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Wound fluid under occlusive dressings from diabetic patients show an increased angiogenic response and fibroblast migration.

Authors
  • Cerny, Michael K1
  • Wiesmeier, Anna2
  • Hopfner, Ursula2
  • Topka, Charlotte3
  • Zhang, Wen4
  • Machens, Hans-Günther2
  • van Griensven, Martijn4
  • Broer, Niclas3
  • Duscher, Dominik2
  • 1 Department for Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technical University of Munich, Germany. Electronic address: [email protected] , (Germany)
  • 2 Department for Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technical University of Munich, Germany. , (Germany)
  • 3 Department for Plastic-, Reconstructive, Hand- and Burn Surgery, Bogenhausen Hospital, Städtisches Klinikum München, Germany. , (Germany)
  • 4 Department of Cell Biology-Inspired Tissue Engineering, MERLN Institute, Maastricht University, the Netherlands. , (Netherlands)
Type
Published Article
Journal
Journal of tissue viability
Publication Date
Aug 01, 2021
Volume
30
Issue
3
Pages
446–453
Identifiers
DOI: 10.1016/j.jtv.2021.02.013
PMID: 33707159
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Metabolic diseases like diabetes mellitus often show prolonged healing and chronic wounds. Occlusive wound dressings are known to support wound closure by creating a moist environment which supports collagen synthesis, epithelialization and angiogenesis. We aimed to assess the effect of occlusion on diabetic wound fluid on the cellular level regarding fibroblast activity and angiogenetic response. 22 split skin donor sites from 22 patients (11 patients with diabetes mellitus) were treated with occlusive dressings intraoperatively. On day 3, fluid and blood serum samples were harvested while changing the dressings. The influence of wound fluid on fibroblasts was assessed by measuring metabolic activity (Alamar Blue assay, Casey Counter), cell stress/death (LDH assay) and migration (in vitro wound healing assay) of fibroblasts. Angiogenesis of endothelial cells (HUVEC) was analyzed with the tube formation assay. Furthermore, a Magnetic Luminex Assay for multi-cytokines detection was performed focusing on inflammatory and pro-angiogenetic cytokines. The influence of wound fluid under occlusive dressings from diabetic patients showed a significantly increased angiogenic response and fibroblast migration compared to the non-diabetic patient group. Additionally, cell stress was increased in the diabetic group. Cytokine analysis showed an increase in VEGF-A in the diabetic group. Occlusive dressings may stimulate regenerative effects in diabetic wounds. Our in-vitro study shows the influence of wound fluid under occlusive dressings from diabetic patients on angiogenesis, migration and proliferation of fibroblasts, which are essential modulators of wound healing and scar modulation. Copyright © 2021 Tissue Viability Society. Published by Elsevier Ltd. All rights reserved.

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