Vacuum-assisted closure therapy increases local interleukin-8 and vascular endothelial growth factor levels in traumatic wounds.

BACKGROUND: Clinical observations are suggesting accelerated granulation tissue formation in traumatic wounds treated with vacuum-assisted closure (VAC). Aim of this study was to determine the impact of VAC therapy versus alternative Epigard application on local inflammation and neovascularization in traumatic soft tissue wounds. METHODS: Thirty-two patients with traumatic wounds requiring temporary coverage (VAC n = 16; Epigard n = 16) were included. At each change of dressing, samples of wound fluid and serum were collected (n = 80). The cytokines interleukin (IL)-6, IL-8, vascular endothelial growth factor (VEGF), and fibroblast growth factor-2 were measured by ELISA. Wound biopsies were examined histologically for inflammatory cells and degree of neovascularization present. RESULTS: All cytokines were found to be elevated in wound fluids during both VAC and Epigard treatment, whereas serum concentrations were negligible or not detectable. In wound fluids, significantly higher IL-8 (p < 0.001) and VEGF (p < 0.05) levels were detected during VAC therapy. Furthermore, histologic examination revealed increased neovascularization (p < 0.05) illustrated by CD31 and von Willebrand factor immunohistochemistry in wound biopsies of VAC treatment. In addition, there was an accumulation of neutrophils as well as an augmented expression of VEGF (p < 0.005) in VAC wound biopsies. CONCLUSION: This study suggests that VAC therapy of traumatic wounds leads to increased local IL-8 and VEGF concentrations, which may trigger accumulation of neutrophils and angiogenesis and thus, accelerate neovascularization.

[Bioelectrostimulation in the rehabilitation of patients with gunshot wounds of the peripheral nervous system (a clinico-immunological study)]. / Bioélektrostimuliatsiia v reabilitatsii bol'nykh s ognestrel'nymi raneniiami perifericheskoi nervnoi sistemy (kliniko-immunologicheskoe issledovanie).

Immune homeostasis was studied in 35 patients with gunshot injuries of the peripheral nerves in the process of rehabilitation using bioelectrostimulation of the muscles impaired. Parameters of cellular and humoral immunity were determined. Bioelectrostimulation resulted in the regression of preexisting motor, sensitive, vegetovascular and trophic disorders. Cellular and humoral immunity improved: the number of T-lymphocytes, T-helpers, T-suppressors increased, the immunoregulatory index normalized, levels of B-lymphocytes, immunoglobulins G, circulating immune complexes reduced. Thus, bioelectrostimulation in patients with gunshot injuries of the peripheral nerves corrects the disturbed homeostasis and promotes recovery of the functions lost.