Microdeformational Wound Therapy

  • Douglas Helm
  • Dennis P. OrgillEmail author


Complex wounds, a growing burden to healthcare from increasing rates of comorbid conditions, are a challenge to treat. Treatments including sharp debridement, optimizing medical conditions, and employing a wide variety of new wound care products including microdeformational wound therapy (also referred to as negative-pressure wound therapy) are strategies to enhance healing and functional recovery. This chapter discusses the scientific principles of the revolutionary and widely adapted microdeformational wound therapy and its clinical application to healing complex wounds and its future impact on healthcare.


Wound healing Negative-pressure wound therapy Mechanotransduction Fluid removal 


  1. 1.
    Argenta LC, Morykwa MJ. Vacuum-assisted closure, A new method of wound control and treatment: clinical experience. Ann Plast Surg. 1997;18:563–77.CrossRefGoogle Scholar
  2. 2.
    Sheepar MD. Sealed drainage of wounds. Lancet. 1952;259:1174–6.CrossRefGoogle Scholar
  3. 3.
    Armstrong DG, Marston WA, Reyzelman AM, Kirsner RS. Comparative effectiveness of mechanically and electrically powered negative pressure wound therapy devices: A multicenter randomized controlled trial. Wound Rep Reg. 2012;20:332–41.CrossRefGoogle Scholar
  4. 4.
    Amstrong DG, Lavery LA, Diabetic Foot Study Consortium. Negative pressure wound therapy after partial diabetic foot amputation: a multicentre, randomised controlled trial. Lancet. 2005;366:1704–10.CrossRefGoogle Scholar
  5. 5.
    Vuerstaek JD, Vainas T, Wuite J, Nelemans P, Neumann MH, Veraart JC. State-of-the-art treatment of chronic leg ulcers: a randomized controlled trial comparing vacuum-assisted closure (V.A.C.) with modern wound dressing. J Vasc Surg. 2006;44:1029–37.CrossRefGoogle Scholar
  6. 6.
    Blume PA, Walters J, Payne W, Ayala J, Lantis J. Comparison of negative pressure wound therapy using vacuum-assisted closure with advanced moist wound therapy in the treatment of diabetic foot ulcers: a multicenter randomized controlled trial. Diabetes Care. 2008;31:631–6.CrossRefGoogle Scholar
  7. 7.
    Amstrong AJ, DG LLA, Boulton AJ. Resource utilization and economic costs of care based on a randomized trial of a vacuum-assisted closured therapy in the treatment of diabetic foot wounds. Am J Surg. 2008;195:182–8.Google Scholar
  8. 8.
    Kairinos N, Solomons M, et al. The paradox of negative pressure wound therapy – in vitro studies. J Plast Reconstr Aesthet Surg. 2010;63:174–9.CrossRefGoogle Scholar
  9. 9.
    Erba P, Ogawa R, Ackermann M, Adini A, Miele LF, Dastouri P, Helm D, Mentzer SJ, D'Amato RJ, Murphy GF, Konerding MA, Orgill DP. Angiogenesis in wounds treated with microdeformational wound therapy. Ann Surg. 2011;253:402–9.CrossRefGoogle Scholar
  10. 10.
    Ingber DE. Mechanochemical basis of cell and tissue regulation. Mech Chem Biosyst. 2004;1:53–68.PubMedPubMedCentralGoogle Scholar
  11. 11.
    Scherer SS, Pietramaggiori G, Mathews JC, Prsa MJ, Huang S, Orgill DP. The mechanism of action of the vacuum assisted closure device. Plast Reconstr Surg. 2008;122:768–97.CrossRefGoogle Scholar
  12. 12.
    Lu F, Ogawa R. Microdeformational of three dimensional cultured fibroblasts induces gene expression and morphological changes. Annals of Plast Surg. 2011;66:296–300.CrossRefGoogle Scholar
  13. 13.
    Green AK, Puder M, Roy R, Arsenault D, Kwei S, Moses MA, Orgill DP. Microdeformational wound therapy: effects on angiogenesis and matrix metalloproteinases in chronic wounds of 3 debilitated patients. Ann Plast Surg. 2006;56:418–22.CrossRefGoogle Scholar
  14. 14.
    Morykwas MJ, Simpson J. Vacuum-assisted closure: state of basic research and physiological foundation. Plast Recon Surg. 2006;117:121s–6s.CrossRefGoogle Scholar
  15. 15.
    Kloth LC, Berman JE, Nett M, Papanek PE, Dumit-Minkel S. A randomized control clinical trial to evaluate the effects of noncontact normothermic wound therapy on chronic full-thickness pressure ulcers. Adv Skin Wound Care. 2002;15:270–6.CrossRefGoogle Scholar
  16. 16.
    Heit YI, Dastori P, Helm DL, Pietramaggiori G, Younan G, Erba P, Münster S, Orgill DP, Scherer SS. Foam pore size is a critical interface parameter of suction-based wound healing devices. Plast Reconst Surg. 2012;(3):589–97.CrossRefGoogle Scholar
  17. 17.
    Agency for Healthcare Research and Quality (AHRQ), Center for Delivery, Organization, and Markets, Healthcare Cost and Utilization Project (HCUP), Nationwide Inpatient Sample (NIS), 2001–2011.Google Scholar
  18. 18.
    Finarelli HJ. Could your financial health be heading for heart break? Costly drug eluting stents could dramatically alter projected demands for cardiac surgery. Healthc Financ Manage. 200357;(8):68–72.Google Scholar
  19. 19.
    Orgill DP, Austen WG, Butler CE, Fine NA, Horvath KA, Mihaljevic T, Sone DH, Wolfe WG. Guidelines for treatment of complex chest wounds with negative pressure wound therapy. Wounds. 2004.;(Suppl B:):1–23.Google Scholar
  20. 20.
    Orgill DP. Utilizing negative pressure wound therapy on open chest/sternotomy wounds Ostomy Wound Manage. 2004;50.(11A Suppl):15S–17S.Google Scholar
  21. 21.
    Miller PR, Meredith JW, Johnson JC, Chang MC. Prospective evaluation of vacuum-assisted fascial closure open abdomen: planned ventral hernia rate is substantially reduced. Ann Surg. 2004;239:608–16.CrossRefGoogle Scholar
  22. 22.
    Kaplan M. Managing the open abdomen: acknowledging the risks, utilizing the technology. Ostomy Wound Manage. 2004;50:s20–5.Google Scholar
  23. 23.
    Miller PR, Thompson JT, Faler BJ, Meredith JW, Chang MC. Late fascial closure in lieu of ventral hernia: the next step in open abdomen management. J Trauma. 2002;53:843–9.CrossRefGoogle Scholar
  24. 24.
    Eginton MT, Brown KR, Seabrook GR, Towne JB, Cambria RA. A prospective randomized evaluation of negative- pressure wound dressing for diabetic foot wounds. Ann Vasc Surg. 2003;17:645–9.CrossRefGoogle Scholar
  25. 25.
    Etoz A, Ozgenel Y, Özcan M. The use of negative pressure wound therapy on diabetic foot ulcers: A preliminary controlled trial. Wounds. 2004;16:264–9.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Brigham and Women’s Hospital Wound Care Center, Division of Plastic and Reconstructive SurgeryBrigham and Women’s HospitalBostonUSA

Personalised recommendations