Results:FEA revealed homogenous tissue displacements, uniform tissue tensile strains, and notable volume of tissue engagement for the peel and place dressing versus heterogenous strain fields for ROCF. Additionally, participants found the peel and place dressing easier and faster (2.6x) to use relative to ROCF while successfully completing dressing application and sealing.Discussion: The homogenous tissue strains and deeper propagation of forces seen in the peel and place dressing FEA model could lead to a modified tissue strain environment. This, in turn, could promote specific cellular responses that may contribute to greater levels of wound healing biomarkers. In addition, quicker dressing application times were recorded for the peel and place dressing with reported improved ease of use.References:1. Wilkes RB, Kilpadi DV, Zhao Y, et al. Closed incision management with negative pressure wound therapy (CIM): biomechanics. Surg Innov. 2012 Mar;19(1):67-75. 2. Wilkes RB, Zhao Y, Kieswetter K, et al. Effects of dressing type on 3D tissue microdeformations during negative pressure wound therapy: a computational study. J Biochem Eng. 2009 Mar; 131(3):031012. 3. Dunn, S. L., & Olmedo, M. L. Mechanotransduction: Relevance to Physical Therapist Practice Understanding Our Ability to Affect Genetic Expression Through Mechanical Forces. Physical Therapy. 2016;96(5):712-721. 4. Allen D, Robinson T, Schmidt M, et al. Preclinical assessment of novel longer-duration wear negative pressure wound therapy dressing in a porcine model. Wound Repair Regen. 2023;31(3):349-359.