Normoxic wound fluid contains high levels of vascular endothelial growth factor.
OBJECTIVE
To examine the temporal integration of vascular endothelial growth factor (VEGF), which has been shown to be present in wound fluid, with the putatively related processes of wound fluid oxygen content, wound angiogenesis, and granulation tissue formation.


BACKGROUND
During cutaneous wound repair, new tissue formation starts with reepithelialization and is followed by granulation tissue formation, including neutrophil and macrophage accumulation, fibroblast ingrowth, matrix deposition, and angiogenesis. Because angiogenesis and increased vascular permeability are characteristic features of wound healing, VEGF may play an important role in tissue repair.


METHODS
A ventral hernia, surgically created in the abdominal wall of female swine, was repaired using silicone sheeting and skin closure. Over time, a fluid-filled wound compartment formed, bounded by subcutaneous tissue and omentum. Ultrasonography was performed serially to examine the anatomy and dimensions of the subcutaneous tissue and wound compartment. Serial wound fluid samples, obtained by percutaneous aspiration, were analyzed for PO2, PCO2, pH, and growth factor concentrations.


RESULTS
Three independent assays demonstrate that VEGF protein is present at substantially elevated levels in a wound fluid associated with the formation of abdominal granulation tissue. However, the wound fluid is not hypoxic at any time. Serial sampling reveals that transforming growth factor beta-1 protein appears in the wound fluid before VEGF.


CONCLUSIONS
The results suggest that VEGF is a prominent regulator of wound angiogenesis and vessel permeability. A factor other than hypoxia, perhaps the earlier appearance of another growth factor, transforming growth factor beta-1, may positively regulate VEGF appearance in the wound fluid.
Howdieshell
T R
TR
Department of Surgery, Medical College of Georgia, Augusta 30912, USA.
Riegner
C
C
Gupta
V
V
Callaway
D
D
Grembowicz
K
K
Sathyanarayana
McNeil
P L
PL
D000009:Abdominal Muscles / Q000502:physiology; D000818:Animals; D001826:Body Fluids / Q000737:chemistry*; D016228:Endothelial Growth Factors / Q000032:analysis*; D005260:Female; D006097:Granulation Tissue / Q000737:chemistry / Q000502:physiology; D006863:Hydrogen-Ion Concentration; D008222:Lymphokines / Q000032:analysis*; D009852:Omentum / Q000502:physiology; D010100:Oxygen / Q000032:analysis; D010537:Peritoneum; D010949:Plasma / Q000737:chemistry; D013552:Swine; D013997:Time Factors; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors; D014945:Wound Healing / Q000502:physiology*
D016228:Endothelial Growth Factors; D008222:Lymphokines; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors; D010100:Oxygen