Vessel transformation in chronic wounds under topical negative pressure therapy: an immunohistochemical analysis

Malsiner, Carmen C M; Schmitz, Marweh; Horch, Raymund E.; Keller, Andrea; Leffler, Mareike

doi:10.1111/iwj.12143

Cited by 17 publications

(15 citation statements)

References 47 publications

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“…Nelson et al, 24 Lance et al, 29 and Qiu et al 34 some experimental studies have proven that NPWT can increase skin perfusion and boost circulation by various mechanisms. 12,15,42,43 Furthermore, two articles included in this review reported that vascular pedicle and flap perfusion were not compromised by NPWT even at a high-pressure setting of NPWT. 25,27 More studies are needed in the future to validate the influence of NPWT on flap perfusion.…”

Section: Discussionmentioning

confidence: 91%

Clinical Efficacy and Safety of Negative-Pressure Wound Therapy on Flaps: A Systematic Review

Yang

et al. 2017

J reconstr Microsurg

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Although flap transfer is a popular reconstructive procedure with a high success rate, it is associated with a high complication rate and low salvage rate. During the past decade, negative-pressure wound therapy (NPWT) has been increasingly applied to facilitate flap transfer and salvage flaps threatened by complications. It has achieved some success, but its efficacy and safety remain controversial because of the limited number of reports and lack of systematic reviews. English-language articles describing the application of NPWT on flaps were screened using predetermined inclusion and exclusion criteria. The articles were summarized and divided into groups based on the purpose of NPWT application. The complication rate, success rate, and salvage rate were obtained. Among the 3,395 articles searched, 16 articles describing 137 flaps were eligible. NPWT was applied on 105 (76.4%) newly transferred flaps to facilitate flap attachment and on 32 (23.4%) complication-threatened flaps to relieve flap infection and venous congestion. In total, complications developed in six flaps, three of which were lost; thus, the complication rate was 5.7% (6/105) and the success rate was 97.1% (102/105). Only 1 of the 32 threatened flaps was not successfully salvaged; thus, the salvage rate was 96.9% (31/32). NPWT may facilitate flap transfer with few side effects and help to rescue flaps threatened by infection and venous congestion with a high salvage rate. Further studies are needed to test the safety of NPWT application on flaps with arterial compromise.

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Section: Discussionmentioning

confidence: 91%

Clinical Efficacy and Safety of Negative-Pressure Wound Therapy on Flaps: A Systematic Review

Yang

et al. 2017

J reconstr Microsurg

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“…Recently, endothelial cells were shown to contribute to vascular remodeling though their transformation into mesenchymal or SM-like phenotype cells that then migrate into their underlying tissues. Other studies also indicated that endothelial cell transformation can occur in adult life during a number of diseases, including PAH [3], atherosclerosis [4] and wound healing [5].…”

Section: Introductionmentioning

confidence: 99%

Galectin-3- Mediated Transdifferentiation of Pulmonary Artery Endothelial Cells Contributes to Hypoxic Pulmonary Vascular Remodeling

Zhang

Zeng

et al. 2018

Cell Physiol Biochem

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Background/Aims: Vascular muscularity is a key event in vessel remodeling during pulmonary artery hypertension (PAH). Endothelial-mesenchymal transdifferentiation (EndMT) has been increasingly reported to play a role in disease occurrence. Galectin-3, a carbohydrate-binding protein regulates cell proliferation, differentiation, migration and neovascularization. However, whether galectin-3 controls endothelial cell transdifferentiation during the development of PAH is unknown. Methods: Rats were exposed to normoxic or hypoxic conditions (fraction of inspired O₂ 0.10) for 21 d to establish PAH models. Hemodynamic changes were evaluated through surgery of the right jugular vein and ultrasound biomicroscopy inviVue. And vessel pathological alterations were detected by H&E staining. Galectin-3 (Gal-3)-induced pulmonary artery endothelium cell (PAEC) dynamic alterations were measured by MTT assays, Cell immunofluorescence, Flow cytometry, Real-time PCR and Western blot. Results: Our study demonstrated that Gal-3 was expressed in hypoxic pulmonary vascular adventitia and intima. The increased Gal-3 expression was responsible for hypoxic vessel remodeling and PAH development in vivo. Gal-3 was found to inhibit cell proliferation and apoptosis in cultured endothelial cells. Meanwhile endothelial cell morphology was altered and exhibited smooth muscle-like cell features as demonstrated by the expression of α-SMA after Gal-3 treatment. Gal-3 activated Jagged1/Notch1 pathways and induced MyoD and SRF. When MyoD or SRF were silenced with siRNAs, Gal-3-initiated transdifferentiation in endothelial cells was blocked as indicated by a lack of α-SMA. Conclusion: These results suggest that Gal-3 induces PAECs to acquire an α-SMA phenotype via a transdifferentiation process which depends on the activation of Jagged1/Notch1 pathways that mediate MyoD and SRF expression.

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“…Despite this variability, an underlying process of wound pathogenesis has evolved through the study of chronic wound care that involves local tissue hypoxia, bacterial colonisation and host inflammatory response, repetitive ischemia–reperfusion injury, and altered cellular or systemic response that occurs with ageing or other comorbidities . Successful therapies in the treatment of chronic wounds have been shown to improve tissue oxygenation within devitalised tissue . Therefore, optimisation of perfusion is a major target for medical therapy in the pathogenesis of chronic wounds and their complications.…”

Section: Discussionmentioning

confidence: 99%

Tadalafil therapy and severe chronic foot wound resolution

Davenport

Dubin

2015

International Wound Journal

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We report an unanticipated medication effect resulting in near-complete wound healing in a patient after beginning tadalafil therapy of 20 mg thrice daily. This patient was treated for 50 years with state-of-the art acute and then chronic wound interventions after a traumatic farm machinery accident which resulted in a devascularised foot wound. This infection was both life- and limb-threatening. The patient had undergone multiple vascular and plastic surgeries and antimicrobial therapies in addition to hospitalisations for sepsis. Limb amputation was being considered, when his urologist placed him on daily phosphodiesterase-5 inhibitor therapy, prior to unrelated urologic surgery. Remarkably, his foot wound underwent near-complete resolution and has been stable for 2 years.

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Vessel transformation in chronic wounds under topical negative pressure therapy: an immunohistochemical analysis

Cited by 17 publications

References 47 publications

Clinical Efficacy and Safety of Negative-Pressure Wound Therapy on Flaps: A Systematic Review

Clinical Efficacy and Safety of Negative-Pressure Wound Therapy on Flaps: A Systematic Review

Galectin-3- Mediated Transdifferentiation of Pulmonary Artery Endothelial Cells Contributes to Hypoxic Pulmonary Vascular Remodeling

Tadalafil therapy and severe chronic foot wound resolution

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