Histological evolution of chronic wounds under negative pressure therapy

Bassetto, Franco; Lancerotto, Luca; Salmaso, Roberto; Pandis, Laura; Pajardi, G.; Schiavon, Maurizio; Tiengo, Cesare; Vindigni, Vincenzo

doi:10.1016/j.bjps.2011.08.016

Cited by 41 publications

(39 citation statements)

References 27 publications

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“…В литературе описаны положительные эффекты вакуум-терапии: клеточные (формирование грануля-ционной ткани), внеклеточные (усиление кровотока, уменьшение отека и снижение протеолитической ак-тивности раневой среды) и комплексные (очищение раны, контроль инфекции, возможность анализа по-лученного экссудата) [13].…”

Section: Discussionunclassified

“…В литературе встречаются сведения о повышении плотности сосудов и экспрессии маркера эндотелия сосудов CD31, снижении маркера макрофагов (CD68) и лимфоцитов (CD45), что говорит о переходе ране-вого процесса в стадию эпителизации (по результа-там иммуногистохимического (ИГХ) исследования), а также клинически -заживление раневых дефектов у большинства пациентов к окончанию терапии отри-цательным давлением [13].…”

Section: синдром диабетической стопыunclassified

“…Сходные резуль-таты были получены в исследовании F.Bassetto et al, где к 7-м суткам терапии отрицательным давлением отмечалось существенное снижение маркера макро-фагов (CD68) [13] (рис. 9).…”

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Effect of negative pressure therapy on repair of soft tissues of the lower extremities in patients with neuropathic and neuroischaemic forms of diabetic foot syndrome

et al. 2014

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Aim. To evaluate the efficiency of topical negative pressure wound therapy (NPWT) compared with standard therapy for the regeneration of the soft tissues of the lower extremities in patients with diabetic foot syndrome. Materials and Methods. The effects of negative pressure therapy on the clinical (size, tissue oxygenation), histological (light microscopy) and immunohistochemical (CD68, MMP-9, TIMP-1) aspects of repair of the soft tissue of the lower extremities in patients with diabetes mellitus were compared with those of standard treatment. Thirty-one patients with diabetic foot ulcers were included in the study from the moment of debridement until the plastic closure of the wound. During the perioperative period, 13 patients received NPWT (-90 to -120 mmHg) and 18 patients received standard therapy. Results. A reduction of the wound area (26.6%?17.2%) and the depth of the defects (40.5%?25.6%) were achieved with negative pressure therapy compared with baseline data. In the control group, the corresponding values were 25.3%?19.4% and 21.8%?21.6%, respectively. The results of transcutaneous oximetry showed a greater increase in the level of local hemodynamics in the study group (p

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Section: Discussionunclassified

Section: синдром диабетической стопыunclassified

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Effect of negative pressure therapy on repair of soft tissues of the lower extremities in patients with neuropathic and neuroischaemic forms of diabetic foot syndrome

et al. 2014

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“…They also reported a gradient of VEGF expression closer to wound surface, correlating with the observations in human wounds by Bassetto et al, who reported concentration of angiogenic phenomena in the close vicinity to the wound-foam interface. 59 Further, the response to MDWT is stronger with cyclical stimulations, 60 and dependent on the pattern of cyclical stimulation. 61 While in all of the above conditions a proliferation of blood vessels is beneficial, in scarring diminishing both the proliferative and angiogenic responses would be preferable.…”

Section: In Vivo Models Of Mechanical Control Of Angiogenesismentioning

confidence: 99%

Mechanoregulation of Angiogenesis in Wound Healing

Lancerotto

Orgill

2014

Advances in Wound Care

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Significance: Mechanical forces are important regulators of cell and tissue function. Endothelial cells proliferate in response to tissue stretch and the mechanical properties of the environment direct capillary sprouting and growth. As the vascular network is a key factor in physiology and disease, control of the vascularity by means of mechanical forces could lead to the development of innovative therapeutic strategies. Recent Advances: Increased understanding of mechanobiology has stimulated translational research and allowed the development and optimization of clinical devices that exploit mechanical forces for the treatment of diseases, in particular in the field of wound healing. Stretching in distraction osteogenesis and tissue expansion induces neogenesis of well-vascularized tissues. In micro-deformational wound therapy, micro-mechanical distortions of the wound bed stimulate cell proliferation and angiogenesis by stretching resident cells to improve healing of difficult wounds. Relief from tension antagonizes proliferation and angiogenesis in primarily closed wounds allowing for better scar quality. Critical Issues: The integration of mechanobiology into traditional cell biology and pathophysiology in general is not yet complete and further research is needed to fill existing gaps, in particular in the complexity of in vivo conditions. Future Directions: Still largely unexplored approaches based on mechanical perturbation of the micro-/macro-environment can be devised to overcome the limits of current strategies in a broad spectrum of clinical conditions. SCOPE AND SIGNIFICANCEMechanical forces are important regulators of cell and tissue biology. This review explains our current understanding of how mechanical stimuli affect cell and tissue biology with a focus on angiogenesis related to wound healing.

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“…Vacuum-assisted closure (VAC®; KCI USA Inc., San Antonio, TX) therapy produces a closed wound healing, reduces edema, promotes perfusion, and removes infectious materials and chronic inflammatory cells from the wound environment by applying topical negative pressure [2,3]. It also stimulates blood flow to the wound bed [4], resulting in delivery of fresh leukocytes and plasma that counteract the chronic wound environment.…”

Section: Introductionmentioning

confidence: 99%

VAC Therapy in Large Infected Sacral Pressure Ulcer Grade IV—Can Be an Alternative to Flap Reconstruction?

Batra

Aseeja²

2012

Indian J Surg

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Vacuum-assisted closure (VAC) therapy is a new entrant in wound care after growth factors and alginate or hydrocolloid dressing, in the treatment of pressure ulcers. We have been using this technique for diabetic foot ulcers. A young nondiabetic man presented with a large sacral bed sore after high doses of ionotropes in an intensive care unit for treating severe hypotension. His wound was debrided, and instead of flap surgery in such infected wound, he was treated with VAC therapy. The complete wound healing was achieved in 6 weeks and at half the cost of flap surgery. Moreover, the chances of flap failure and its related complications were eliminated.

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Histological evolution of chronic wounds under negative pressure therapy

Cited by 41 publications

References 27 publications

Effect of negative pressure therapy on repair of soft tissues of the lower extremities in patients with neuropathic and neuroischaemic forms of diabetic foot syndrome

Effect of negative pressure therapy on repair of soft tissues of the lower extremities in patients with neuropathic and neuroischaemic forms of diabetic foot syndrome

Mechanoregulation of Angiogenesis in Wound Healing

VAC Therapy in Large Infected Sacral Pressure Ulcer Grade IV—Can Be an Alternative to Flap Reconstruction?

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