Negative Pressure Wound Therapy In The Diabetic Wound Repair

Objective:(1) To study the TGF-β1, TGF-β3expression in diabetic rats flap repair with thenegative pressure wound therapy and explore its possible mechanism of action.(2) To Study the clinical application of negative pressure wound therapy on the woundrepair of diabetic foot, and the differences between traditional repair methods andnegative pressure wound therapy in the rate of preserve limbs and treatment time.Methods:Study on the TGF-β1, TGF-β3Expression in Diabetic Rats Flap Repair withNegative Pressure Wound Therapy1. Preparation diabetic rat model. The experimental rats were fasted for24hours aftera one-time single dose of intraperitoneal injection of STZ65mg/kg. Four hourslater, it was gave a5%glucose solution to drink. The next day, we determine bloodglucose level more than10mmol/L in tail blood.That means model was successful.After the modeling, blood glucose of the experimental group was measured everyother day until the animals were killed.2. Model diabetic rats were randomly divided into experimental and control groups.Pedicle flaps about2cm×5cm were made on the back of rats. The experimentalgroup was given the continued closure of the vacuum suction. The control groupreceived dressing treatment with normal saline.3. Rats were killed in experimental3d,5d,7d,11d respectively in both experimentalgroup and the control group. Wound granulation tissue was separated and fixed with10%neutral formalin. 4. TGF-β1, TGF-β3expression in immunohistochemical determination in differentphases were observed under microscope.The Clinical Application of Negative Pressure Wound Therapy on the WoundRepair of Diabetic Foot.From2006to2008,82cases of diabetic foot gangrene (Wagner4，5) was treated withplastic surgery or minor amputation. From2009to2011June, we treatment82cases ofdiabetic foot gangrene patients with negative pressure wound therapy on their woundrepair operation. Continuous negative pressure drainage6-7days, and then sutureremoval at the7th day after removing the negative pressure drainage. Rate of preservelimbs and treatment time were compared the in two groups.Results:1. Study on the TGF-β1, TGF-β3Expression in Diabetic Rats Flap Repair withNegative Pressure Wound TherapyThe experimental results show that the TGF-β1, TGF-β3expression in the wound ofcontrol group was lower than that of experimental group at different phases. TGF-β1expression peaked at the5th day in the control group, the expression peak in theexperimental group was at the7th day phase. TGF-β3expression in the control grouppeaked at the3th day phase, the expression peak in the experimental group was at the5th day phase.2. The Clinical Application of Negative Pressure Wound Therapy on the WoundRepair of Diabetic Foot.In the group of surgical repair only,57cases got wound healing, and25cases withdelayed wound healing. The average time of hospitalization were43.1days. The rate oflimbs preserve was69.5%. In the group of surgical repair with negative pressure wound therapy,80cases got wound healing, and11cases with delayed wound healing.. Theaverage time of hospitalization were33.7days. The rate of limbs preserve was87.9%.The limbs preserve rate of surgical repair with negative pressure wound therapy washigher than the surgical repair only, and the average treatment time was decreased.(p<0.05).Conclusion: Negative pressure wound therapy technique can promote the diabeticwound healing in wound repair operation. It can also decrease average time ofhospitalization and improve the rate of limbs preserve. Negative pressure woundtherapy can improve TGF-β1, TGF-β3expression in diabetic rats wound repair operation.The mechanisms of negative pressure wound therapy promoting diabetic wound healingmay be ralated to the increased TGF-β1, TGF-β3expression.