Abstract
Background: There is a dynamic and reciprocal interaction among ECM and involving cells, cytokines, growth factors and proteases (MMP/TIMP). The controlled degradation of ECM by extracellular proteases particularly MMP/TIMP and serene proteases forms the basis of wound healing. To study clinical factors (BMI, DM) influencing healing of acute abdominal surgical wounds as graded by tissue expression of MMP 2, MMP 9 and TIMP. Subjects and Methods: The present study was conducted in 46 patients in the Department of General Surgery, Kamineni Hospitals, L.B. Nagar, Hyderabad. Results: Type II DM was found in 63 % of patients and found to be having significantly affecting wound healing (p = 0.0017). Wound healing was delayed in uncontrolled DM. Diabetics with healed wound had increased expression of MMP-2 and decreased expression of MMP-9 while Diabetics with non-healed had strong expression of MMP-9 and TIMP as compared to MMP-2. Obesity was seen in 47.82 % of patients and significantly affected wound healing (p = 0.0022). Obese patients with healed wounds had increased expression of MMP-2 and MMP – 9 with decreased TIMP levels. Conclusion: The present study strongly supported tissue expression of MMP-2, MMP-9 and TIMP 2 balance between 7-14 days as a good predictor of wound healing in abdominal laprotomy wounds.
Highlights
[3] Extensive study has been done chronic diabetic wounds to understand the pathophysiology of wound healing. [4,5,6,7,8,9]It is a collaborative process involving a continuous and reciprocal interaction of variety of cells and Extracellular matrix (ECM) components.The role of ECM as critical zone of wound healing has been studied in detail in recent past. [1,10,11,12,13] There is a dynamic and reciprocal interaction among ECM and involving cells, cytokines, growth factors and proteases (MMP/TIMP)
The controlled degradation of ECM by extracellular proteases MMP/TIMP and serene proteases forms the basis of wound healing
The aim of this study is to predict the outcome of abdominal wound healing using Clinical – diabetes mellitus, BMI, Histological and Biomolecular markers (MMP2,MMP9 and TIMP)
Summary
Wound is not just a defect in tissue, it is an insult initiated dynamic biological process. [1] Wound healing is extremely complex and dynamic process which involves cell to cell signaling and cellular and molecular interactions leading to restoration of tissue integrity and function. [2]Conventionally wound healing was divided into 3 stages: inflammation, proliferation, remodeling. [3] Extensive study has been done chronic diabetic wounds to understand the pathophysiology of wound healing. [4,5,6,7,8,9]It is a collaborative process involving a continuous and reciprocal interaction of variety of cells and Extracellular matrix (ECM) components.The role of ECM as critical zone of wound healing has been studied in detail in recent past. [1,10,11,12,13] There is a dynamic and reciprocal interaction among ECM and involving cells, cytokines, growth factors and proteases (MMP/TIMP). [4,5,6,7,8,9]It is a collaborative process involving a continuous and reciprocal interaction of variety of cells and Extracellular matrix (ECM) components.The role of ECM as critical zone of wound healing has been studied in detail in recent past. Various studies have been made in understanding wound healing at molecular level after discovery of many molecules – Growth factors, cytokines, MMP/TIMP. To study clinical factors (BMI, DM) influencing healing of acute abdominal surgical wounds as graded by tissue expression of MMP 2, MMP 9 and TIMP. Obese patients with healed wounds had increased expression of MMP-2 and MMP – 9 with decreased TIMP levels. Conclusion: The present study strongly supported tissue expression of MMP-2, MMP-9 and TIMP 2 balance between 7-14 days as a good predictor of wound healing in abdominal laprotomy wounds
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