Division of Plastic & Reconstructive Surgery, Columbia University College of Physicians & Surgeons, New York, NY, USA.
J Plast Reconstr Aesthet Surg. 2009 Oct;62(10):1331-8. doi: 10.1016/j.bjps.2008.03.024. Epub 2008 Jul 9.
The vacuum-assisted closure device (VAC) has revolutionised wound care, although molecular mechanisms are not well understood. We hypothesise that the VAC device induces production of pro-angiogenic factors and promotes formation of granulation tissue and healing.
A novel rodent model of VAC wound healing was established. Excisional wounds were created on rat dorsa. Wounds were dressed with Tegaderm (control group), VAC Granulofoam and Tegaderm (special control group), or VAC Granulofoam, T.R.A.C. PAD((R)) with 125 mm Hg continuous negative pressure (VAC group). Wound closure rates were calculated as a percentage of initial wound sizes. Rats were sacrificed on postoperative days 3, 5 and 7; harvested tissues were processed for histology [haematoxylin & eosin (H&E), Masson's trichrome, picrosirius red] and Western blot analysis (CD31, vascular endothelial growth factor, basic fibroblast growth factor).
Statistically significant wound closure rates were achieved in the experimental group at all measured time points: day 3, 28.1% (VAC) vs 8.2% (control) and 8.8% (special control) (ANOVA, P<0.0001); day 5, 45.3% (VAC) vs 23.7% (control) and 22.5% (special control) (ANOVA, P=0.0003); day 7, 54.4% (VAC) vs 43.0% (control) and 31.5% (special control) (ANOVA; P<0.0001). Morphological evaluation by Masson's trichrome stain showed increased collagen organisation and wound maturation in the VAC group. These wounds also showed increased expression of vascular endothelial growth factor and fibroblast growth factor-2 on day 5 by Western blot analysis.
A small animal VAC wound model was established. Wounds treated with a VAC device showed accelerated wound closure rates, increased pro-angiogenic growth factor production and improved collagen deposition. Further application of this model may elucidate other mechanisms.
负压伤口治疗设备（VAC）改变了伤口护理方式，但其分子机制尚不清楚。我们假设 VAC 设备可诱导产生促血管生成因子，并促进肉芽组织形成和愈合。
建立了一种新型 VAC 伤口愈合的啮齿动物模型。在大鼠背部创建切除伤口。用 Tegaderm（对照组）、VAC 泡沫敷料和 Tegaderm（特殊对照组）或 VAC 泡沫敷料、T.R.A.C. PAD((R)) （带 125mmHg 持续负压）包扎伤口。计算初始伤口大小的百分比作为伤口闭合率。术后第 3、5 和 7 天处死大鼠；采集组织进行组织学处理[苏木精和伊红（H&E）、马松三色、苦味酸天狼星红]和 Western blot 分析（CD31、血管内皮生长因子、碱性成纤维细胞生长因子）。
实验组在所有测量时间点的伤口闭合率均具有统计学意义：第 3 天，28.1%（VAC）比 8.2%（对照组）和 8.8%（特殊对照组）（方差分析，P<0.0001）；第 5 天，45.3%（VAC）比 23.7%（对照组）和 22.5%（特殊对照组）（方差分析，P=0.0003）；第 7 天，54.4%（VAC）比 43.0%（对照组）和 31.5%（特殊对照组）（方差分析，P<0.0001）。马松三色染色的形态学评估显示，VAC 组胶原组织增加，伤口成熟。第 5 天，Western blot 分析显示 VAC 组血管内皮生长因子和成纤维细胞生长因子-2 的表达增加。
建立了一种小型动物 VAC 伤口模型。VAC 治疗的伤口显示出更快的伤口闭合率、增加的促血管生成生长因子产生和改善的胶原沉积。进一步应用这种模型可能阐明其他机制。
