Format

Send to

Choose Destination
Chin J Traumatol. 2017 Aug;20(4):202-206. doi: 10.1016/j.cjtee.2016.08.004. Epub 2017 Apr 20.

Histomorphological observation of surgical debridement combined with negative pressure therapy in treatment of diabetic foot.

Author information

1
Institute of Burn, Ruijin Hospital, Medical School, Shanghai Jiaotong University, Shanghai 20025, China.
2
Institute of Burn, Ruijin Hospital, Medical School, Shanghai Jiaotong University, Shanghai 20025, China. Electronic address: qsping@hotmail.com.

Abstract

PURPOSE:

To further study the mechanism of epithelization on the fascia side of the flap after surgical incision and the treatment of the negative pressure therapy.

METHODS:

With the patients' informed consent, parts of tissue samples were obtained from a 51-year-old diabetic patient who was suffering lower extremity ulcers. The samples were processed with hematoxylin and eosin (HE) staining and Masson trichrome staining. The keratin 19, keratin 15 and carcino-embryonic antigen (CEA) were immunohistochemically detected.

RESULTS:

The results of HE staining showed that the specimen was divided into two regions, newborn area and original epithelial area. There were more inflammatory cells infiltrating in the dermis in the newborn epithelial area, compared with the original epithelial area. Cells in newborn epithelial area were more active and many dinuclear and polynuclear cells were observed in newborn epithelial area. But there were more cuticular layers and obvious rete pegs in original epithelial area. In addition, the cells with keratin 19 and CEA positive were found around hair follicle, while keratin 15 was negative. Masson trichrome staining showed that there was a lot of de novo collagen in newborn epithelial area.

CONCLUSION:

Epidermal cells on the fascia side of the flap could be derived from the stem cells. Negative pressure wound therapy would attract not only cells but also other elements such as growth factors, cytokines, some nutrients and extracellular matrix. With the formation of the appropriate microenvironment after debridement, the migrated cells can grow, differentiate and spread, eventually leading to the epithelization on the fascia side of the flap in diabetic foot.

KEYWORDS:

Diabetic foot; Epithelium; Negative-pressure wound therapy; Stem cells; Wound healing

PMID:
28526612
PMCID:
PMC5555242
DOI:
10.1016/j.cjtee.2016.08.004
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for PubMed Central
Loading ...
Support Center