RESULTS

Wound contraction was slightly greater for foam (both

MHC Avance & V.A.C. GranuFoam) than for gauze.
Wound contraction is the same when using Mepitel and
Mepitel One.
There is more pronounced granulation tissue formation
with foam (green and black) than with gauze.
Granulation tissue formation is slightly greater under
foam than under gauze and in the presence of a wound
contact layer (in this case, Mepitel and Mepitel One)
Degree of granulation tissue is similar for both Avance
foam and V.A.C. GranuFoam.
Wound bed tissue grows into foam but not into gauze.
Degree of tissue ingrowth is similar for both Avance
foam and V.A.C. GranuFoam.
This is reflected in findings of case studies showing
gauze to be easier to remove.
Removal of AMD gauze does not disrupt the wound bed
and may lessen patient pain during dressing changes.
The presence of Mepitel and Mepitel One hinders in-growth
and lessens the force needed for removal of foam in NPWT.
Waring M, Bielfeldt S, Brandt M
Wounds UK 2009; 5 (3): 22-31
INTRODUCTION
From a clinical perspective, NPWT is superior to
standard moist wound care in a variety of wound types.
15 RCTs of varying quality indicate superiority and safety
from a clinical perspective.
Majority of trials involve KCIs V.A.C. system using foam.
The Avance NPWT system is suitable for use with both
foam and gauze.
Recommended pressure levels for Avance vary,
depending on filler type:
Avance foam (-120 mmHg)
AMD gauze (-80 mmHg)
AIMS
Demonstrate equivalency of MHC Avance NPWT green
foam system with KCIs V.A.C. black foam system, for
which there is already a large evidence base (15 RCTs).
Achieve this by drawing on data from an MHC animal study
comparing KCI V.A.C. GranuFoam with MHC Avance foam.
Demonstrate equivalency of the gauze component of the
Avance system with other systems using gauze.
Show that Mepitel

One performs in a similar way to

Mepitel

in conjunction with NPWT.

METHODS
MHC-sponsored animal studies involving eight healthy
domestic pigs:
Effects of MHC Avance foam, AMD gauze, and KCI V.A.C.
GranuFoam were compared.
Biological effects of Mepitel/Mepitel One, used as
interpositional dressing, were assessed.
Measures compared in the first MHC study included:
Mechanical effects (contraction).
Quantity and quality of granulation tissue with
different fillers.
Wound bed tissue ingrowth into the wound filler.
Measures compared in the second MHC study were:
Pressure transduction.
Blood flow in the wound bed.
ANIMAL STUDY
Evaluation of MHC Avance

foam, KCI V.A.C.

GranuFoam,

and gauze for

negative pressure wound therapy (NWPT): Biological effects on the
wound bed including granulation quantity, tissue ingrowth into wound filler,
delivery of negative pressure to wound bed, and blood flow in the wound bed
Malin Malmsj MD, PhD, Lund University, Sweden. Poster presented at EWMA 2010
B
e
f
o
r
e

N
W
P
T
N
P
W
T
,

O
h
N
P
W
T
,

2
4
h
N
P
W
T
,

4
8
h
N
P
W
T
,

7
2
h
A
f
t
e
r

N
W
P
T
102
100
98
96
94
92
90
W
o
u
n
d

s
u
r
f
a
c
e

a
r
e
a

(
%

c
h
a
n
g
e
)
Gauze, with NPWT
B
e
f
o
r
e

N
W
P
T
N
P
W
T
,

O
h
N
P
W
T
,

2
4
h
N
P
W
T
,

4
8
h
N
P
W
T
,

7
2
h
A
f
t
e
r

N
W
P
T
102
100
98
96
94
92
90
W
o
u
n
d

s
u
r
f
a
c
e

a
r
e
a

(
%

c
h
a
n
g
e
)
MHC foam,
with NPWT
B
e
f
o
r
e

N
W
P
T
N
P
W
T
,

O
h
N
P
W
T
,

2
4
h
N
P
W
T
,

4
8
h
N
P
W
T
,

7
2
h
A
f
t
e
r

N
W
P
T
102
100
98
96
94
92
90
W
o
u
n
d

s
u
r
f
a
c
e

a
r
e
a

(
%

c
h
a
n
g
e
)
VAC foam,
with NPWT
G
a
u
z
e
,

0
m
m
H
g
G
a
u
z
e
,

-
1
2
0
m
m
H
g
G
a
u
z
e
,
l
a
y
e
r
1

-
1
2
0
m
m
H
g
G
a
u
z
e
,
l
a
y
e
r
2

-
1
2
0
m
m
H
g
G
r
e
e
n

f
o
a
m
,

0
m
m
H
g
G
r
e
e
n

f
o
a
m
,

-
1
2
0
m
m
H
g
G
r
e
e
n

f
o
a
m
,
l
a
y
e
r
1

-
1
2
0
m
m
H
g
G
r
e
e
n

f
o
a
m
,
l
a
y
e
r
2

-
1
2
0
m
m
H
g
B
l
a
c
k

f
o
a
m
,

0
m
m
H
g
B
l
a
c
k

f
o
a
m
,

-
1
2
0
m
m
H
g
6
4
2
0
A
v
e
r
a
g
e

f
o
r
c
e

(
N
)
Average force
1 = Mepitel
2 = Mepitel One
WCC0702PS/1
CONCLUSIONS
MHC animal studies comparing MHC Avance foam with V.A.C. GranuFoam demonstrate equivalency to KCI V.A.C.
GranuFoam for multiple parameters.
Similarly, MHC animal studies using gauze packing mirror published findings of other systems using gauze packing.
Other measures not considered in MHC studies but verified in KCI clinical studies, such as reduced time to achieve wound
closure, might reasonably be achieved with the Avance system.
Mepitel and Mepitel One demonstrate equivalence in combination with NPWT, less in-growth under foam supports other
studies with respect to reduced levels of pain.
Mlnlycke Health Care AB (publ) Box 13080, SE-402 52 Gteborg, Sweden
Phone + 46 31 722 30 00. www.molnlycke.com
The Mlnlycke Health Care name and logo, Avance,

Safetac

and Mepitel

are registered trademarks of Mlnlycke Health Care.
Optimal pressure transduction with MHC foam, V.A.C.
GranuFoam, and gauze.
All three fillers were comparable.
When using Safetac

technology (Mepitel and Mepitel One),

wound bed pressures achieved were reduced.
NPWT induced an increase in the wound edge
microvascular blood flow at 2.5cm from the wound edge.
At 0.5cm from the wound edge, a decrease in blood flow
was noted.
Observations regarding blood flow were similar for MHC
green and KCI black foam. Gauze had slightly less
pronounced blood flow effects, especially at 0.5cm from
the wound edge.
Increased blood flow facilitates oxygenation, nutrient
supply and removal of waste products.
Decreased blood flow stimulates angiogenesis and
granulation tissue formation.
MHC Avance foam (green) allows easier monitoring of
wound status since exudate and bleeding are easier to
see than in the black GranuFoam.

Outcomes from RCTs with KCIs V.A.C. system, which
demonstration of equivalence suggests would be similar
with Avance:
Reduced number of days required to achieve 100%
re-epithelialisation.
Reduced need for secondary amputations in patients with
diabetic foot ulcers.
Reduction in the number of days required to achieve
complete healing.
Reduced need for re-grafting.
Reduction in time to stop wound exudate.
Reduction of bacteria levels in infected wounds.
Increased rate of granulation tissue formation.
Increased rates of achieving successful skin grafts.
Increased reduction in wound volume at 6 weeks.
Increased ulcer width reduction at 6 weeks.
Increased graft take.
Clinical studies using gauze supporting claims for NPWT
and possibly replicable with Avance:
Median 88% reduction in volume (p<0.001).
68% reduction in area (p<0.001).
Green foam Black foam Gauze
0
-20
-40
-60
-80
-100
-120
-140
-160
W
o
u
n
d

b
e
d

p
r
e
s
s
u
r
e

(
m
m
H
g
)
0 -20 -40 -60 -80 -100 -120 -140 -160
Set negative pressure (mmHg)
Green foam
Black foam
Gauze
100
90
80
70
60
50
40
30
20
10
0
-10
-20
-30
-40
-50
B
l
o
o
d

f
l
o
w

(
%

o
f

b
a
s
e
l
i
n
e
)
20 40 60 80 100 120
Negative pressure (-mmHg)
Black foam, 0.5cm
Black foam, 2.5cm
Green foam, 0.5cm
Green foam, 2.5cm
Gauze, 0.5cm
Gauze, 2.5cm