Hyperglycemia Interacts with Ischemia in a Synergistic Way on Wound Repair and Myofibroblast Differentiation

Tobalem, Mickaël; Lévigne, Dominik; M, Ali; Atashi, Fatemeh; Villard, Frédéric; Hinz, Boris; Pittet‐Cuénod, Brigitte

doi:10.1097/gox.0000000000000443

Cited by 18 publications

(20 citation statements)

References 31 publications

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“…In addition, hypoproteinemia can lead to decreased anti-infective capacity of injured tissue ( 28 ). Of course, excessive protein intake can also have a negative impact because hyperglycemia can increase the burden on organs and then delay in tissue repair ability occurs ( 29 , 30 ). In this study, in addition to healing time and pressure ulcer area of the two indicators, H&E staining result also proved the above view point.…”

Section: Discussionmentioning

confidence: 99%

Pressure ulcer healing promoted by adequate protein intake in rats

et al. 2018

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The effect of protein intake on rat pressure ulcer healing was evaluated. One hundred rats were numbered according to body weight and then they were randomly divided into 4 groups (n=25) using the random number table. After rat models of stage II pressure ulcer were established, they were fed with feed containing different protein levels (10, 15, 20 and 25%). Healing time, pressure ulcer area, body weight, albumin (ALB) and hemoglobin (Hb) levels among groups were compared. Hematoxylin and eosin (H&E) staining was also performed to observe pressure ulcer tissue structure. In the healing process of pressure ulcer, rats with 20% protein intake had the shortest healing time and the smallest pressure ulcer area. Body weight, ALB and Hb levels were much closer to the normal level. H&E staining result also suggested that the pressure ulcer healing degree of rats with 20% protein intake was much better than the others. Adequate protein intake is therefore conducive to pressure ulcer healing, while excessive or insufficient protein intake has negative impact on healing.

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Section: Discussionmentioning

confidence: 99%

Pressure ulcer healing promoted by adequate protein intake in rats

et al. 2018

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“…14 17 18 Alizadeh et al 14 reported that the wound was completely closed by day 17 in all animals within the non-ischemic group as compared with day 27 in the ischemic group. Tobalem et al 17 18 reported that non-ischemic wounds closed in a mean of 27.3±3.1 days as compared with 33.4±7.6 days for ischemic wounds (p=0.002) under normoglycemic condition. The meta-analysis showed that ischemia significantly delayed the time to full wound closure (SMD=1.97 (95% CI 1.59 to 2.34)) (online supplementary figure 4).…”

Section: Effect Of Ischemia On Complete Wound Closurementioning

confidence: 96%

“…Of 5844 screened studies, a total of 7 were included (online supplementary figure 1). [14][15][16][17][18][19][20]…”

Section: Study Selectionmentioning

confidence: 99%

“…Diabetes was present as a comorbidity in 322 wounds (Ischemia=161; Non-ischemia=161) during assessments performed at days 7 (n=144), 14 (n=136) and 21 (n=42). All included studies reported wound area at days 7 and 14, [14][15][16][17][18][19][20] whereas four studies reported wound area at day 21. 14 16-18 All time-points were eligible for meta-analysis.…”

Section: Effect Of Ischemia On Wound Healingmentioning

confidence: 99%

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Animal models of ischemic limb ulcers: a systematic review and meta-analysis

Thanigaimani

Phie

Golledge

2020

BMJ Open Diab Res Care

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The aims of this systematic review were to assess the clinical relevance and quality of previously published animal models of ischemic ulceration and examine the available evidence for interventions improving ulcer healing in these models. Publicly available databases were searched for original studies investigating the effect of limb ischemia on wound healing in animal models. The quality of studies was assessed using two tools based on the Animal research: Reporting of In Vivo Experiments (ARRIVE) guidelines and the clinical relevance of the models. A total of 640 wounds (ischemic=314; non-ischemic=326) were assessed in 252 animals (92 mice, 140 rats, 20 rabbits) from 7 studies. Meta-analyses showed that wound healing was consistently delayed by ischemia at all time-points examined (day-7 standard median difference (SMD) 5.36, 95% CI 3.67 to 7.05; day-14 SMD 4.50, 95% CI 2.90 to 6.10 and day-21 SMD 2.53, 95% CI 1.25 to 3.80). No significant difference in wound healing was observed between 32 diabetic and 32 non-diabetic animals with ischemic wounds. Many studies lacked methods to reduce bias, such as outcome assessors blinded to group allocation and sample size calculations and clinically relevant model characteristics, such as use of older animals and a peripheral location of the wound. Five different interventions were reported to improve wound healing in these models. The impaired wound healing associated with limb ischemia can be modeled in a variety of different animals. Improvements in study design could increase clinical relevance, reduce bias and aid the discovery of translatable therapies.

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“…Лечение гнойно-некротических форм диабетической стопы предусматривает многократные хирургические вмешательства и, как следствие, многократное анестезиологическое обеспечение [11]. Обезболивание является необходимым компонентом хирургического лечения пациента, которое, с одной стороны защищает организм от хирургической агрессии, а с другой, влияет на системы жизнеобеспечения, подвергая пациента на риск возможных осложнений [17,20]. Наличие полиорганной патологии, характерной для данного заболевания, предъявляет повышенные требования, прежде всего к безопасности анестезии с минимальным влиянием на углеводный обмен и функции центральной нервной системы (ЦНС) [10], необходимости сохранения сознания больного во время вмешательства с целью диагностики или мониторинга функций ЦНС [2,7].…”

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