The Experimental Study Of The Effect Of The Vacuum-assisted Closure On Activated Gelatinases And FN In Human Chronic Wound

The Experimental Study of the Effect of the Vacuum-assisted Closure on activated Gelatinases and FN in Human Chronic WoundThe Vacuum -assisted Closure (V.A.C.), also known as Negative Pressure Wound Therapy, is a new treatment in which controlled negative pressure is used to provide evacuation of wound fluid, stimulation of granulation tissue, improvement of microcirculation and a decrease in bacterial colonization. In this experiment, we study the effect of the Vacuum-assisted Closure (V.A.C) on activated gelatinases (activated MMP-2, 62KD; activated MMP-9, 82KD) and fibronectin(FN) in human chronic wound so as to elucidate some mechanisms of V.A.C improving wound healing.Five patients who underwent chronic wounds are treated with V.A.C applying a negative pressure (-120mmHg). Wound Fluids are obtained before thetreatment and 24 hours, 3 days, 5 days, 10 days and 15 days after the treatment. The fluids of 10 patients who underwent mastectomy, which are obtained 3 days after surgery, are used as controlled group. Wound fluid samples are analyzed with zymography and ELISA. The experiment shows that:Before V.A.C treatment, three fluid samples obtained from chronic wound contain lower activated gelatinases activity than that in controlled group, while the activity of MMP-2 in a sample and of MMP-9 in another is higher. After 15-day treatment there is no significant statistic difference in activated MMP-2 and activated MMP-9 between chronic wounds and controlled group (p>0.05), and so are the total activity of activated gelatinases (p>0.05). Before V.A.C treatment, chronic wounds contain lower FN than controlled group. At the 5th day after treatment by V.A.C, there is no significant difference between chronic wounds and controlled group.Conclusion: The activity of activated gelatinases may be one of the causes retarding the process of humanchronic wounds when it is too high or too low. V.A.C can modulate activity of activated gelatinases in human chronic wound. FN is low in chronic wound fluid. V.A.C can sharply increase the quantity of FN in chronic wound fluid.