Effect of vacuum sealing drainage on expressions of transforming growth factor β<sub>1</sub> and its receptor in diabetic foot wound _Chinese Journal of Reparative and Reconstructive Surgery

Authors：

HU Chenghao ^1,2 , LI Dongyu ³ , PANG Zongchao ⁴ ,  LI Huibin ² , DONGYE Yuhui ^1,2 , WU Jiani ²

1. College of Clinical Medicine, Weifang Medical University, Weifang Shandong, 261000, P.R.China;
2. The Second Department of Burns and Plastic Surgery, People’s Hospital of Linyi, Linyi Shandong, 276000, P.R.China;
3. College of Agricultural and Life Science, University of Wisconsin-Madison, Madison Wisconsin, 53706, USA;
4. The First Department of Surgery, Linyi Lanshan District Hospital, Linyi Shandong, 276000, P.R.China;

Corresponding?author：

LI Huibin, Email: lihuibin1234@163.com

Keywords：

Diabetic foot; vacuum sealing drainage; wound healing; transforming growth factor β₁; type Ⅱ of transforming growth factor β-receptor

DOI：

10.7507/1002-1892.201802024

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Objective To investigate the changes of transforming growth factor β₁ (TGF- β₁) and type Ⅱ of TGF-β-receptor (TβRⅡ) expressions in wound tissue after the treatment of diabetic foot with vaccum sealing drainage (VSD), and to analyze the mechanism of accelerating wound healing. Methods Between May 2012 and May 2016, 80 patients with diabetic foot were randomly divided into 2 groups, 40 cases in each group. After the same basic treatment, the wounds of VSD group and control group were treated with VSD and external dressing, respectively. There was no significant difference in gender, age, disease duration, body mass, foot ulcer area, and Wagner grade between 2 groups (P>0.05). The time of foundation preparation and hospitalization stay of 2 groups were recorded. The wound tissue was collected before treatment and at 7 days after treatment, and the positive indexes of TGF-β₁ and TβRⅡexpressions were measured by immunohistochemical staining. Results Before skin grafting, the patients in VSD group were treated with VSD for 1 to 3 times (mean, 2 times), and the patients in control group were treated with dressing change for 1 to 6 times (mean, 4 times). The time of foundation preparation and hospitalization stay in VSD group were significantly shorter than those in control group (t=–13.546, P=0.036; t=–12.831, P=0.041). The skin grafts of both groups survived smoothly and the wound healed well. Before treatment, immunohistochemical staining results showed that the positive indexes of TGF-β₁ and TβRⅡ expressions in VSD group were 5.3±2.4 and 14.0±2.6, while those in control group were 4.4±2.3 and 14.7±3.1, respectively. There was no significant difference between 2 groups (t=1.137, P=0.263; t=1.231, P=0.409). At 7 days after treatment, the positive indexes of TGF-β₁ and TβRⅡ expressions in VSD group were 34.3±2.9 and 41.7±3.7, respectively, and those in control group were 5.8±2.0 and 18.1±2.5. There were significant differences between 2 groups (t=–35.615, P=0.003; t=23.725, P=0.002). Conclusion VSD can increase the expressions of TGF-β₁ and TβRⅡ in diabetic ulcer tissue, promote granulation tissue growth, and accelerate wound healing.

Citation： HU Chenghao, LI Dongyu, PANG Zongchao, LI Huibin, DONGYE Yuhui, WU Jiani. Effect of vacuum sealing drainage on expressions of transforming growth factor β₁ and its receptor in diabetic foot wound . Chinese Journal of Reparative and Reconstructive Surgery, 2018, 32(8): 1061-1065. doi: 10.7507/1002-1892.201802024 Copy

1.	Wagner FW Jr. The diabetic foot. Orthopedics, 1987, 10(1): 163-172.
2.	Faglia E, Clerici G, Caminiti M, et al. Predictive values of transcutaneous oxygen tension for above-the-ankle amputation in diabetic patients with critical limb ischemia. Eur J Vasc Endovasc Surg, 2007, 33(6): 731-736.
3.	童利偉, 劉真, 羅富瓊, 等. 持續封閉負壓吸引治療糖尿病足的療效觀察. 西南軍醫, 2017, 19(6): 523-526.
4.	Sullivan KM, LorenzH P, Meuli M, et al. A model of scarless human fetal wound repair is deficient in transforming growth factor beta. J Pediatr Surg, 1995, 30(2): 198-203.
5.	Hinz B, Gabbiani G. Cell-matrix and cell-cell contacts of myofibroblasts: role in connective tissue remodelling. Thromb Haemostat, 2003, 90(6): 993-1002.
6.	Border WA, Ruoslahti E. Transforming growth factor-beta in disease: the dark side of tissue repair. J Clin Invest, 1992, 90(1): 1-7.
7.	Riedel K, Riedel F, Goessler UR, et al. Tgf-beta antisense therapy increase angiogenic potential in human keratinocytes in vitro. Arch Med Res, 2007, 38(1): 45- 51.
8.	Heldin CH, Landstr?m M, Moustakas A. Mechanism of TGF-β signaling to growth arrest, apoptosis, and epithelial-mesenchymal transition. Curr Opin Cell Biol, 2009, 21(2): 166-176.
9.	陸再英, 鐘南山. 內科學. 7版. 北京: 人民衛生出版社, 2008: 778.
10.	韓焱福, 徐光, 周京志, 等. 負壓創面治療結合植皮術修復糖尿病足潰瘍的臨床研究. 中國美容醫學, 2012, 21(14): 88-90.
11.	Huang C, Leavitt T, Bayer LR, et al. Effect of negative pressure wound therapy on wound healing. Curr Probl Surg, 2014, 51(7): 301-331.
12.	Murase C, Kono M, Nakanaga K, et al. Buruli ulcer successfully treated with negative-pressure wound therapy. JAMA Dermatol, 2015, 151(10): 1137-1139.
13.	許樟榮, 李翔. 2011國際糖尿病足工作組糖尿病足處置和預防指南介紹. 中國醫學前沿雜志 (電子版), 2013, 5(1): 70-72.
14.	方艷麗, 童成國, 唐杰兵, 等. 負壓封閉引流技術 (VSD) 在深部難治性創面修復中的應用. 中國美容醫學雜志, 2014, 23(15): 1239-1242.
15.	劉偉, 熊浩, 鄭佐勇, 等. VSD 聯合帶旋髂淺動脈髂腹股溝皮瓣游離移植修復脛前大面積軟組織缺損. 中國骨與關節損傷雜志, 2013, 28(4): 369-370.
16.	李志強, 劉樹江, 吳文杰. 負壓封閉引流技術的研究進展及在骨科的應用. 牡丹江醫學院學報, 2015, 36(6): 93-95.
17.	Andres C, Hasenauer J, Ahn HS, et al. Wound-healing growth factor, basic FGF, induces Erk1/2-dependent mechanical hyperalgesia. Pain, 2013, 154(10): 2216-2226.

1. Wagner FW Jr. The diabetic foot. Orthopedics, 1987, 10(1): 163-172.
2. Faglia E, Clerici G, Caminiti M, et al. Predictive values of transcutaneous oxygen tension for above-the-ankle amputation in diabetic patients with critical limb ischemia. Eur J Vasc Endovasc Surg, 2007, 33(6): 731-736.
3. 童利偉, 劉真, 羅富瓊, 等. 持續封閉負壓吸引治療糖尿病足的療效觀察. 西南軍醫, 2017, 19(6): 523-526.
4. Sullivan KM, LorenzH P, Meuli M, et al. A model of scarless human fetal wound repair is deficient in transforming growth factor beta. J Pediatr Surg, 1995, 30(2): 198-203.
5. Hinz B, Gabbiani G. Cell-matrix and cell-cell contacts of myofibroblasts: role in connective tissue remodelling. Thromb Haemostat, 2003, 90(6): 993-1002.
6. Border WA, Ruoslahti E. Transforming growth factor-beta in disease: the dark side of tissue repair. J Clin Invest, 1992, 90(1): 1-7.
7. Riedel K, Riedel F, Goessler UR, et al. Tgf-beta antisense therapy increase angiogenic potential in human keratinocytes in vitro. Arch Med Res, 2007, 38(1): 45- 51.
8. Heldin CH, Landstr?m M, Moustakas A. Mechanism of TGF-β signaling to growth arrest, apoptosis, and epithelial-mesenchymal transition. Curr Opin Cell Biol, 2009, 21(2): 166-176.
9. 陸再英, 鐘南山. 內科學. 7版. 北京: 人民衛生出版社, 2008: 778.
10. 韓焱福, 徐光, 周京志, 等. 負壓創面治療結合植皮術修復糖尿病足潰瘍的臨床研究. 中國美容醫學, 2012, 21(14): 88-90.
11. Huang C, Leavitt T, Bayer LR, et al. Effect of negative pressure wound therapy on wound healing. Curr Probl Surg, 2014, 51(7): 301-331.
12. Murase C, Kono M, Nakanaga K, et al. Buruli ulcer successfully treated with negative-pressure wound therapy. JAMA Dermatol, 2015, 151(10): 1137-1139.
13. 許樟榮, 李翔. 2011國際糖尿病足工作組糖尿病足處置和預防指南介紹. 中國醫學前沿雜志 (電子版), 2013, 5(1): 70-72.
14. 方艷麗, 童成國, 唐杰兵, 等. 負壓封閉引流技術 (VSD) 在深部難治性創面修復中的應用. 中國美容醫學雜志, 2014, 23(15): 1239-1242.
15. 劉偉, 熊浩, 鄭佐勇, 等. VSD 聯合帶旋髂淺動脈髂腹股溝皮瓣游離移植修復脛前大面積軟組織缺損. 中國骨與關節損傷雜志, 2013, 28(4): 369-370.
16. 李志強, 劉樹江, 吳文杰. 負壓封閉引流技術的研究進展及在骨科的應用. 牡丹江醫學院學報, 2015, 36(6): 93-95.
17. Andres C, Hasenauer J, Ahn HS, et al. Wound-healing growth factor, basic FGF, induces Erk1/2-dependent mechanical hyperalgesia. Pain, 2013, 154(10): 2216-2226.

Chinese Journal of Reparative and Reconstructive Surgery

Effect of vacuum sealing drainage on expressions of transforming growth factor β₁ and its receptor in diabetic foot wound

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Chinese Journal of Reparative and Reconstructive Surgery

Effect of vacuum sealing drainage on expressions of transforming growth factor β1 and its receptor in diabetic foot wound

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Effect of vacuum sealing drainage on expressions of transforming growth factor β₁ and its receptor in diabetic foot wound