From the Departments of Plastic, Reconstructive, and Aesthetic Surgery and Pharmacology, Nippon Medical School; and the Department of R&D, Pixie Dust Technologies.
Plast Reconstr Surg. 2020 Feb;145(2):348e-359e. doi: 10.1097/PRS.0000000000006481.
The authors developed a noncontact low-frequency ultrasound device that delivers high-intensity mechanical force based on phased-array technology. It may aid wound healing because it is likely to be associated with lower risks of infection and heat-induced pain compared with conventional ultrasound methods. The authors hypothesized that the microdeformation it induces accelerates wound epithelialization. Its effects on key wound-healing processes (angiogenesis, collagen accumulation, and angiogenesis-related gene transcription) were also examined.
Immediately after wounding, bilateral acute wounds in C57BL/6J mice were noncontact low-frequency ultrasound- and sham-stimulated for 1 hour/day for 3 consecutive days (10 Hz/90.6 Pa). Wound closure (epithelialization) was recorded every 2 days as the percentage change in wound area relative to baseline. Wound tissue was procured on days 2, 5, 7, and 14 (five to six per time point) and subjected to histopathology with hematoxylin and eosin and Masson trichrome staining, CD31 immunohistochemistry, and quantitative polymerase-chain reaction analysis.
Compared to sham-treated wounds, ultrasound/phased-array-treated wounds exhibited significantly accelerated epithelialization (65 ± 27 percent versus 30 ± 33 percent closure), angiogenesis (4.6 ± 1.7 percent versus 2.2 ± 1.0 percent CD31 area), and collagen deposition (44 ± 14 percent versus 28 ± 13 percent collagen density) on days 5, 2, and 5, respectively (all p < 0.05). The expression of Notch ligand delta-like 1 protein (Dll1) and Notch1, which participate in angiogenesis, was transiently enhanced by treatment on days 2 and 5, respectively.
The authors' noncontact low-frequency ultrasound phased-array device improved the wound-healing rate. It was associated with increased early neovascularization that was followed by high levels of collagen-matrix production and epithelialization. The device may expand the mechanotherapeutic proangiogenesis field, thereby helping stimulate a revolution in infected wound care.
作者开发了一种基于相控阵技术的非接触式低频超声设备，可提供高强度机械力。与传统超声方法相比，它可能具有较低的感染和热诱导疼痛风险，从而有助于伤口愈合。作者假设它诱导的微变形加速了伤口上皮化。还检查了其对关键伤口愈合过程（血管生成、胶原蛋白积累和血管生成相关基因转录）的影响。
在 C57BL/6J 小鼠受伤后立即，双侧急性伤口接受非接触式低频超声和假刺激，每天 1 小时，连续 3 天（10 Hz/90.6 Pa）。每隔 2 天记录一次伤口闭合（上皮化），即相对于基线的伤口面积百分比变化。在第 2、5、7 和 14 天（每个时间点五到六个）采集伤口组织，并进行苏木精和伊红以及 Masson 三色染色、CD31 免疫组织化学和定量聚合酶链反应分析。
与假处理伤口相比，超声/相控阵处理伤口表现出明显更快的上皮化（65 ± 27% 与 30 ± 33% 的闭合）、血管生成（4.6 ± 1.7% 与 2.2 ± 1.0% 的 CD31 区域）和胶原沉积（44 ± 14% 与 28 ± 13% 的胶原密度）分别在第 5、2 和 5 天（所有 p < 0.05）。参与血管生成的 Notch 配体 delta-like 1 蛋白（Dll1）和 Notch1 的表达分别在第 2 和 5 天短暂增强。
作者的非接触式低频超声相控阵设备提高了伤口愈合率。它与早期新生血管形成增加有关，随后是高水平的胶原蛋白基质产生和上皮化。该设备可能扩展机械治疗促血管生成领域，从而有助于刺激感染性伤口护理的革命。
