Analysis of nerve and neuropeptide patterns in vacuum-assisted closure-treated diabetic murine wounds.
BACKGROUND
Reestablishment of the peripheral nervous system occurs in parallel with wound healing. With accelerated wound healing seen with the vacuum-assisted closure device, the authors studied its effects on nerve fiber regeneration, nerve sprouting, and the stimulation of neuropeptides and neurotrophins.


METHODS
A vacuum-assisted closure device was applied to a full-thickness diabetic mouse wound using continuous or cyclical modes and compared with foam dressing or occlusive dressing controls, using 10 mice per group. Nerve fibers, substance P, calcitonin gene-related peptide, and nerve growth factor were analyzed using two-dimensional immunohistochemistry and real-time reverse-transcriptase polymerase chain reaction.


RESULTS
A significant increase in dermal and epidermal nerve fiber densities and in substance P, calcitonin gene-related peptide, and nerve growth factor expression was seen in vacuum-assisted closure-treated wounds. Cyclical treatment mode correlated with the largest increase in granulation tissue production, wound surface microdeformations, and a slightly faster wound closure rate.


CONCLUSIONS
This study suggests that vacuum-assisted closure therapy can modulate nerve fiber and neuropeptide production in the wound. Optimized kinetics of vacuum-assisted closure application may provide an opportunity for clinicians to further improve wound healing in denervated wounds such as pressure sores and diabetic foot ulcerations.
Younan
George
G
Boston, Mass.; and Tokyo, Japan From the Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, and the Department of Plastic, Reconstructive, and Aesthetic Surgery, Nippon Medical School.
Ogawa
Rei
R
Ramirez
Michelle
M
Helm
Douglas
D
Dastouri
Pouya
P
Orgill
Dennis P
DP
D000818:Animals; D020405:Dermis / Q000294:innervation; D003921:Diabetes Mellitus, Experimental / Q000150:complications* / Q000378:metabolism; D004195:Disease Models, Animal; D004817:Epidermis / Q000294:innervation; D005500:Follow-Up Studies; D005786:Gene Expression Regulation; D006097:Granulation Tissue / Q000294:innervation / Q000378:metabolism / Q000473:pathology; D007150:Immunohistochemistry; D008297:Male; D051379:Mice; D008810:Mice, Inbred C57BL; D054843:Negative-Pressure Wound Therapy / Q000379:methods*; D009412:Nerve Fibers / Q000378:metabolism / Q000473:pathology*; D009479:Neuropeptides / Q000096:biosynthesis* / Q000235:genetics; D012313:RNA / Q000032:analysis; D020133:Reverse Transcriptase Polymerase Chain Reaction; D014945:Wound Healing / Q000502:physiology*; D014947:Wounds and Injuries / Q000150:complications / Q000378:metabolism / Q000628:therapy*
D009479:Neuropeptides; D012313:RNA