Study On The Changes Of Wound Exudate MMP-9 TIMP-1 And Wound PH Value During The Healing Process Of Stage ? And Stage ? Pressure Ulcers

Objective:To investigate the relationship between the expression level of matrix metalloproteinase-9(MMP-9),matrix metalloproteinase inhibitor-1(TIMP-1),as well as the wound PH value,in the exudate of stage ?,? pressure ulcers,and the healing of pressure ulcer.Methods:Patients with stage ? and ? pressure ulcers who were treated at a certain top three hospital from July 2017 to July 2018 were selected.After evaluation,cleaning and debridement according to a unified method,the appropriate treatment plan was chosen to change the medicine and track for 4 weeks.The PUSH scale was used to evaluate the healing of pressure sore wounds at five time points,namely at the time of clinical reception,the first weekend,the second weekend,the third weekend and the fourth weekend,including the cases with healing trend.The PH value of the wound at the above five time points was measured,and the wound exudate at the corresponding time points was collected.The expression level of MMP-9,TIMP-1 in the wound exudate was detected by ELISA.The changes in the wound PH value,the expression level of MMP-9,TIMP-1 and the MMP-9 / TIMP-1 ratio in the process of pressure ulcer healing were analyzed,and the correlation between the PH value of the wound and the expression level of MMP-9 TIMP-1 was analyzed as well.Results:1.A total of 64 patients with stage ? ? pressure ulcers were included,including 30 patients with stage ? pressure ulcers with 30 pressure ulcers wounds and 34 patients with stage ? pressure ulcers with 50 pressure ulcers wounds.At the time of diagnosis,the PH value of stage ? pressure ulcer wound was significantly higher than that of stage ? pressure ulcer wound,and the difference was statistically significant(P<0.001).The MMP-9 / TIMP-1 ratio in the exudate of stage ? pressure ulcer wound was significantly higher than that of stage ? pressure ulcer wound,and the difference was statistically significant(P<0.001).There was no significant difference in the expression level of MMP-9 and TIMP-1 in wound exudate(P>0.05).2.The PUSH score of stage ? and ? pressure ulcers showed a declining trend over time(P<0.001).3.The PH value of stage ? and ? pressure ulcers showed a declining trend over time(P<0.001).Moreover,the PH value of pressure sore wound at different time points was statistically significant(P<0.001).4.The expression level of MMP-9,TIMP-1 and the ratio of MMP-9 / TIMP-1 in the wound exudate of stage ? pressure ulcers decreased over time(P<0.001).Moreover,the MMP-9,MMP-9 / TIMP-1 ratio difference was statistically significant at different time points(P<0.001).The expression level of TIMP-1 at the third and fourth weekends was significantly lower than at the time of diagnosis(P<0.001).However,there was no significant difference at other time points(P>0.05).The expression level of MMP-9 TIMP-1 and the ratio of MMP-9 / TIMP-1 in the wound exudate of stage ? pressure ulcers decreased over time(P<0.001).Furthermore,the MMP-9,MMP-9 / TIMP-1 ratio difference was statistically significant at different time points(P<0.001).Nevertheless,there was no significant change trend in the expression level of TIMP-1(P>0.05).5.There was a significant positive correlation between wound PH and MMP-9 expression level and TIMP-1 expression level(r=0.750,0.400,P<0.001).Conclusions:1.The PH value of wound,the expression level of MMP-9 in wound exudate,and the ratio of MMP-9 / TIMP-1 were closely related to the healing of pressure ulcers.2.With the healing of stage ? and ? pressure ulcers,the PH value of the wound presented a downward trend.3.With the healing of stage ? and ? pressure ulcers,the expression level of MMP-9 in wound exudate and the ratio of MMP-9 / TIMP-1 decreased.4.There was a significant positive correlation between the PH value of the wound and the expression levels of MMP-9 and TIMP-1 in the wound exudate.