Microcirculation in wound tissue treated with negative pressure therapy

Wound Care Revolution: Rethinking Negative Pressure Therapy

Lena Voss in Health & Wellness August 2025 • 4 min read.

"Is the Established Understanding of NPWT on Blood Flow and Oxygenation Accurate? New research challenges old beliefs and opens doors to innovative treatment strategies."

Negative Pressure Wound Therapy (NPWT) has become a cornerstone in modern wound care, utilizing controlled suction to promote healing. For years, the accepted wisdom has been that NPWT increases blood flow to wound sites, aiding in tissue regeneration. However, recent research is challenging this long-held belief, sparking a debate about the true impact of NPWT on microcirculation.

A pivotal study by Sogorski et al. investigated the effects of intermittent NPWT on local microcirculation in healthy volunteers. This research employed both laser Doppler flowmetry (LDF) and advanced spectroscopic techniques, providing a comprehensive look at what happens beneath the surface of treated tissue. While LDF has been a common method for assessing perfusion changes during NPWT, its reliability has come under scrutiny. The combined approach used in this study offers a more nuanced understanding, moving beyond the limitations of LDF alone.

The findings from Sogorski's team suggest that NPWT's impact on tissue oxygen availability may be more complex than previously thought. While the proportion of oxygenated blood remains stable, the total amount of blood and its velocity through the tissue increase. This observation challenges the traditional explanation that NPWT-induced compression decreases vessel diameter and reduces blood content. This article unpacks these groundbreaking findings, explores the ongoing debate, and considers new avenues for optimizing wound care.

Debunking NPWT Myths: What Does the Science Say?

Microcirculation in wound tissue treated with negative pressure therapy

The traditional view, largely shaped by the work of Kairinos et al., posits that NPWT compresses blood vessels, leading to increased flow but decreased tissue blood content and oxygen availability. Sogorski's research throws a wrench in this model. Their data indicates an increase in both blood flow and total blood content, suggesting that oxygen availability to the tissue actually rises. This directly contradicts the compression-based explanation.

To fully grasp the implications, consider the following key points from the study:

LDF vs. Spectroscopic Techniques: While LDF has been a standard tool, it may not provide a complete picture of perfusion changes. Spectroscopic techniques offer a more detailed analysis of blood content and oxygen saturation.
Increased Blood Flow and Content: Sogorski's study demonstrates that NPWT can increase both blood flow and the total amount of blood in the treated area.
Oxygen Availability: Contrary to previous assumptions, the research suggests that oxygen availability to the tissue may increase during NPWT.
Challenging the Compression Model: The traditional explanation of NPWT relies on the idea that compression leads to decreased vessel diameter. The new findings suggest a more complex mechanism.

These observations open up new avenues for understanding NPWT's effects. Rather than simply compressing vessels, NPWT might trigger a cascade of physiological responses that promote increased blood supply and oxygen delivery. This could involve the release of growth factors, the stimulation of angiogenesis (new blood vessel formation), or other cellular mechanisms.

The Future of NPWT: A Call for Further Research

The debate surrounding NPWT and its effects on microcirculation highlights the need for continued research and refinement of treatment strategies. As Sogorski et al. suggest, complementary spectroscopic techniques may hold the key to unlocking a more definite answer. By calculating the mean vessel diameter of tissue under investigation, researchers can gain deeper insights into the mechanisms at play. The evolving understanding of NPWT promises to optimize wound care practices and improve patient outcomes.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1016/j.jtv.2018.10.002, Alternate LINK

Title: Letter To The Editor Regarding ‘Improvement Of Local Microcirculation Through Intermittent Negative Pressure Wound Therapy (Npwt)’

Subject: Dermatology

Journal: Journal of Tissue Viability

Publisher: Elsevier BV

Authors: Pieter R. Zwanenburg, Henricus J.C.M. Sterenborg, Marja A. Boermeester

Published: 2019-02-01

Everything You Need To Know

What is Negative Pressure Wound Therapy (NPWT)?

Negative Pressure Wound Therapy (NPWT) is a modern wound care technique that uses controlled suction to encourage healing. It's a cornerstone of current wound care, and its impact on microcirculation and tissue regeneration is significant. It involves applying a dressing over the wound, which is then connected to a device that creates a vacuum, drawing out fluids and promoting tissue growth.

What is the significance of the study by Sogorski et al.?

The study by Sogorski et al. is pivotal because it challenges the traditional understanding of how Negative Pressure Wound Therapy (NPWT) affects blood flow and oxygenation. The research employs both laser Doppler flowmetry (LDF) and advanced spectroscopic techniques. While LDF is commonly used to assess perfusion changes, the combined approach used in this study offers a more nuanced understanding, moving beyond the limitations of LDF alone. The findings suggest that NPWT's impact on tissue oxygen availability may be more complex than previously thought.

How does the research challenge the traditional view of Negative Pressure Wound Therapy (NPWT)?

The main difference lies in the understanding of how Negative Pressure Wound Therapy (NPWT) impacts microcirculation. The traditional view, influenced by Kairinos et al., suggests that NPWT compresses blood vessels, leading to increased flow but decreased oxygen availability. However, Sogorski's research indicates that NPWT actually increases both blood flow and the total blood content, suggesting that oxygen availability to the tissue may increase. This challenges the compression model.

What are the differences between the methods used to study Negative Pressure Wound Therapy (NPWT) effects?

Laser Doppler flowmetry (LDF) is a standard tool used to assess perfusion changes during Negative Pressure Wound Therapy (NPWT), but it may not provide a complete picture. Spectroscopic techniques offer a more detailed analysis of blood content and oxygen saturation. The study used both to provide a comprehensive understanding of how NPWT affects microcirculation. LDF's limitations highlight the need for advanced techniques to fully understand the effects of NPWT, which can impact how effective it is.

What are the implications of the new findings regarding Negative Pressure Wound Therapy (NPWT)?

The implications are significant. The research suggests that Negative Pressure Wound Therapy (NPWT) might trigger physiological responses that promote increased blood supply and oxygen delivery, such as the release of growth factors or the stimulation of angiogenesis. These findings suggest that the mechanisms of NPWT are complex, which could lead to more optimized wound care practices and improve patient outcomes by enhancing tissue healing and reducing complications. Further research is needed to validate these findings.