Vacuum-Assisted Closure Therapy Increases Local Interleukin-8 and Vascular Endothelial Growth Factor Levels in Traumatic Wounds
Vacuum-Assisted Closure Therapy Increases Local Interleukin-8 and Vascular Endothelial Growth Factor Levels in Traumatic Wounds
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DOI：
10.1097/ta.0b013e318171971a
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发表时间：
2009-03-01
影响因子：
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通讯作者：
Keel, Marius
中科院分区：
文献类型：
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作者：
Labler, Ludwig;Rancan, Mario;Keel, Marius
背景：临床观察表明，采用真空辅助闭合（VAC）治疗的创伤性伤口会加速肉芽组织的形成。本研究的目的是确定 VAC 治疗与替代 Epigard 应用对创伤性软组织伤口局部炎症和新生血管形成的影响。方法：纳入了 32 名需要临时覆盖的创伤性伤口患者（VAC n = 16；Epigard n = 16）。每次更换敷料时，都会收集伤口液体和血清样本（n = 80）。通过ELISA测定细胞因子白细胞介素(IL)-6、IL-8、血管内皮生长因子(VEGF)和成纤维细胞生长因子-2。对伤口活检进行组织学检查，了解炎症细胞和新生血管形成的程度。结果：在 VAC 和 Epigard 治疗期间，发现伤口液中的所有细胞因子均升高，而血清浓度可忽略不计或检测不到。在伤口液中，VAC 治疗期间检测到显着较高的 IL-8 (p < (1.001) 和 VEGF (p < 0.05) 水平。此外，组织学检查显示 VAC 治疗伤口活检中 CD31 和冯维勒布兰德因子免疫组织化学显示新血管形成增加 (p < 0.05)。此外，中性粒细胞积聚以及 VEGF 表达增强 (p < 0.05)。 0.005）在VAC伤口活检中。结论：这项研究表明VAC治疗创伤性伤口会导致局部IL-8和VEGF浓度增加，这可能触发中性粒细胞的积累和血管生成，从而加速新血管形成。
Background: Clinical observations are suggesting accelerated granulation tissue formation in traumatic wounds treated with vacuum-assisted closure (VAC). Aim of this study was to determine the impact of VAC therapy versus alternative Epigard application on local inflammation and neovascularization in traumatic soft tissue wounds.Methods: Thirty-two patients with traumatic wounds requiring temporary coverage (VAC n = 16; Epigard n = 16) were included. At each change of dressing, samples of wound fluid and serum were collected (n = 80). The cytokines interleukin (IL)-6, IL-8, vascular endothelial growth factor (VEGF), and fibroblast growth factor-2 were measured by ELISA. Wound biopsies were examined histologically for inflammatory cells and degree of neovascularization present.Results: All cytokines were found to be elevated in wound fluids during both VAC and Epigard treatment, whereas serum concentrations were negligible or not detectable. In wound fluids, significantly higher IL-8 (p < (1.001) and VEGF (p < 0.05) levels were detected during VAC therapy. Furthermore, histologic examination revealed increased neovascularization (p < 0.05) illustrated by CD31 and von Willebrand factor immunohistochemistry in wound biopsies of VAC treatment. In addition, there was an accumulation of neutrophils as well as an augmented expression of VEGF (p < 0.005) in VAC wound biopsies.Conclusion: This study suggests that VAC therapy of traumatic wounds leads to increased local IL-8 and VEGF concentrations, which may trigger accumulation of neutrophils and angiogenesis and thus, accelerate neovascularization.