Document Detail


Role of different negative pressure values in the process of infected wounds healing treated by vacuum-assisted closure: an experimental study.
MedLine Citation:
PMID:  22640026     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Vacuum-assisted closure (VAC) device is widely used to treat infected wounds at clinical work. Although the effect of VAC with different negative pressure values was well established, different negative pressures could result in varying modulation of wound relative cytokines was not clear. We hypothesise that instead of the highest negative pressure value the suitable value for VAC is the one which is the most effective on regulating wound relative cytokines. Infected wounds created on pigs' back model were used to investigate the effects of varying negative pressure values of VAC devices. Wounds were treated with VAC of different negative pressure values or moist gauze, which was set as control. The VAC foam, semiocclsive dresses and moist gauze were changed on days 3, 5, 7 and 9 after wounds were created. When changing dresses, tissues from wounds were harvested for bacteria counting and histology examination including Masson's trichrome stain and immunohistochemistry for microvessels. Western blot was carried out to test the expression of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF). Bacteria counts showed that on days 3 and 5 the number of bacteria in wounds treated with VAC by 75 , 150, 225 and 300 mmHg was significantly decreased compared with that in wounds treated by gauze and 0 mmHg pressure value. However, there was no difference in wounds treated with negative pressure values of 75 , 150, 225 and 300 mmHg at any time spot. Immunohistochemistry showed that more microvessels were generated in wounds treated by VAC using 75 and 150 mmHg negative pressure comparing with that using 225 and 300 mmHg on days 3 and 5. However this difference vanished on days 7 and 9. Morphological evaluation by Masson's trichrome staining showed increased collagen deposition in VAC of 75 and 150 mmHg compared with that in VAC of 225 and 300 mmHg. Western blot showed that the expression of VEGF and bFGF significantly increased when the wounds treated with 75 and 150 mmHg negative pressure values compared with the wounds treated with 225 and 300 mmHg on day 5. Treatment of VAC with different negative pressure values more than 75 mmHg has similar efficiency on reducing bacteria in the infected wound. VAC with negative pressure values of 75 and 150 mmHg promote wound healing more quickly than other pressure values. Moreover, comparing with vigorous negative pressure, relatively moderate one contributes to wound healing via accelerated granulation growth, increased angiogenic factor production and improved collagen fibres deposition. Further study of this model may show other molecular mechanisms.
Authors:
Min Zhou; Aixi Yu; Gang Wu; Chengyan Xia; Xiang Hu; Baiwen Qi
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-5-29
Journal Detail:
Title:  International wound journal     Volume:  -     ISSN:  1742-481X     ISO Abbreviation:  -     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-5-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101230907     Medline TA:  Int Wound J     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 The Authors. © 2012 Blackwell Publishing Ltd and Medicalhelplines.com Inc.
Affiliation:
M Zhou, MD, Department of Micro-Orthopedics, Zhongnan Hospital of Wuhan University, Wuhan, China A Yu, MD, PhD, Department of Micro-Orthopedics, Zhongnan Hospital of Wuhan University, Wuhan, China G Wu, Department of Micro-Orthopedics, Zhongnan Hospital of Wuhan University, Wuhan, China C Xia, MD, Department of Micro-Orthopedics, Zhongnan Hospital of Wuhan University, Wuhan, China X Hu, MD, Department of Micro-Orthopedics, Zhongnan Hospital of Wuhan University, Wuhan, China B Qi, MD, Department of Micro-Orthopedics, Zhongnan Hospital of Wuhan University, Wuhan, China.
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