Expression of HIF-1α in Irradiated Tissue is Altered by Topical Negative-Pressure Therapy

Grimm, Alexandra; Dimmler, Arno; Stange, Sebastian; Labanaris, Apostolos P.; Sauer, Rolf; Grabenbauer, Gerhard G.; Horch, Raymund E.

doi:10.1007/s00066-007-1560-1

Cited by 23 publications

(17 citation statements)

References 35 publications

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“…These results are somewhat different from a previous study by Grimm et al with five post-irradiated wounds (47). One reason could be related to the irradiation in the study patients of Grimm et al In our study, only few exclusion criteria were applied, except age and acute wound stage in comparison to irradiated tissue wounds (47). This fact might be responsible for the variable behaviour of regeneration.…”

Section: Discussioncontrasting

confidence: 79%

“…Because of the low number of patients, statistical significance was not applicable; however, we could clearly observe an increasing tendency in vessel proliferation. These results are somewhat different from a previous study by Grimm et al with five post-irradiated wounds (47). One reason could be related to the irradiation in the study patients of Grimm et al In our study, only few exclusion criteria were applied, except age and acute wound stage in comparison to irradiated tissue wounds (47).…”

Section: Discussioncontrasting

confidence: 76%

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Vessel transformation in chronic wounds under topical negative pressure therapy: an immunohistochemical analysis

Malsiner

Schmitz

Horch

et al. 2013

International Wound Journal

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The underlying physiological mechanism of topical negative pressure (TNP) therapy is not yet completely understood. This prospective clinical study aims to clarify a potential influence of TNP therapy on vessel proliferation and hypoxia in chronic wounds. TNP was applied on chronic wounds of 16 patients (-125 mmHg) to prepare them for a plastic-surgical reconstruction using free or pedicled flaps. Tissue biopsies were taken from the wound edge and wound bed at different time points. All samples were stained with haematoxylin and eosin, hypoxia-induced factor-1α and endothelial cell markers (CD31 and CD34) for the immunohistological analysis of inflammation, hypoxia and vessel proliferation. Between day 5 and day 8 of treatment, a considerable increase in blood vessel density could be observed, reaching a maximum of approximately 200% in contrast to the vessel density prior to treatment. In addition, the number of hypoxic and inflammatory cells was found to be increased at particular time points. This study demonstrates a stimulating effect on vessel proliferation under TNP treatment. TNP appears to support (neo-) angiogenesis and transformation of chronic non-healing wounds in a physiological wound healing process when combined with surgical debridement. This effect underlines the positive influence of TNP in the treatment of chronic wounds as shown by various clinical reports.

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Section: Discussioncontrasting

confidence: 79%

Section: Discussioncontrasting

confidence: 76%

Vessel transformation in chronic wounds under topical negative pressure therapy: an immunohistochemical analysis

Malsiner

Schmitz

Horch

et al. 2013

International Wound Journal

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“…Vacuum assisted wound therapy is widely used to improve wound healing and has been shown to increase wound angiogenesis 38-41 . Mechanical microdeformations, evacuation of inhibitory angiogenic factors (eg.…”

Section: Discussionmentioning

confidence: 99%

“…Vacuum Assisted Closure (VAC) is widely used in wound therapies and has been shown to positively affect angiogenesis 38-41 . Research suggests that the combination of a foam interface with negative pressure leads to the application of mechanical microdeformations to wound cells and thereby affects the expression of angiogenic factors 42 .…”

Section: Introductionmentioning

confidence: 99%

Angiogenesis in Wounds Treated by Microdeformational Wound Therapy

et al. 2011

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Summary Background Data Mechanical forces play an important role in tissue neovascularisation and are a constituent part of modern wound therapies. The mechanisms by which Vacuum Assisted Closure (VAC) modulates wound angiogenesis are still largely unknown. Objective To investigate how VAC treatment affects wound hypoxia and related profiles of angiogenic factors as well as to identify the anatomical characteristics of the resultant, newly formed vessels. Methods Wound neovascularization was evaluated by morphometric analysis of CD31- stained wound cross sections as well as by corrosion casting analysis. Wound hypoxia and mRNA expression of HIF-1α and associated angiogenic factors were evaluated by pimonidazole hydrochloride staining and quantitative RT-PCR, respectively. VEGF protein levels were determined by western blot analysis. Results VAC-treated wounds were characterized by the formation of elongated vessels aligned in parallel and consistent with physiologically function, compared to occlusive dressing control wounds that showed formation of tortuous, disoriented vessels. Moreover, VAC-treated wounds displayed a well-oxygenated wound bed, with hypoxia limited to the direct proximity of the VAC-foam interface, where higher VEGF levels were found. By contrast, occlusive dressing control wounds showed generalized hypoxia, with associated accumulation of HIF-1α and related angiogenic factors. Conclusions The combination of established gradients of hypoxia and VEGF expression along with mechanical forces exerted by VAC therapy was associated with the formation of more physiological blood vessels compared to occlusive dressing control wounds. These morphological changes are likely a necessary condition for better wound healing.

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“…Delayed primary wound closure or plastic reconstructive methods can be electively scheduled after assurance of clear resection margins on the pathology report [4,5,11,16,20,25,29]. Vacuum therapy is shown to increase local blood flow, decrease bacterial growth, and promote delivery of oxygen and the growth of granulation tissue [14,30,41]. The increased oxygen delivery may theoretically enhance the efficacy of radiotherapy, as local postsurgical ischemia is overcome, thus ultimately improving local control.…”

Section: Introductionmentioning

confidence: 99%

A New Modification of Combining Vacuum Therapy and Brachytherapy in Large Subfascial Soft –Tissue Sarcomas of the Extremities

et al. 2010

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Expression of HIF-1α in Irradiated Tissue is Altered by Topical Negative-Pressure Therapy

Cited by 23 publications

References 35 publications

Vessel transformation in chronic wounds under topical negative pressure therapy: an immunohistochemical analysis

Vessel transformation in chronic wounds under topical negative pressure therapy: an immunohistochemical analysis

Angiogenesis in Wounds Treated by Microdeformational Wound Therapy

A New Modification of Combining Vacuum Therapy and Brachytherapy in Large Subfascial Soft –Tissue Sarcomas of the Extremities

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