Twitter YouTube LinkedIn

AAPS 2007 Annual Meeting, May 19 - 22, 2007, The Coeur d'Alene Resort, Coeur d'Alene, Idaho.
Back to Scientific Program
Back to Annual Meeting

The Evaluation of VAC® Wound Fluid from Diabetic and Non-Diabetic Wounds: Levels of VEGF, Il-1, EDA-Fibronectin, Collagen Correlation with Fibroblast Function
Reza Miraliakbari, MD, Donald R. Mackay, MD, H. Paul Ehrlich, PhD, Robert Grunfeld, MA, Reza Roghani, BA, Jason Hancey, MD, S William Hazard, MD, Noel Natoli, MD.
Penn State Hershey Medical Center, Hershey, PA, USA.

Purpose: Vacuum-Assisted Wound Closure, VAC®, is an effective method for expediting the closure of chronic wounds. Diabetic patients with chronic wounds are commonly encountered and are significant cost in the health care system. The pathological mechanism underlying impaired diabetic wound healing and the influence of VAC® treatment on diabetic wounds is unclear. In the current study, the effect of diabetic and non-diabetic VAC® wound fluid upon human dermal fibroblast migration is correlated with the synthesis of collagen, fibronectin and cytokines.
Methods: VAC®-treated wound fluid was collected from 24 non-Diabetic (non-DM) (98 collections) and 18 Diabetic wounds (DM) (77 collections). Collections were made over an average period of 7 to 10 days. For the final analyses only patients with chronic lower leg wounds were compared, including 8 non-DM (40 collections) and 10 DM (46 collections). Cell migration studies were executed using human dermal fibroblasts. EDA-Fibronectin and collagen type I levels were determined by Dot-Blot and Western blot analysis. ELISA immunoassay measured IL-1 Beta and Vascular Endothelial Growth Factor (VEGF).
Results: DM wounds exhibited greater levels of IL-1 and VEGF (p<.05), diminished cell migration, and decreased fibronectin levels as compared to non-DM (p <.05) wounds. Diabetic wound fluids expressed lower levels of wound protein (fibronectin or collagen), as compared to non-DM wounds over the treatment course.
Conclusion: This study corroborates previous findings regarding higher levels of IL-1 and lower collagen levels in DM wounds. However, higher VEGF levels and diminished cell migration in DM wounds have not been previously reported. Depressed fibroblast function is evidenced by lower cell migration and lower protein synthesis. On the other hand, elevated cytokine levels may reflect an attempt by the wound milieu to promote wound closure. These findings add to the growing body of knowledge in elucidating impaired wound healing in diabetic wounds. Additional research is underway to further study the basic physiology in diabetic wound healing.

Back to Scientific Program
Back to Annual Meeting
Quick Links
Annual Meeting
Twitter YouTube LinkedIn