Chronic Wound Treatment With High-density Nanofat Grafting Combined With Negative Pressure Wound Therapy

Objective: Objective to explore the clinical effect of high-density nano fat grafting combined with negative pressure wound therapy on chronic wound healing,and to find a new treatment method for chronic wound.Methods: June 2016 ~2018 January,screening of 15 patients with chronic wound in the burn plastic Surgery of Zunyi Medical College,the adipose tissue was obtained by Coleman technique in the ipsilateral or bilateral thigh of the patient,and the adipose tissue was made into high-density nanofat by centrifugation and mechanical emulsification.After routine debridement of the chronic wound of the lower extremities,the high-density nanofat local injection was grafted to the edge and the basement of the wound and combined with the negative pressure wound therapy to treat the chronic wound as 8 cases,the negative pressure wound therapy was used as the control group in 7 cases alone.After 10 days of treatment,the wound healing was observed,and there were no local or systemic complications after treatment,and the safety of treatment was evaluated.The wound area was measured before and after treatment and the wound healing rate was calculated.The histological examination was performed by drilling biopsy before and after the treatment: he staining was used to observe the skin structure of the wound,Masson staining was used to detect the collagen deposition of wound,and the percentage of collagen content(blued)was calculated by using image J,and the formula was as follows: relative collagen content =(blue-stained collagen fiber area/total field area)× 100%;CD31 immunohistochemical staining analysis of skin angiogenesis in wounds,microscopic observation and taking photographs,counting 5 high magnification of the number of neovascularization.Results: After 10 days of treatment,15 patients with chronic wound area were reduced before treatment,all cases did not appear the wound infection aggravating,the wound enlargement,the local necrosis,the organization abnormal hyperplasia and so on wound local complication and the bacterium blood disease,the allergic reaction,the rejection reaction and so on systemic adverse reaction,the adipose supply area all did not appear the ache,Complications such as subcutaneous hematoma.The wound healing rate of high-density nanofat combined with negative pressure wound therapy group was 26.50%±9.51%,and the wound healing rate was 12.02%±4.20% with the negative pressure wound therapy,the difference was statistically significant(p<0.01).He staining showed that the concentration of nanofat grafting combined with negative pressure wound therapy was more obvious in group dermal inflammatory cell infiltration.The results of Masson staining showed that the highdensity nanofat combined with negative pressure wound therapy Group had more collagen deposition and thicker collagen layer,The relative collagen content was higher than that of the single negative pressure wound therapy group,and the difference was statistically significant(p<0.001).The results of CD31 immunohistochemical staining showed that the density of capillary capillaries in two groups was increased after 10 days,and the relative number of new blood vessels in the high-density nanofat combined with negative pressure wound therapy Group was more than that by using negative pressure wound therapy Group,the difference was statistically significant(p<0.001).Conclusion: High-density nano fat grafting combined with negative pressure wound therapy has the advantages of small trauma and strong clinical feasibility,and can effectively promote the healing of chronic wound,which is a new and effective method to treat chronic wound.