Sugiyama Takuro, Murakami Hidetaka, Tanaka Shinichiro, Yoshida Shiro, Sato Takahiro, Hiraoka Koji
Department of Orthopedic Surgery, Kurume University, Fukuoka, JPN.
Department of Molecular Genetics, Kurume University, Fukuoka, JPN.
Cureus. 2025 May 2;17(5):e83369. doi: 10.7759/cureus.83369. eCollection 2025 May.
Wound healing remains a major challenge in orthopedic surgeries involving thin soft-tissue injuries, such as calcaneal fractures and open wounds. Recent advancements, such as negative pressure wound therapy, have demonstrated efficacy but have practical limitations, such as patient immobility and fall risk, restricting their broader application. Extracorporeal shockwave therapy, recognized by the International Society for Medical Shockwave Treatment, has shown potential in treating complex wounds, ulcers, and burns. However, the mechanism through which extracorporeal shockwave therapy accelerates wound healing is still unclear. In this study, we aimed to investigate the effects of extracorporeal shockwave therapy on wound healing using a rat model.
We examined the effects of extracorporeal shockwave therapy on wound healing in a Sprague-Dawley rat model. Extracorporeal shockwave therapy was applied to the wound area using a cylindrical device, and histological evaluations, including immunohistochemical staining and real-time polymerase chain reaction analysis, were conducted to assess the effect of extracorporeal shockwave therapy on angiogenesis and tissue repair.
Although no significant differences were found in wound contraction or vascular endothelial growth factor R2 (VEGFR2), CD31, or transforming growth factor-β1 (TGF-β1) expression, the histological analysis revealed increased vascularization and tissue regeneration in the extracorporeal shockwave therapy-treated group compared with those in the control group. On day 3, the number of blood vessels and area of CD31-positive cells were significantly higher in the extracorporeal shockwave therapy group than in the control group, with a continued increase in TGF-β1-positive cell count by day 7.
These findings suggest that extracorporeal shockwave therapy may enhance early wound healing by promoting angiogenesis and collagen production. Further research is needed to optimize extracorporeal shockwave therapy protocols and investigate their long-term effects on wound healing.
在涉及薄软组织损伤的骨科手术中，如跟骨骨折和开放性伤口，伤口愈合仍然是一项重大挑战。近期的进展，如负压伤口治疗，已证明有效，但存在实际局限性，如患者行动不便和跌倒风险，限制了其更广泛的应用。体外冲击波疗法已得到国际医学冲击波治疗协会的认可，在治疗复杂伤口、溃疡和烧伤方面显示出潜力。然而，体外冲击波疗法加速伤口愈合的机制仍不清楚。在本研究中，我们旨在使用大鼠模型研究体外冲击波疗法对伤口愈合的影响。
我们在Sprague-Dawley大鼠模型中研究了体外冲击波疗法对伤口愈合的影响。使用圆柱形装置将体外冲击波疗法应用于伤口区域，并进行组织学评估，包括免疫组织化学染色和实时聚合酶链反应分析，以评估体外冲击波疗法对血管生成和组织修复的影响。
虽然在伤口收缩或血管内皮生长因子R2（VEGFR2）、CD31或转化生长因子-β1（TGF-β1）表达方面未发现显著差异，但组织学分析显示，与对照组相比，体外冲击波疗法治疗组的血管化和组织再生增加。在第3天，体外冲击波疗法组的血管数量和CD31阳性细胞面积显著高于对照组，到第7天，TGF-β1阳性细胞计数持续增加。
这些发现表明，体外冲击波疗法可能通过促进血管生成和胶原蛋白产生来促进早期伤口愈合。需要进一步研究以优化体外冲击波疗法方案，并研究其对伤口愈合的长期影响。
