Effect Of Vacuum-assisted Closure On The Expression Of C-ski And Smad3 In Human Chronic Wound Tissues And Its Significance

Objective: The regulation of genes plays an important role during the courses of wound healing. It is proved that vacuum-assisted closure (Vacuum-assisted closure,VAC) could promote chronic wound healing, but the mechanisms aren't clear. Our study is aim to investigate the expression of Smad3 and C-ski in the chronic wound tissue treated with VAC, and to explore its mechanisms, which will provide a novel theory for effectively treating chronic wound with VAC.Methods: 14 patients with chronic wound from our department were enrolled into the study, and the full-thickness skin defects were choosed before treatment, 1d, 4d or 7d after treatment with VAC.Immunohistochemistry (IHC) was done to detect the expression of C-ski and Smad3, and RT-PCR was used to determine the expression of C-ski and Smad3 mRNA.Results: 1) macrocopy after VAC: surface of the wound was clean, exudate decreased, lots of cardinal red granulation tissue formed, the flaggy, newly grown epithelium covered wound margin; 2)microscopy after VAC: cellular edema disappeared, inflammatory cells infiltrated, granulation tissue made of vast of inflammatory cells, fibroblast and vascular endothelial cells was appeared; 3)IHC results: the positive staining of C-ski and Smad3 were both located in the nucleus and cytoplasm of fibroblast. After VAC, the positive expression of C-ski was gradually becoming stronger, compared with the control, there was a statistical significance (P<0.01). On the contrary, the expression of Smad3 gradually became weaker, and there was also a statistical significance, compared with the control (P<0.01). 4) RT-PCR results: the expression of C-ski mRNA was gradually strengthened( p<0.05) , but the expression of Smad3 mRNA was becoming markedly weaker with the extension of time with VAC( p<0.05 ). 5)the expression of C-ski andSmad3 was negatively correlated (r=-0.873)(p<0.01).Conclusion: VAC could make the chronic wound heal, the mechanism was perhaps that VAC induced the expression of C-ski and inhibit the expression of Smad3 in the edge of wound, and accelerated the proliferation of fibroblast.