Clinical Study Of Vacuum Sealing Drainage Combined With Hyperoxia Solution On The Inflammation And Collagen Synthesis Of Chronic Wounds In High Altitude Area

Objectives:To study the application of VSD combined with HPSW in high-altitude areas on the inflammatory response and collagen synthesis of patients with chronic wounds in high-altitude areas provides the theoretical basis and experimental basis for clinical research on the application of VSD combined with HPSW in high-altitude areas to promote chronic wound healing.Methods:Selected 45 patients who were diagnosed with chronic wounds and hospitalized in the Burn Plastic Surgery Department of the Affiliated Hospital of Qinghai University from September 2018 to December 2020.The above patients were randomly divided into 3 groups using the random word table method,respectively.15people in the negative pressure closed drainage technology（VSD）group,15 people in the negative pressure closed drainage technology combined with 0.9%saline lavage（VSDNS）group,15 people in the negative pressure closed drainage technology combined with hyperoxic fluid lavage（VSDOS）group,The above-mentioned patients were given corresponding group treatment on the basis of general symptomatic treatment.The granulation tissue at the center of the wound was collected before group treatment and on the 7^th day of treatment,and CD68 immunocytochemical staining was performed to observe the production of macrophages in the wound granulation tissue;Western blotting was used to detect interleukin-6 in the wound granulation tissue（IL-6）expression;masson staining to observe the production of fibroblasts and collagen in the wound granulation tissue;Western blotting to detect the expression of type I collagen in the wound granulation tissue.Results:1.The effect of VSD combined with HPSW on the inflammatory response of patients with chronic wounds in high altitude areas:（1）Comparing the formation of macrophages in wound granulation tissue before treatment and on the 7^thday of treatment in the three groups,it is shown that the granulation tissue of wounds in the three groups is macrophage after treatment.The number of phages decreased compared with before,and the decrease of macrophages in the wound granulation tissue of the three groups was significantly higher in the VSDOS group than in the VSD group and the VSDOS group.（2）Comparing the expression of IL-6 in wound granulation tissue before and on the 7^th day of treatment in the three groups,it was shown that the expression of IL-6 in wound granulation tissue after treatment in the three groups was lower than before,while the expression of IL-6 in wound granulation tissue in the three groups.The reduction in the VSDOS group was significantly higher than that of the VSD group and the VSDOS group.2.The effect of VSD combined with HPSW on the collagen synthesis of chronic wound patients in high-altitude areas:（1）Comparing the masson staining of the wound granulation tissue before and on the 7^thday of treatment in the three groups,it shows that the fibrous tissues in the wound granulation tissue of the three groups are all higher after treatment.The amount of fibrous tissue in the wound granulation tissue of the three groups was significantly higher in the VSDOS group than in the VSD group and the VSDOS group.（2）Comparing the expression of type I collagen in wound granulation tissue before and on the 7^th day of treatment in the three groups,it was shown that the expression of type I collagen in wound granulation tissue after treatment in the three groups was higher than before,while the expression of type I collagen in wound granulation tissue in the three groups,the increase in VSDOS group was significantly higher than that of VSD group and VSDOS group.Conclusions:1.The combined treatment of VSD and HPSW can control the inflammatory response of the wound by reducing the infiltration of macrophages and the expression of IL-6 on the wound.2.The combined treatment of VSD and HPSW can promote wound healing by increasing the production of wound fibroblasts and collagen.