Homemade-device-induced negative pressure promotes wound healing more efficiently than VSD-induced positive pressure by regulating inflammation, proliferation and remodeling.
Homemade-device-induced negative pressure promotes wound healing more efficiently than VSD-induced positive pressure by regulating inflammation, proliferation and remodeling.
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DOI：
10.3892/ijmm.2017.2919
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发表时间：
2017-04
影响因子：
5.4
通讯作者：
Zhou J
中科院分区：
文献类型：
--
作者：
Liu J;Hu F;Tang J;Tang S;Xia K;Wu S;Yin C;Wang S;He Q;Xie H;Zhou J
真空密封引流术（VSD）是促进创面愈合的有效技术。然而，最近的研究表明，它对皮肤施加的是正压（PP）而不是负压（NP）。在本研究中，我们自制了一种维持NP在创面上的装置，并将vsd诱导的PP与自制的诱导NP的创面愈合装置的治疗效果进行了比较。与VSD诱导的PP相比，我们的装置诱导的NP所需的伤口愈合时间更短，并且更有效地减少了伤口面积。NP和PP均通过上调中性粒细胞浸润和白细胞介素(IL)-1β表达，下调IL-10表达来促进炎症反应。结果表明，NP处理的创面组织表皮生长因子（EGF）、转化生长因子(TGF)-β和血小板源性生长因子（PDGF）水平高于PP处理的创面组织，碱性成纤维细胞生长因子（bFGF）水平低于PP处理的创面组织，第10天NP处理的创面组织增殖显著高于PP处理的创面组织。NP组和PP组的胶原ⅰ和胶原ⅲ水平均降低。与PP相比，NP组在第3天和第10天诱导纤维连接蛋白（FN）的表达有统计学意义。此外，NP组在第3天升高了基质金属蛋白酶(MMP)-13的水平，而PP组则降低了。NP还能诱导创面愈合早期组织金属蛋白酶抑制剂（tissue inhibitor of metalloproteinase， TIMP）-1和TIMP-2水平下降，与PP在相应时间点对TIMP-1和TIMP-2水平升高的作用有显著差异。总的来说，我们的数据表明，我们自制的诱导NP的装置比vsd诱导的PP更有效地通过调节伤口组织中不同细胞的炎症、分泌、增殖和分布来促进伤口愈合。
Vacuum sealing drainage (VSD) is an effective technique used to promote wound healing. However, recent studies have shown that it exerts positive pressure (PP) rather than negative pressure (NP) on skin. In this study, we created a homemade device that could maintain NP on the wound, and compared the therapeutic effects of VSD-induced PP to those of our home-made device which induced NP on wound healing. The NP induced by our device required less time for wound healing and decreased the wound area more efficiently than the PP induced by VSD. NP and PP both promoted the inflammatory response by upregulating neutrophil infiltration and interleukin (IL)-1β expression, and downregulating IL-10 expression. Higher levels of epidermal growth factor (EGF), transforming growth factor (TGF)-β and platelet-derived growth factor (PDGF), and lower levels of basic fibroblast growth factor (bFGF) were observed in the wound tissue treated with NP compared to the wound tissue exposed to PP. Proliferation in the wound tissue exposed to NP on day 10 was significantly higher than that in wound tissue exposed to PP. NP generated more fibroblasts, keratinized stratified epithelium, and less epithelia with stemness than PP. The levels of ccollagen I and III were both decreased in both the NP and PP groups. NP induced a statistically significant increase in the expression of fibronectin (FN) on days 3 and 10 compared to PP. Furthermore, the level of matrix metalloproteinase (MMP)-13 increased in the NP group, but decreased in the PP group on day 3. NP also induced a decrease in the levels of tissue inhibitor of metalloproteinase (TIMP)-1 and TIMP-2 during the early stages of wound healing, which was significantly different from the increasing effect of PP on TIMP-1 and TIMP-2 levels at the corresponding time points. On the whole, our data indicate that our homemade device which induced NP, was more efficient than VSD-induced PP on wound healing by regulating inflammation, secretion, proliferation and the distribution of different cells in wound tissue.