Impact of negative pressure wound therapy on basic fibroblast growth factor in human diabetic foot wounds

Abstract

Objective To assess the endogenous regulation of basic fibroblast growth factor(bFGF) in the foot wound healing response induced by negative pressure wound therapy (NPWT) in diabetic patients. Methods From January 2010 to December 2014, 40 patients with diabetic foot wounds fitting the inclusion criteria were enrolled in the clinical trial. The subjects were randomly assigned for NPWT or conventional (control group) treatment with a computer randomization algorithm, with 20 cases in each group. Granulated tissue biopsies were collected before(0 day) and 7 days after treatment in both groups. All biopsies were subdivided into two parts. One part was preserved in 4% paraformaldehyde for HE staining, Masson's trichrome staining and immunocytochemical staining for bFGF expression. Another part was stored at -80 ℃ for Western blotting analysis of bFGF protein expression. Differences between two groups were analyzed by using two-sample t test. Results Compared with control group, the NPWT-treated wounds developed characteristics of granulated tissue, which presented with intense inflammatory cells, fibroblasts and neoformation of vessels. Masson's trichrome staining showed that the collagen content in the NPWT group was significantly increased compared with that in the control group after treatment(13.4%±5.3% vs 1.1%± 2.6%, t=9.26, P<0.01, α=0.05). The immunohistochemical analysis revealed that the bFGF expression was significantly up-regulated in foot wounds of NPWT-treated groups when compared with that in the control group(0.21 ± 0.06 vs 0.01 ± 0.03, t=12.06, P<0.01, α=0.05). And the protein expression of bFGF in NPWT group with Western blotting analysis was significantly up-regulated when compared with that in the control group (2.30 ± 1.00 vs 0.12 ± 0.07, t=10.43, P<0.01, α=0.05). Conclusion NPWT enhances the bFGF expression in granulation tissue in diabetic foot wound and promotes the wound healing. Key words: Diabetic foot; Negative pressure wound therapy; Basic fibroblast growth factor