Exp Mol Med.  2013 Nov;45(11):e62.

Negative-pressure wound therapy induces endothelial progenitor cell mobilization in diabetic patients with foot infection or skin defects

• Seo SG
• Yeo JH
• Kim JH
• Kim JB
• Cho TJ
• Lee DY

Abstract

Non healing chronic wounds are difficult to treat in patients with diabetes and can result in severe medical problems for these patients and for society. Negative-pressure wound therapy (NPWT) has been adopted to treat intractable chronic wounds and has been reported to be effective. However, the mechanisms underlying the effects of this treatment have not been elucidated. To assess the vasculogenic effect of NPWT, we evaluated the systemic mobilization of endothelial progenitor cells (EPCs) during NPWT. Twenty-two of 29 consecutive patients who presented at the clinic of Seoul National Universty Hospital between December 2009 and November 2010 who underwent NPWT for diabetic foot infections or skin ulcers were included in this study. Peripheral blood samples were taken before NPWT (pre-NPWT) and 7-14 days after the initiation of NPWT (during-NPWT). Fluorescence-activated cell sorting (FACS) analysis showed that the number of cells in EPC-enriched fractions increased after NPWT, and the numbers of EPC colony forming units (CFUs) significantly increased during NPWT. We believe that NPWT is useful for treating patients with diabetic foot infections and skin ulcers, especially when these conditions are accompanied by peripheral arterial insufficiency. The systemic mobilization of EPCs during NPWT may be a mechanism for healing intractable wounds in diabetic patients with foot infections or skin defects via the formation of increased granulation tissue with numerous small blood vessels.

Keyword

diabetic foot; endothelial progenitor cell; negative-pressure wound therapy

MeSH Terms

Adolescent
Adult
Aged
Aged, 80 and over
Case-Control Studies
Child
Colony-Forming Units Assay
Cytokines/genetics/metabolism
Diabetic Foot/*surgery
Endothelial Cells/metabolism/*physiology
Endothelium, Vascular/cytology
Female
Humans
Male
Middle Aged
*Negative-Pressure Wound Therapy
Stem Cells/metabolism/*physiology
Cytokines