title: Intermittent pneumatic compression enhances neurovascular ingrowth and tissue proliferation during connective tissue healing: a study in the rat.
abstract: Intermittent pneumatic compression (IPC) is a treatment method to decrease venous stasis and stimulate blood flow. Recently, it was hypothesized that IPC may exert positive effects on tissue healing, a process highly dependent upon adequate circulation. In this study, we investigated the effects of daily 1-h IPC treatment during 2 and 4 weeks post-rat Achilles tendon rupture. The tendons were subjectively and semiquantitatively analyzed for collagen organization, fibroblast density, angiogenesis, and the occurrence of sensory neuropeptides, substance P (SP) and calcitonine gene related peptide (CGRP), as well as for a nerve regeneration marker, growth associated protein 43 (GAP-43). After 2 weeks of treatment, fibroblast density increased by 53% (p = 0.0004), vessel density by 64% (p = 0.022), and the occurrence of SP by 110% (p = 0.047) and CGRP by 47% (p = 0.0163) compared to untreated controls. Following 4 weeks of treatment, both the occurrence of sensory neuropeptides and the vessel density remained significantly higher (p < 0.05), whereas fibroblast density returned to normal. However, at 4 weeks the treated tendons displayed a higher degree of organized parallel collagen fibers, a sign of increased maturation. Daily IPC treatment improves neurovascular ingrowth and fibroblast proliferation in the healing tendon and may accelerate the repair process.
authors.affiliation: Karolinska Institutet, Department of Molecular Medicine and Surgery, Section of Orthopaedics and Sports Medicine, Orthopedic Laboratory, M3:02 Karolinska University Hospital, S-171 76 Stockholm, Sweden.
authors.forename: Johan
authors.initials: J
authors.lastname: Dahl
authors.forename: Jian
authors.initials: J
authors.lastname: Li
authors.forename: Daniel K-I
authors.initials: DK
authors.lastname: Bring
authors.forename: Per
authors.initials: P
authors.lastname: Renström
authors.forename: Paul W
authors.initials: PW
authors.lastname: Ackermann
mesh_terms: D000125:Achilles Tendon / Q000098:blood supply / Q000293:injuries* / Q000294:innervation / Q000473:pathology; D000818:Animals; D015415:Biomarkers / Q000378:metabolism; D015740:Calcitonin Gene-Related Peptide / Q000378:metabolism; D049109:Cell Proliferation; D003238:Connective Tissue; D005347:Fibroblasts / Q000378:metabolism / Q000473:pathology; D048228:Intermittent Pneumatic Compression Devices; D008297:Male; D009389:Neovascularization, Pathologic; D009412:Nerve Fibers / Q000378:metabolism / Q000473:pathology; D009416:Nerve Regeneration; D051381:Rats; D017207:Rats, Sprague-Dawley; D012421:Rupture; D013373:Substance P / Q000378:metabolism; D014945:Wound Healing
chemical_list: D015415:Biomarkers; D013373:Substance P; D015740:Calcitonin Gene-Related Peptide