Effect Of Vacuum Sealing Drainage Technique Combined With Hyperoxia Solution Washing On The Expression Of VEGF In Chronic Wounds At High-altitude Area

Objective: To investigate the effect of vacuum sealing drainage(VSD)combined with hyperoxia solution washing(HPSW)on VEGF and its expression in granulation tissue in chronic wounds at high altitude area.Methods: A total of 60 patients with chronic wounds who were admitted to the department of burn plastic surgery,affiliated hospital of Qinghai university from January 2018 to December 2019 were selected.According to the random number table method into 3 groups.Different VSD combinations were given on the basis of the general treatment.Negative pressure was set at-100 ?-80mmhg(1 mm Hg= 0.133kpa)in the three groups,and the negative pressure was removed on the seventh day of treatment.The VSD group was given only negative pressure suction and regular tube flushing.In the VSDNS group,the infusion tubes which were connected with normal saline(connected with bag of normal saline and 40 drops/minute infusion)was directly connected with the negative pressure flushing tube to perform negative pressure suction and flushing on the wound surface.The infusion was performed once every 8 hours for 2 hours each time.In the VSDHS group,normal saline was replaced with hyperoxic liquid.Granulation tissue growth was observed before treatment(0d)and on the seventh day of treatment.The expression of CD31,VEGF and HIF-1? in tissues was detected by immunohistochemistry.The expression of VEGF and HIF-1? in tissues were detected by Western Blot.The experimental data were analyzed by t-test and one-way ANOVA.Results: Before treatment,the general data of the three groups were compared,and they didn't have statistical significance(P >0.05),we believe that the experiment can be carried out in the three groups.After 7 days of treatment:(1),the granulation growth of VSDHS group was better than that of the other two groups through the observation of HE staining and MASSON staining pictures.(2),The CD31 expression and MVD count of the VSDHS group were higher than those of the other two groups,the results showed significant difference(P<0.05).(3),Comparing the VEGF content in wound tissue,the VSDHS group was higher than the VSDNS group and the VSD group,and the difference was statistically significant(P <0.05),the comparison of HIF-1? radiation content in wound tissue showed that the VSDHS group was lower than the VSDNS group and the VSD group,and the difference was statistically significant(P <0.05).Conclusions: 1.VSD combined with Hyperoxia solution washing is better than VSD alone and VSD combined with normal saline washing;2.The VSD combined with Hyperoxia solution washing treatment can significantly promote wound capillaries,collagen formation,improve the level of VEGF expression in granulation tissue,the wound microenvironment from hypoxia state,to improve microcirculation and granulation tissue hyperplasia,accelerate wound healing.