Shao Ling Yang1,2, Lv Yun Zhu2, Rui Han3, Lei Lei Sun4, Jing Tao Dou1. 1. 1 Department of Endocrinology, Chinese PLA General Hospital (301 Hospital), Beijing, China. 2. 2 Department of Endocrinology, Bethune International Peace Hospital of PLA, Shijiazhuang, China. 3. 3 Department of Neurology, First Affiliated Hospital of Hebei Medical University, Shijiazhuang, China. 4. 4 Department of Endocrinology, Armed Police Hospital of Shandong, Shandong, China.
Abstract
BACKGROUND:Chronic diabetic foot wounds are a leading cause of amputation, morbidity, and hospitalization for patients with diabetes. Negative-pressure wound therapy (NPWT) can putatively facilitate wound healing, but the underlying mechanisms remain unclear. Cellular fibronectin (cFN) and transforming growth factor-β1 (TGF-β1) play an important role in wound healing. This prospective randomized controlled trial evaluated the effects of NPWT on the production of cFN and the expression of TGF-β1 in diabetic foot wounds of patients. METHODS:From January 2012 to January 2015, 40 patients with diabetic foot wounds were randomly and equally apportioned to receive either NPWT or advanced moist wound therapy (control) for 7 days. Granulation tissue was harvested before and after treatment. Immunohistochemistry and Western blot were performed to evaluate protein levels of cFNand TGF-β1, and real-time polymerase chain reaction (PCR) to measure corresponding mRNA expressions. RESULTS:NPWT facilitated the expression of cFN and TGF-β1 in diabetic foot wounds. Immunohistochemical analysis revealed higher levels of cFN and TGF-β1 in the NPWT group than in the control group. Western blot and real-time PCR analysis further showed that protein and mRNA levels of cFN or TGF-β1 were higher in the NPWT group than that in the control group ( P < .01, both). CONCLUSION: Our results showed that NPWT facilitated the production of cFN and the expression of TGF-β1 in granulation tissue in diabetic foot ulcers. LEVEL OF EVIDENCE: Level I, randomized controlled study.
RCT Entities:
BACKGROUND: Chronic diabetic foot wounds are a leading cause of amputation, morbidity, and hospitalization for patients with diabetes. Negative-pressure wound therapy (NPWT) can putatively facilitate wound healing, but the underlying mechanisms remain unclear. Cellular fibronectin (cFN) and transforming growth factor-β1 (TGF-β1) play an important role in wound healing. This prospective randomized controlled trial evaluated the effects of NPWT on the production of cFN and the expression of TGF-β1 in diabetic foot wounds of patients. METHODS: From January 2012 to January 2015, 40 patients with diabetic foot wounds were randomly and equally apportioned to receive either NPWT or advanced moist wound therapy (control) for 7 days. Granulation tissue was harvested before and after treatment. Immunohistochemistry and Western blot were performed to evaluate protein levels of cFN and TGF-β1, and real-time polymerase chain reaction (PCR) to measure corresponding mRNA expressions. RESULTS: NPWT facilitated the expression of cFN and TGF-β1 in diabetic foot wounds. Immunohistochemical analysis revealed higher levels of cFN and TGF-β1 in the NPWT group than in the control group. Western blot and real-time PCR analysis further showed that protein and mRNA levels of cFN or TGF-β1 were higher in the NPWT group than that in the control group ( P < .01, both). CONCLUSION: Our results showed that NPWT facilitated the production of cFN and the expression of TGF-β1 in granulation tissue in diabetic foot ulcers. LEVEL OF EVIDENCE: Level I, randomized controlled study.
Authors: Zhenmi Liu; Jo C Dumville; Robert J Hinchliffe; Nicky Cullum; Fran Game; Nikki Stubbs; Michael Sweeting; Frank Peinemann Journal: Cochrane Database Syst Rev Date: 2018-10-17
Authors: S Borys; A H Ludwig-Slomczynska; M Seweryn; J Hohendorff; T Koblik; J Machlowska; B Kiec-Wilk; P Wolkow; Maciej T Malecki Journal: Acta Diabetol Date: 2018-09-17 Impact factor: 4.280