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自制装置诱导的负压通过调节炎症、增殖和重塑,比VSD诱导的正压更有效地促进伤口愈合。

Homemade-device-induced negative pressure promotes wound healing more efficiently than VSD-induced positive pressure by regulating inflammation, proliferation and remodeling.

作者信息

Liu Jinyan, Hu Feng, Tang Jintian, Tang Shijie, Xia Kun, Wu Song, Yin Chaoqi, Wang Shaohua, He Quanyong, Xie Huiqing, Zhou Jianda

机构信息

Department of Nuclear Medicine, The First Xiangya Hospital of Central South University, Changsha, Hunan 410008, P.R. China.

Department of Plastic Surgery, The Third Xiangya Hospital of Central South University, Changsha, Hunan 410013, P.R. China.

出版信息

Int J Mol Med. 2017 Apr;39(4):879-888. doi: 10.3892/ijmm.2017.2919. Epub 2017 Mar 13.

Abstract

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 homemade 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.

摘要

负压封闭引流(VSD)是一种促进伤口愈合的有效技术。然而,最近的研究表明,它对皮肤施加的是正压(PP)而非负压(NP)。在本研究中,我们制作了一种能在伤口上维持负压的自制装置,并比较了VSD诱导的正压与我们自制装置诱导的负压对伤口愈合的治疗效果。我们的装置诱导的负压比VSD诱导的正压所需的伤口愈合时间更短,且能更有效地减小伤口面积。负压和正压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。与暴露于正压的伤口组织相比,在接受负压治疗的伤口组织中观察到更高水平的表皮生长因子(EGF)、转化生长因子(TGF)-β和血小板衍生生长因子(PDGF),以及更低水平的碱性成纤维细胞生长因子(bFGF)。在第10天,暴露于负压的伤口组织中的增殖明显高于暴露于正压的伤口组织。与正压相比,负压产生更多的成纤维细胞、角化复层上皮,且具有干性的上皮细胞更少。在负压组和正压组中,Ⅰ型和Ⅲ型胶原蛋白水平均降低。与正压相比,在第3天和第10天,负压诱导纤连蛋白(FN)表达有统计学意义的增加。此外,在第3天,负压组基质金属蛋白酶(MMP)-13水平升高,而正压组降低。在伤口愈合早期,负压还诱导金属蛋白酶组织抑制剂(TIMP)-1和TIMP-2水平降低,这与正压在相应时间点对TIMP-1和TIMP-2水平的升高作用有显著差异。总体而言,我们的数据表明,我们制作的诱导负压的自制装置在通过调节伤口组织中的炎症、分泌、增殖和不同细胞分布来促进伤口愈合方面比VSD诱导的正压更有效。

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