Alloxan diabetes alters the tensile strength, morphological and morphometric parameters of abdominal wall healing in rats

Minossi, José Guilherme; Lima, Flávio de Oliveira; Caramori, Carlos Antonio; Hasimoto, Cláudia Nishida; Ortolan, Érika Veruska Paiva; Rodrigues, P.; Spadella, César Tadeu

doi:10.1590/s0102-86502014000200008

Cited by 12 publications

(9 citation statements)

References 10 publications

(13 reference statements)

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“…This finding could potentially be explained by the observed increased risk of SSI, and is consistent with previously published studies by Sandy‐Hodgetts et.al and Riou et.al demonstrating that SSIs constitute a significant risk factor for wound dehiscence . Furthermore, animal data have previously demonstrated that wounds in diabetic rat models exhibit decreased tensile strength, collagen density, and wound contraction, which could also explain the association between diabetes and wound dehiscence observed in our study …”

Section: Discussionsupporting

confidence: 94%

Diabetes is associated with an increased risk of wound complications and readmission in patients with surgically managed pressure ulcers

Alfonso

Kantar

Ramly

et al. 2019

Wound Repair Regeneration

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The effect of diabetes on postoperative outcomes following surgical management of pressure ulcers is poorly defined despite evidence showing that patients with diabetes are at increased risk for developing pressure ulcers, as well as postoperative wound complications including delayed healing and infection. This study aimed to examine the impact of diabetes on postoperative outcomes following surgical management of pressure ulcers using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. In this retrospective analysis all CPT codes with ICD-9 diagnoses of pressure ulcers were reviewed. A total of 3,274 patients who underwent surgical management of pressure ulcers were identified, of which 1,040 (31.8%) had diabetes. Overall primary outcomes showed rates of superficial and deep incisional surgical site infection (SSI) were 2.0 and 4.2%, respectively, while the rate of wound dehiscence was 2.1%. Univariate analysis of primary outcomes stratified by diabetes status showed that patients with diabetes had significantly higher rates of superficial incisional SSI (3.9 vs. 2.3%; p = 0.01), deep incisional SSI (7.0 vs. 4.3%; p = 0.001), wound dehiscence (5.2 vs. 2.7%; p < 0.001), as well as significantly higher rates of readmission (12.8 vs. 8.9%; p = 0.001). Multivariate analysis for significant outcomes between groups on univariate analysis demonstrated that diabetes was an independent risk factor for superficial incisional SSI (OR = 2.7; 95% CI: 1.59-4.62; p < 0.001), deep incisional SSI (OR = 1.85; 95% CI: 1.26-2.70; p = 0.002), wound dehiscence (OR = 4.09; 95% CI: 2.49-6.74; p < 0.001), and readmission within 30 days (OR = 1.38; 95% CI: 1.05-1.82; p = 0.02). These findings emphasize the importance of preoperative prevention, and vigilant postoperative wound care and monitoring in patients with diabetes to minimize morbidity and optimize outcomes. Future prospective studies are needed to establish causality between diabetes and these outcomes.

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Section: Discussionsupporting

confidence: 94%

Diabetes is associated with an increased risk of wound complications and readmission in patients with surgically managed pressure ulcers

Alfonso

Kantar

Ramly

et al. 2019

Wound Repair Regeneration

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show abstract

“…Our study also revealed increased rates of wound dehiscence in diabetic patients ( P = .01). Animal data from wounds in diabetic rats have been shown to exhibit decreased tensile strength, collagen density, and contraction (Minossi et al, ). Furthermore, wound infection is a common risk factor for dehiscence (Sandy‐Hodgetts, Carville, & Leslie, ), which might contribute to this finding.…”

Section: Discussionmentioning

confidence: 99%

Diabetes is not associated with increased rates of free flap failure: Analysis of outcomes in 6030 patients from the ACS‐NSQIP database

et al. 2018

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Our study evaluated the largest national cohort of free flap procedures. These results suggest that diabetes is not associated with increased rates of flap failure. However, diabetic patients are at significantly higher risk of postoperative deep incisional SSI, wound dehiscence, and longer LOS. Our findings provide the most concrete evidence to date in support of free flap reconstruction in diabetic patients, but highlight the need for heightened clinical vigilance and wound care for optimal outcomes.

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“…Reduced scar collagen formation and tensile strength have also been observed in mice lacking a11b1 integrin 41 and in diabetic rats, in which these abnormalities lead to higher incidence of dehiscence. 42 Of interest, reduced collagen deposition is not necessarily coupled with decreased tensile strength, because the opposite has been shown with poly-N-acetyl-glucosamine nanofiber treatment 43 or with the use of a selective adenosine A2AR-antagonist. 44 In both cases, reduced scar collagen content was seen with concomitantly increased tensile strength.…”

Section: Discussionmentioning

confidence: 99%

Neuronal Protein 3.1 Deficiency Leads to Reduced Cutaneous Scar Collagen Deposition and Tensile Strength due to Impaired Transforming Growth Factor-β1 to -β3 Translation

Cheng

Yue

Aslam

et al. 2017

The American Journal of Pathology

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Neuronal protein 3.1 (P311), a conserved RNA-binding protein, represents the first documented protein known to stimulate transforming growth factor (TGF)-b1 to -b3 translation in vitro and in vivo. Because TGF-bs play critical roles in fibrogenesis, we initiated efforts to define the role of P311 in skin scar formation. Here, we show that P311 is up-regulated in skin wounds and in normal and hypertrophic scars. Genetic ablation of p311 resulted in a significant decrease in skin scar collagen deposition. Lentiviral transfer of P311 corrected the deficits, whereas down-regulation of P311 levels by lentiviral RNA interference reproduced the deficits seen in P311 À/À mice. The decrease in collagen deposition resulted in scars with reduced stiffness but also reduced scar tensile strength. In vitro studies using murine and human dermal fibroblasts showed that P311 stimulated TGF-b1 to -b3 translation, a process that involved eukaryotic translation initiation factor 3 subunit b as a P311 binding partner. This resulted in increased TGF-b levels/activity and increased collagen production. In addition, P311 induced dermal fibroblast activation and proliferation. Finally, exogenous TGF-b1 to -b3, each restituted the normal scar phenotype. These studies demonstrate that P311 is required for the production of normal cutaneous scars and place P311 immediately up-stream of TGF-bs in the process of fibrogenesis. Conditions that decrease P311 levels could result in less tensile scars, which could potentially lead to higher incidence of dehiscence after surgery. (Am J Pathol 2017, 187: 292e303; http://dx

show abstract

Alloxan diabetes alters the tensile strength, morphological and morphometric parameters of abdominal wall healing in rats

Cited by 12 publications

References 10 publications

Diabetes is associated with an increased risk of wound complications and readmission in patients with surgically managed pressure ulcers

Diabetes is associated with an increased risk of wound complications and readmission in patients with surgically managed pressure ulcers

Diabetes is not associated with increased rates of free flap failure: Analysis of outcomes in 6030 patients from the ACS‐NSQIP database

Neuronal Protein 3.1 Deficiency Leads to Reduced Cutaneous Scar Collagen Deposition and Tensile Strength due to Impaired Transforming Growth Factor-β1 to -β3 Translation

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