To Compare The Effects Of Human Acidic Fibroblast Growth Factor And Human Basic Fibroblast Growth Factor Combined With Vacuum Sealing Drainage On Chronic Refractory Wound

Objective:By observing and comparing the content of rhaFGF and rhbFGF combined with Vacuum Sealing Drainage,we studied the content of rhaFGF and rhbFGF,and compared the content of rhaFGF and rhbFGF.To investigate the effects of VSD on wound healing,granulation tissue growth,angiogenesis,cell proliferation and collagen deposition in chronic refractory wound.Methods:Collection of north sichuan medical college affiliated hospital plastic/burn surgery in November 2019 to December 2020 during hospitalization and included in the standard of 45 patients with chronic painless wound,the patients were randomly divided into three groups according to random number table,the VSD combined rhaFGF(group A,n=15),the VSD combined rhbFGF(group B,n=15)and the VSD combined physiological saline(group C,n=15).Closed negative pressure suction and flushing tube were placed on the wound surface after the first debridement operation in the three groups.Three time points before treatment(DAY0),the 7th day after treatment(DAY7)and the 14th day after treatment(DAY 14)were selected as observation points.The wound area of DAY0,DAY7 and DAY 14 of the three groups of patients were measured and the granulation tissue growth score was performed,the wound healing rate was calculated,and the granulation tissue was collected for fixation and embedding.Hematoxylin-eosin staining(HE staining)was used to observe the infiltration of inflammatory cells in the wound tissue,immunohistochemical staining was used to observe the expression of proliferating cell nuclear antigen(PCNA)and vascular endothelial growth factor(VEGF)protein,and Masson staining was used to observe the deposition of collagen.The effects of different treatment methods on wound healing were compared and observed.Results:1.There were no significant differences in age,gender,course of disease,vascular status and infection among the three groups(all P values>0.05);2.There was no significant difference in the wound granulation tissue assessment on DAY0 among the three groups(0.27±0.46 VS 0.27±0.46 VS 0.33±0.49,P>0.05),but there was significant difference in the wound granulation tissue assessment on DAY7 and DAY 14 among the three groups(1.87±0.35 VS 1.80±0.56 VS 1.27±0.46;2.93±0.46 VS 2.87±0.64 VS 2.40±0.51,P<0.05),the granulation tissue growth score of groups A and B was significantly higher than that of group C(P<0.05).There was no significant difference between group A and group B(P>0.05).3.There was no significant difference in the initial area of DAY0 wound after debridement among the three groups(P>0.05),and there was significant difference in the wound healing rate between DAY7 and DAY 14 groups(9.10 ± 2.96%VS 8.82 ± 1.23%VS 6.81 ± 1.84%;22.53±4.67%VS 20.11±3.06%VS 15.96±3.02%;P<0.05),the wound healing rate of groups A and B was significantly higher than that of group C(P<0.05),and there was no significant difference between group A and group B(P>0.05).4.HE staining results showed that more inflammatory cells were infiltrated before treatment in all the three groups,and inflammatory cells were significantly reduced and vascularization was significantly increased after treatment.Immunohistochemical staining results in three groups of patients DAY0 wound granulation tissue of PCNA,only A small amount of VEGF expression,and no statistical difference(P>0.05),and DAY7 DAY14 wound granulation tissue and PCNA and VEGF positive expression of collagen were significantly increased(P<0.05),and positive expression of group A and B group was obviously higher than that of group C(P<0.05),but there was no significant difference between group A and group B(P>0.05).Conclusion:1.VSD+rhaFGF irrigation and VSD+rhbFGF irrigation have good clinical effect in the treatment of chronic refractory wounds without obvious adverse reactions,and have the functions of convenient operation,promoting the growth of wound granulation tissue and accelerating wound healing;2.There was no significant difference between VSD+rhaFGF irrigation and VSD+rhbFGF irrigation in the treatment of chronic refractory wounds;3.VSD+rhaFGF irrigation and VSD+rhbFGF irrigation can promote the high expression of wound growth factors PCNA and VEGF,increase the deposition of wound collagen,promote cell proliferation,vascularization and granulation tissue growth,and promote wound healing.