1. Vacuum-assisted closure therapy increases local interleukin-8 and vascular endothelial growth factor levels in traumatic wounds.
- Author
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Labler L, Rancan M, Mica L, Härter L, Mihic-Probst D, and Keel M
- Subjects
- Adult, Amputation, Traumatic immunology, Amputation, Traumatic pathology, Amputation, Traumatic therapy, Arm Injuries immunology, Arm Injuries pathology, Arm Injuries therapy, Biopsy, Female, Fibroblast Growth Factor 2 blood, Fluorocarbon Polymers, Fractures, Open immunology, Fractures, Open pathology, Fractures, Open therapy, Humans, Injury Severity Score, Interleukin-6 blood, Leg Injuries immunology, Leg Injuries pathology, Leg Injuries therapy, Leukocyte Count, Male, Middle Aged, Neovascularization, Pathologic immunology, Neovascularization, Pathologic pathology, Neutrophils immunology, Platelet Endothelial Cell Adhesion Molecule-1 blood, Skin Transplantation, Soft Tissue Injuries immunology, Soft Tissue Injuries pathology, Soft Tissue Injuries therapy, Surgical Flaps, Wound Healing immunology, Wounds and Injuries pathology, von Willebrand Factor metabolism, Interleukin-8 blood, Negative-Pressure Wound Therapy, Vascular Endothelial Growth Factor A blood, Wounds and Injuries immunology, Wounds and Injuries therapy
- Abstract
Background: Clinical observations are suggesting accelerated granulation tissue formation in traumatic wounds treated with vacuum-assisted closure (VAC). Aim of this study was to determine the impact of VAC therapy versus alternative Epigard application on local inflammation and neovascularization in traumatic soft tissue wounds., Methods: Thirty-two patients with traumatic wounds requiring temporary coverage (VAC n = 16; Epigard n = 16) were included. At each change of dressing, samples of wound fluid and serum were collected (n = 80). The cytokines interleukin (IL)-6, IL-8, vascular endothelial growth factor (VEGF), and fibroblast growth factor-2 were measured by ELISA. Wound biopsies were examined histologically for inflammatory cells and degree of neovascularization present., Results: All cytokines were found to be elevated in wound fluids during both VAC and Epigard treatment, whereas serum concentrations were negligible or not detectable. In wound fluids, significantly higher IL-8 (p < 0.001) and VEGF (p < 0.05) levels were detected during VAC therapy. Furthermore, histologic examination revealed increased neovascularization (p < 0.05) illustrated by CD31 and von Willebrand factor immunohistochemistry in wound biopsies of VAC treatment. In addition, there was an accumulation of neutrophils as well as an augmented expression of VEGF (p < 0.005) in VAC wound biopsies., Conclusion: This study suggests that VAC therapy of traumatic wounds leads to increased local IL-8 and VEGF concentrations, which may trigger accumulation of neutrophils and angiogenesis and thus, accelerate neovascularization.
- Published
- 2009
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