Application of regulated oxygen-enriched negative pressure-assisted wound therapy in combating anaerobic infections

Regulated negative pressure-assisted wound therapy (RNPT) applies non-pharmaceutical technology for enhanced healing of hard to cure, acute and chronic wounds. Although used for over two decades, wound pO₂ levels, an essential physical parameter inherent in RNPT that follows Henry’s Law of gases, have not been reported. Necrotizing fasciitis (NF), a severe soft tissue infection, necessitates prompt intensive therapeutic response using pharmaceutical, surgical, and hyperbaric oxygen treatment when anaerobes are involved. We report a linear decrease in pO₂ values in direct correlation with sub-atmospheric pressure and concurrent changes in wound atmospheric pO₂ by supplemented oxygen in an in vitro phantom leg simulated wound model treated with RNPT. We designed a system using regulated oxygen-enriched negative pressure therapy (RO-NPT) for controlling wound atmospheric pO_2. A representative patient case report treated for NF with RO-NPT is presented. RNPT follows Henry’s law of gases and leads to a decrease in wound atmospheric pO₂. The application of RNPT in anaerobic wound infections should be contraindicated. Wound pO₂ is enhanced by simultaneous application of oxygen by RO-NPT. We have demonstrated the rationale for the possible use of RO-NPT for prevention of anaerobic wound infections and as a supplemental mode of treatment of NF.