Open AccessVessel transformation in chronic wounds under topical negative pressure therapy: an immunohistochemical analysis
Author(s) -
Malsiner Carmen CM,
Schmitz Marweh,
Horch Raymund E,
Keller Andrea K,
Leffler Mareike
Publication year - 2015
Publication title -
international wound journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.867
H-Index - 63
eISSN - 1742-481X
pISSN - 1742-4801
DOI - 10.1111/iwj.12143
Subject(s) - medicine , cd31 , angiogenesis , wound healing , chronic wound , immunohistochemistry , negative pressure wound therapy , hypoxia (environmental) , inflammation , cd34 , surgery , pathology , blood vessel , vascular endothelial growth factor , stem cell , chemistry , alternative medicine , organic chemistry , biology , oxygen , vegf receptors , genetics
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.