FEATURES OF ANGENESIS AGAINST THE BACKGROUND OF NEGATIVE PRESSURE WOUND THERAPY IN PATIENTS WITH NEUROPATHIC AND NEUROISCHEMIC FORMS OF DIABETIC FOOT ULCERS
https://doi.org/10.24884/0042-4625-2014-173-5-64-72
Abstract
The authors analyzed clinical (size, tissue oxygenation), histological (light microscopy) and immunohistochemical (CD68, MMP-9, TIMP-1) features of reparative processes of soft tissue of lower extremities in patients with diabetes mellitus against the background of vacuum therapy in comparison with standard local treatment. Patients (31 cases) with diabetic foot ulcers were followed-up after surgical d-bridement and before plastic closure of the wound. During perioperative period 13 patients obtained the negative pressure wound therapy (NPWT of 90-120 mmHg) and 18 patients had the standard care. Given results supported higher efficacy of NPWT as compared with standard local care. The therapy caused rapid reduction of wound and its depth, increased local microcirculation and reduced inflammation. These data were confirmed by the histological and immunohistochemical studies. The high efficacy of the method of local treatment could significantly reduce the time of wound preparation for the next step of surgical treatment.
About the Authors
E. L. Zaitseva
Endocrinological Research Centre
Russian Federation
Russian Federation
L. P. Doronina
Endocrinological Research Centre
Russian Federation
Russian Federation
R. V. Molchkov
Endocrinological Research Centre
Russian Federation
Russian Federation
I. A. Voronkova
Endocrinological Research Centre
Russian Federation
Russian Federation
V. A. Mitish
Endocrinological Research Centre
Russian Federation
Russian Federation
A. Yu. Tokmakova
Endocrinological Research Centre
Russian Federation
Russian Federation
References
1. Зайцева Е. Л., Токмакова А. Ю. Вакуум-терапия в лечении хронических ран // Сахарный диабет. 2012. № 3. C. 45-49.
2. Зайцева Е. Л., Токмакова А. Ю. Роль факторов роста и цитокинов в репаративных процессах в мягких тканях у больных сахарным диабетом // Сахарный диабет. 2014. №. 1. C. 57-62.
3. Basseto F., Lancerotto L., Salmaso R. et al. Histological evolution of chronic wounds under negative pressure // J. of Plastic, Reconstructive & Aesthetic Surgery. 2012, № 65. P. 91-99.
4. Boulton A., Cavanagh P., Raymann G. New and alternative treatments for diabetic foot ulcers: hormones and growth factors // The foot in diabetes, 4th edition. John Willey& sons, Ltd, 2006. P. 214-221.
5. Dinh T., Tecilazich F., Kafanas A. et al. Mechanisms involved in the development and healing of diabetic foot ulceration // Diabetes. 2012. Vol. 61, № 1. P. 2937-2947.
6. Falanga V. Wound healing and its impairment in the diabetic foot // Lancet. 2005. № 366. P. 1736-1743.
7. Galkowska H., Wojewodzka U., Olszewski W. L. Chemokines, cytokines, and growth factors in keratinocytes and dermal endothelial cells in margin of chronic diabetic foot ulcers // Wound repair and Regen. 2006. №Vol. 14. P. 558-565.
8. Gibran N. S., Jang Y-C., Isik F. F. et al. Diminished neuropeptide levels contribute to the impaired cutaneous healing response associated with diabetes mellitus // J. Surg. Res. 2002. Vol. 108. P. 122-128.
9. Li Z., Guo S., Yao F., Zhang Y., Li T. Increased ratio of serum matrix metalloproteinase-9 against TIMP-1 predicts poor wound healing in diabetic foot ulcers // J. Diabetes Complications. 2013. № 27. P. 380-382.
10. Liu Y., Min D., Bolton T. et al. Increased matrix metalloproteinase-9 predicts poor wound healing in diabetic foot ulcers // Diabetes Care. 2009. Vol. 32, № 1. P. 117-119.
11. Maruyama K., Asai J., Ii M. et al. Decreased macrophage number and activation lead to reduced lymphatic vessel formation and contribute to impaired diabetic would healing // Am. J. Pathol. 2007. Vol. 170. P. 1178-1191.
12. Morykwas M. J., Simpson J., Punger K. et al. Vacuum-assisted closure: state of basic research and physiologic foundation // Plast. Reconstr. Surg. 2006. Vol. 117. P. 121S-126S.
13. Muller M., Trocme C., Lardy B. et al. Matrix metalloproteinases and diabetic foot ulcers: The ratio of MMP-1 to TIMP-1 is a predictor of wound healing // Diabetic Medicine. 2008. Vol. 4, № 25, № 4. P. 419-426.
14. Singh N., Armstrong D. C., Lipsky B. A. Prevention foot ulcers in patients with diabetes // Jama. 2005. Vol. 293, № 2. P. 217-228.
15. Werner S., Grose R. Regulation of wound healing by growth factors and cytokines // Physiol. Rev. 2003. № 83. P. 835-870.
Review
For citations:
Zaitseva E.L., Doronina L.P., Molchkov R.V., Voronkova I.A., Mitish V.A., Tokmakova A.Yu. FEATURES OF ANGENESIS AGAINST THE BACKGROUND OF NEGATIVE PRESSURE WOUND THERAPY IN PATIENTS WITH NEUROPATHIC AND NEUROISCHEMIC FORMS OF DIABETIC FOOT ULCERS. Grekov's Bulletin of Surgery. 2014;173(5):64-72. (In Russ.) https://doi.org/10.24884/0042-4625-2014-173-5-64-72
Views:
452
Email this article 