Genomic Evaluation of a Novel Negative Pressure Wound Therapy Dressing

Negative pressure wound therapy (NPWT) with a reticulated open cell foam (ROCF) has dramatically impacted the practice of healing wounds. While effective in stimulating granulation tissue formation, the ease of use of the therapy can be improved due to challenges including rapidly obtaining a good seal and performing dressing changes at 2–3 day intervals. The goal of this study was to evaluate genomic responses due to a novel dressing from a porcine study.

Four domestic swine were used to obtain samples from full-thickness skin excisional wounds (3 x 7.5 cm) treated with NPWT ROCF1, NPWTi-d2  NPWT ROCF with a novel dressing, or NPWTi-d with a novel dressing. Biopsy samples were taken at study termination day 7. Porcine PCR wound healing arrays were performed to determine differences in gene expression (>twofold difference; p<0.05).

The novel dressing demonstrated greater upregulation in genes important in signaling (WNT1-inducible signaling pathway protein 1-like, (2.19)) and collagen (collagen type 1, alpha 1, (2.04)) while downregulating genes for extracellular matrix remodeling enzymes (Matrix metallopeptidase 9 (MMP9), (-5.89)) as compared to NPWT with ROCF. The novel dressing with instillation showed an increase in endotheliin 1 (2.82) while downregulating MMP9 (-3.86) as compared to NPWT ROCF, and when NPWTi-d was compared to NPWTi-d with novel dressing, only prostaglandin synthase-2 was decreased (-3.34). Remarkably, if the novel dressing was left in place for all seven days of treatment, the only difference was a greater downregulation of MMP9 (-9.74).

Following seven days of treatment in a porcine model, a novel NPWT dressing has, relative to control ROCF dressings, been shown to increase extracellular matrix constituents and WNT1-inducible signaling pathway protein 1 while downregulated MMP9, which might lead to an increase in structural constituents important to wound healing.