The Mechanism Of The Vacuum Sealing Drainage In The Promoting Of The Diabetic Foot Ulcers Healing

Objective:To investigate the effect of vacuum assisted closure(VAC)on the change of VEGF,MMP-2,MMP-9 and TIMP-1 in diabetic foot ulcers.Method:Using randomized method(Coin toss method,"Digital face" for the negative group and "Flower" for the control group)to divide the 56 diabetic foot ulcer patients who suffered debridement into negative group and the control group,30 were negative pressure group and 26 were control group.30 postoperative patients belong to the negative pressure group were treated with wound vacuum-assisted closure[-450--125mmHg pressure(1mmHg=0.133kPa)]for 7 days.After the removal of the negative pressure,we collected the wound exudates at 0,3rd,7th and 14th day.While collected the wound exudates from the 26 postoperative patients belong to the control group who went through conventional dressing for 7 days.Use double antibody sandwich enzyme-linked immunosorbent assay(ELISA)to determine the change of VEGF,MMP-2,MMP-9 and TIMP-1 in the wound exudates.Calculated the wound healing rate of the negative patients after removal of negative 1,2,3,4w and the corresponding time of control patients respectively.Recorded the hospitalization days,the expenses and the other basic information of the two groups.Results:Compared with the control group,the hospitalization days and the expenses of the negative pressure group were significantly less,and the difference was statistically significant(t values were-3.556,-3.449).Comparing the wound healing rate of each period of the patients belong to the two groups after 7 days'debridement,the wound healing rate of each period of the negative pressure group was significantly higher than the control group(z values were 2.159.2.239.-2.688.-3.033).Compared the concentrations of VEGF(excepted for the Od,P>0.05),MMP-2?MMP-9?TIMP-1 and MMP-9/TIMP-1 of each period from wound exudates of the negative pressure group with the control group.the differences have statistical significance.Compared with the control group.the concentrations of VEGF of the negative pressure group was more,but the statistical significance of the difference occurred from the 3rd day after the demolition of negative pressure.Compared the concentrations of MMP-2,MMP-9 and MMP-9/TIMP-1 of each period of the negative pressure group with the control group,the former group were less.The difference about the concentrations of MMP-2 between the two groups gradually increasing,after the 14th day that demolished the negative pressure,the difference peaked.While the difference of MMP-9 and MMP-9/TIMP-1 between the two groups peaked after the 7th day that demolished the negative pressure.The concentrations of TIMP-1 of each period were more in the negative pressure group,and the difference also peaked after the 7th day that demolished the negative pressure.Conclusion:Vacuum assisted closure can promote wound healing in the diabetic foot ulcers by reduce the concentration of MMP-2,MMP-9 and increasing the concentration of VEGF,TIMP-1.