Chen Bin, Kao Huang-Kai, Dong Ziqing, Jiang Zhaohua, Guo Lifei
Burlington, Mass.; Taoyuan, Taiwan; and Guangzhou and Shanghai, People's Republic of China.
From the Department of Plastic Surgery, Lahey Hospital & Medical Center; the Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung University; the Department of Plastic and Cosmetic Surgery, Nanfang Hospital, Southern Medical University; and the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital.
Plast Reconstr Surg. 2017 Jan;139(1):105-117. doi: 10.1097/PRS.0000000000002909.
Negative-pressure wound therapy and pulsed radiofrequency energy are two clinical modalities used to treat soft-tissue wounds. They are purported to affect healing differently. The aim of this experimental study was to contrast the two modalities at a mechanistic level and to investigate whether their combined therapy could achieve additive and complementary effects on wound healing.
Full-thickness dorsal cutaneous wounds of diabetic, db/db, mice were treated with either negative-pressure wound therapy, pulsed radiofrequency energy, or combined therapies. Macroscopic healing kinetics were examined. Epidermal regeneration (proliferation rate and length of reepithelialization) and neovascularization (blood vessel density) were investigated. Messenger RNA levels indicative of angiogenic (basic fibroblast growth factor), profibrotic (transforming growth factor-β), epidermal proliferative (keratinocyte growth factor), and extracellular matrix remodeling (collagen 1) processes were measured in wound tissues.
All three treatment groups displayed faster wound healing. The negative-pressure wound therapy/pulsed radiofrequency energy combined therapy led to significantly faster healing than either the negative-pressure wound therapy or pulsed radiofrequency energy therapy alone. Epidermal regeneration and neovascularization were enhanced in all three groups. The two negative-pressure wound therapy groups (alone and combined with pulsed radiofrequency energy) demonstrated more significant increases in expression of all assayed growth factors than the pulsed radiofrequency energy group. Furthermore, the combined therapy exhibited a more profound elevation in collagen 1 expression than either of the two therapies alone.
Combining the negative-pressure wound therapy and pulsed radiofrequency energy modalities can achieve additive benefits in cutaneous healing, and the two therapies can be easily used together to complement each other in clinical wound treatments.
负压伤口治疗和脉冲射频能量是用于治疗软组织伤口的两种临床方式。据称它们对愈合的影响有所不同。本实验研究的目的是在机制层面比较这两种方式,并研究它们的联合治疗是否能对伤口愈合产生累加和互补效应。
对糖尿病db/db小鼠的背部全层皮肤伤口进行负压伤口治疗、脉冲射频能量治疗或联合治疗。检查宏观愈合动力学。研究表皮再生(增殖率和再上皮化长度)和新血管形成(血管密度)。测量伤口组织中指示血管生成(碱性成纤维细胞生长因子)、促纤维化(转化生长因子-β)、表皮增殖(角质形成细胞生长因子)和细胞外基质重塑(胶原蛋白1)过程的信使核糖核酸水平。
所有三个治疗组的伤口愈合都更快。负压伤口治疗/脉冲射频能量联合治疗导致的愈合速度明显快于单独的负压伤口治疗或脉冲射频能量治疗。所有三组的表皮再生和新血管形成均得到增强。两个负压伤口治疗组(单独和与脉冲射频能量联合)在所有检测的生长因子表达上的增加比脉冲射频能量组更显著。此外,联合治疗在胶原蛋白1表达上的升高比单独的两种治疗更显著。
将负压伤口治疗和脉冲射频能量方式相结合可在皮肤愈合中实现累加益处,并且这两种治疗在临床伤口治疗中可轻松联合使用以相互补充。