| Part I Protein biochip array analysis of angiogensis-related growthfactors local expression treated by vacuum assisted closure Objective: Angiogenesis is important in wound healing processes. Increased angiogenesis and blood flow constitute a major mechanism of negative pressure wound therapy (NPWT), which has been shown to facilitate healing of infected wounds, but the change of angiogensis-related growth factors expressions remains unknown. The goal of this study was to investigate the angiogenic factor level before and after NPWT in infected wounds.Methods:40patients with soft tissue defects were were divided into two groups-treatment group and control group. Patients in treatment group treated were treated with NPWT while control group were treated with traditional gauze covered. Wound surface and healing time were recorded. Blood flow were scaned with Periscan PIM3system and ten angiogensis-related growth factors were detected using a protein biochip array to analyse the differences between the two group.. Results:All patients' wounds were successfully reconstructed by suture or skin grafting. NPWT resulted in significantly increased blood flow in the wound on treatment group. There were significant increases in VEGF, EGF, PDGF and ANG-2on NPWT group, while bFGF decreased significantly. Angiogenin, HGF and PIGF were present at higher levels in treatment group, but the change had no statistical significance (P value were0.188,0.245,0.089respective, they were all greater than0.05).Conclusions: NPWT can increase the bilood flow perfusion and influence the local expression of angiogenesis-related growth factors such as VEGF? EGF?PDGF? ANG-2and bFGF, which could represent another mechanism to explain how NPWT accelerates wound healing. Part II Investigation of quality of granulation tissue generated during the healing of infected wounds under negative pressure wound therapyBackground:In clinical work, negative pressure wound therapy (NPWT) has been widely used in the treatment of infected wounds. The mechanism is to promote the formation of wound granulation tissue. The purpose of this study was to assess the quality of the granulation tissue in the infected wounds under negative pressure and explore the mechanism by which NPWT promotes wound healing.Method: Infected wounds created on pigs' back model were used to investigate effects of varying negative pressure of devices. Wounds were treated with negative pressure value of-150mmHg were set as experimental group, the others were covered with sterile gauze, which were set as control. The NPWT dressing and sterile gauze were changed on day1,3,7and14after wounds were created. When changing dresses, tissues from wounds were harvested. Following test was performed:1. Wound was observed and the situation of wound healing was recorded regularly on day3,7and14.2. Levels of hydroxyproline on wound wasdetermined, and the expression levels of related cytokines were examined by Western blot.Result: Compared with the control group, experimental group exhibited less wound secretions, fresher granulation tissue, and shorter healing time. On days1and14, hydroxyproline level of the experimental group was significantly higher than that of the control group; whereas on days3and7, the former was significantly lower than the latter. On days1,3,7, and14post-treatment, levels of VEGF, EGF, and PDGF were significantly higher over the control group. On days1and14, bFGF level of the experimental group was significantly higher than that of the control group; whereas on days3and7, the former was significantly lower than the latter. Conclusion: NPWT can gain better quality granulation tissue in initial and later stage but poor quality from3rd to7th during wound healing, and the expression of VEGF, EGF, PDGF, and bFGF was affected by NPWT, bFGF is the key indicator of the quality of granulation tissue. |
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