Negative-pressure wound therapy induces endothelial progenitor cell mobilization in diabetic patients with foot infection or skin defects.
- Author:
Sang Gyo SEO
1
;
Ji Hyun YEO
;
Ji Hye KIM
;
Ji Beom KIM
;
Tae Joon CHO
;
Dong Yeon LEE
Author Information
1. Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea. leedy@snu.ac.kr
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
diabetic foot;
endothelial progenitor cell;
negative-pressure wound therapy
- MeSH:
Adolescent;
Adult;
Aged;
Aged, 80 and over;
Case-Control Studies;
Child;
Colony-Forming Units Assay;
Cytokines/genetics/metabolism;
Diabetic Foot/*surgery;
Endothelial Cells/metabolism/*physiology;
Endothelium, Vascular/cytology;
Female;
Humans;
Male;
Middle Aged;
*Negative-Pressure Wound Therapy;
Stem Cells/metabolism/*physiology
- From:Experimental & Molecular Medicine
2013;45(11):e62-
- CountryRepublic of Korea
- Language:English
-
Abstract:
Non healing chronic wounds are difficult to treat in patients with diabetes and can result in severe medical problems for these patients and for society. Negative-pressure wound therapy (NPWT) has been adopted to treat intractable chronic wounds and has been reported to be effective. However, the mechanisms underlying the effects of this treatment have not been elucidated. To assess the vasculogenic effect of NPWT, we evaluated the systemic mobilization of endothelial progenitor cells (EPCs) during NPWT. Twenty-two of 29 consecutive patients who presented at the clinic of Seoul National Universty Hospital between December 2009 and November 2010 who underwent NPWT for diabetic foot infections or skin ulcers were included in this study. Peripheral blood samples were taken before NPWT (pre-NPWT) and 7-14 days after the initiation of NPWT (during-NPWT). Fluorescence-activated cell sorting (FACS) analysis showed that the number of cells in EPC-enriched fractions increased after NPWT, and the numbers of EPC colony forming units (CFUs) significantly increased during NPWT. We believe that NPWT is useful for treating patients with diabetic foot infections and skin ulcers, especially when these conditions are accompanied by peripheral arterial insufficiency. The systemic mobilization of EPCs during NPWT may be a mechanism for healing intractable wounds in diabetic patients with foot infections or skin defects via the formation of increased granulation tissue with numerous small blood vessels.
