负压伤口治疗（NPWT）在软组织损伤后早期使用，以促进组织肉芽形成和伤口收缩。受伤后早期通过航空医疗后送 (AE) 转移至明确护理中心实际上可能会导致伤口细菌增殖。然而，NPWT 或滴注 NPWT 在限制损伤后 AE 期间细菌增殖方面的有效性尚未研究。我们假设在模拟 AE 期间滴注 NPWT 会减少简单和复杂软组织伤口内的细菌定植。在任何实验之前对猪模型进行麻醉。对于简单的组织伤口模型，在 34.9±0.6 公斤的猪身上制作两个 4 厘米的背部伤口，并在 4 小时的模拟 AE 或地面对照之前 24 小时接种鲍曼不动杆菌 (AB) 或金黄色葡萄球菌。在 AE 期间，动物被随机分为五组之一：湿-干 (WTD) 敷料组、NPWT、生理盐水滴注 NPWT (NS-NPWT)、滴注 Normosol-R® NPWT (NM-NPWT) 和RX-4-NPWT 与 RX-4 系统。对于复杂的肌肉骨骼伤口，在皮肤、皮下组织、腓骨三肌和胫骨中创建后肢伤口，并在用 WTD 或 RX-4-NPWT 敷料模拟 AE 前 24 小时用 AB 接种。在基线、飞行前和飞行后 72 小时收集血样，检测炎症细胞因子白细胞介素 (IL)-1β、IL-6、IL-8 和肿瘤坏死因子 α。飞行后 24 小时和 72 小时进行伤口活检，并对细菌进行定量。在模拟 AE 期间和每次伤口重新评估时连续测量生命体征。地面组或模拟飞行组之间或任一伤口模型中随着时间的推移，血流动力学或血清细胞因子没有显着差异。与地面对照相比，单独的模拟 AE 不会影响细菌增殖。使用 RX-4-NPWT 模拟 AE 后 72 小时，简单组织伤口手臂的金黄色葡萄球菌和 AB 菌落形成单位显着减少。 AE 期间的 NS-NPWT 比 WTD 敷料更有效地防止细菌增殖。不同治疗组在地面的菌落形成单位没有差异。AE的低氧、低压环境并不独立影响简单组织伤口或复杂肌肉骨骼伤口后的细菌生长。 RX-4-NPWT 在模拟 AE 后提供了最有效的细菌减少效果，其次是 NS-NPWT。未来的研究将有必要确定理想的滴注液、负压设置以及 AE 之前和期间的敷料更换频率。© 美国军事外科医生协会 2023。保留所有权利。如需权限，请发送电子邮件至：journals.permissions@oup.com。

Negative pressure wound therapy (NPWT) is utilized early after soft tissue injury to promote tissue granulation and wound contraction. Early post-injury transfers via aeromedical evacuation (AE) to definitive care centers may actually induce wound bacterial proliferation. However, the effectiveness of NPWT or instillation NPWT in limiting bacterial proliferation during post-injury AE has not been studied. We hypothesized that instillation NPWT during simulated AE would decrease bacterial colonization within simple and complex soft tissue wounds.The porcine models were anesthetized before any experiments. For the simple tissue wound model, two 4-cm dorsal wounds were created in 34.9 ± 0.6 kg pigs and were inoculated with Acinetobacter baumannii (AB) or Staphylococcus aureus 24 hours before a 4-hour simulated AE or ground control. During AE, animals were randomized to one of the five groups: wet-to-dry (WTD) dressing, NPWT, instillation NPWT with normal saline (NS-NPWT), instillation NPWT with Normosol-R® (NM-NPWT), and RX-4-NPWT with the RX-4 system. For the complex musculoskeletal wound, hind-limb wounds in the skin, subcutaneous tissue, peroneus tertius muscle, and tibia were created and inoculated with AB 24 hours before simulated AE with WTD or RX-4-NPWT dressings. Blood samples were collected at baseline, pre-flight, and 72 hours post-flight for inflammatory cytokines interleukin (IL)-1β, IL-6, IL-8 and tumor necrosis factor alpha. Wound biopsies were obtained at 24 hours and 72 hours post-flight, and the bacteria were quantified. Vital signs were measured continuously during simulated AE and at each wound reassessment.No significant differences in hemodynamics or serum cytokines were noted between ground or simulated flight groups or over time in either wound model. Simulated AE alone did not affect bacterial proliferation compared to ground controls. The simple tissue wound arm demonstrated a significant decrease in Staphylococcus aureus and AB colony-forming units at 72 hours after simulated AE using RX-4-NPWT. NS-NPWT during AE more effectively prevented bacterial proliferation than the WTD dressing. There was no difference in colony-forming units among the various treatment groups at the ground level.The hypoxic, hypobaric environment of AE did not independently affect the bacterial growth after simple tissue wound or complex musculoskeletal wound. RX-4-NPWT provided the most effective bacterial reduction following simulated AE, followed by NS-NPWT. Future research will be necessary to determine ideal instillation fluids, negative pressure settings, and dressing change frequency before and during AE.© The Association of Military Surgeons of the United States 2023. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.