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Biochemical Analysis of Chronic Wounds Treated with the V.A.C. ® System
Author(s) -
Stechmiller J. K.,
Childress B. B.,
Blalock T. D.,
Kilpadi D. V.,
Nappo R. W.,
Chin G. A.,
Mozingo D. W.,
Schultz G. S.
Publication year - 2004
Publication title -
wound repair and regeneration
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.847
H-Index - 109
eISSN - 1524-475X
pISSN - 1067-1927
DOI - 10.1111/j.1067-1927.2004.0abstractcp.x
Subject(s) - matrix metalloproteinase , proinflammatory cytokine , wound healing , medicine , chronic wound , tumor necrosis factor alpha , gastroenterology , inflammation , surgery
Proinflammatory cytokines TNF‐α, IL‐1β, and matrix metalloproteinases (MMPs) are elevated in chronic wounds and their levels decrease during healing. TNF‐α and IL‐1β stimulate the production of MMPs which cause degradation of growth factors. Wound fluid from the V.A.C. ® is of interest when investigating the mechanisms by which V.A.C. ® therapy aids in wound healing. We hypothesize that the clinical improvement in healing of chronic wounds by the V.A.C. ® system occurs by a shift from a chronic cytotoxic environment to a more conducive acute healing wound environment. This study aims at understanding the molecular and mechanistic consequences of V.A.C. ® therapy on chronic wound healing.Methods: Wound fluid collected from two patients with Stage IV pressure ulcers at baseline, 24hours, 72hours, and 7 days following V.A.C. ® therapy. Concentrations of TNF‐α, IL‐1β, MMP‐2, ‐3, ‐9, TIMP‐2, and total protein were determined using ELISA.Results: TNF‐α levels in wound fluids decreased from baseline levels in two patients following 3 days of treatment. Similarly, levels of MMP‐3, MMP‐9 and TIMP‐2 decreased from baseline following 3 days of treatment. There were no consistent trends in IL‐1β & MMP‐2.Conclusion: The preliminary results from this study suggest that improved wound healing with V.A.C. ® therapy is related to decreased levels of proinflammatory cytokines, MMPs and TIMP‐2 in wound fluid.