Martínez-Jiménez Mario Aurelio, Valadez-Castillo Francisco Javier, Aguilar-García Jorge, Ramírez-GarciaLuna José Luis, Gaitán-Gaona Francisco Israel, Pierdant-Perez Mauricio, Valdes-Rodríguez Rodrigo, Sánchez-Aguilar Jesús Martín
Division of Plastic and Reconstructive Surgery and Burn Center, Department of Surgery, Hospital Central "Dr Ignacio Morones Prieto", San Luis Potosí, México.
Department of Clinic Epidemiology, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México.
Plast Surg (Oakv). 2018 May;26(2):75-79. doi: 10.1177/2292550317740688. Epub 2017 Nov 22.
Clinical trials have shown the positive effects of local insulin therapy in the formation of new vessels and fibrosis in acute and chronic diabetic wounds without major adverse effects.
The aim of this study was to investigate the effects of local insulin use on wound healing in non-diabetic patients.
A randomized, split-plot, double-blind, placebo-controlled trial was conducted. Ten non-diabetic patients with full-thickness acute wounds were recruited (5 due to trauma, 3 to burns, and 2 to pressure). All wounds received standard bedside treatment. Each wound was divided into 2 zones. One side received a standard care plus insulin, while the other received standard care plus injection of saline solution. A biopsy specimen was taken from both sites on days 0 and 14. The amount of blood vessel growth and the percentage of fibrosis were evaluated.
A significant difference in the number of new vessels was observed on the insulin-treated site (70.6 [29.21]) compared to saline only (26.5 [34.3]; < .04). The percentage of fibrosis (insulin 34.7 [28.02] vs saline 27.8 [29.9]) showed no significant difference. No adverse events related to the study occurred. The clinical implications of this study are considerable in terms of the formation of blood vessels but not fibrosis.
We suggest that local insulin administration is a safe therapeutic option for angiogenesis in wounds of non-diabetic patients.
临床试验表明，局部胰岛素治疗对急慢性糖尿病伤口的新血管形成和纤维化具有积极作用，且无重大不良反应。
本研究旨在探讨局部使用胰岛素对非糖尿病患者伤口愈合的影响。
进行了一项随机、裂区、双盲、安慰剂对照试验。招募了10名患有全层急性伤口的非糖尿病患者（5例因创伤，3例因烧伤，2例因压迫）。所有伤口均接受标准床边治疗。每个伤口分为2个区域。一侧接受标准护理加胰岛素，另一侧接受标准护理加注射生理盐水。在第0天和第14天从两个部位采集活检标本。评估血管生长量和纤维化百分比。
与仅使用生理盐水的部位（26.5 [34.3]）相比，胰岛素治疗部位的新血管数量有显著差异（70.6 [29.21]；P <.04）。纤维化百分比（胰岛素组为34.7 [28.02]，生理盐水组为27.8 [29.9]）无显著差异。未发生与该研究相关的不良事件。就血管形成而言，本研究的临床意义重大，但对纤维化而言并非如此。
我们建议局部给予胰岛素是一种治疗非糖尿病患者伤口血管生成的安全治疗选择。
