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extremity. The intermittent negative pressure regimen pathophysiological event in diabetes. It is well
[27]
[39]
used in LAD has been shown to be an economical and known that MDA from lipid peroxidation reacts with
[40]
effective alternative in treating traumatic wounds. [28,29] DNA bases and induces mutagenic lesions. In the
present study, after 10 days of therapy, the mean
Evidence shows that increased oxidative stress causes level of MDA (± SD) was significantly less in the LAD
delayed wound healing in diabetics with altered group than in the conventional dressing group (LAD
antioxidant enzyme activities. Various studies [31,32] have vs. conventional = 6.8 ± 2.3 vs. 10.4 ± 3.4 nmol/mg
[30]
shown a significant reduction in collagen content in the protein, P = 0.024).
granulation tissue of diabetic animals. The authors of
these studies have proposed that the decreased collagen In conclusion, LAD (intermittent NPWT and moist wound
levels seen in diabetic wounds are likely in response to dressing) exerts a beneficial effect on diabetic wound
an altered extracellular environment (i.e. hyperglycemia, healing as seen by a significant increase in the levels
persistent inflammation, excess H O and free radical hydroxyproline, total protein, NO, antioxidants, a decrease
2
2
production, and low levels of antioxidants). Collagen in MMP‑2 and MMP‑9, and oxidative biomarkers (MDA) as
is the major component of extracellular tissue which compared to conventional dressings.
provides support and strength. It is measured by The use of intermittent NPWT using LAD may be an
monitoring the concentration of hydroxyproline, that effective alternative therapy used to achieve faster
[33]
is, synthesized by fibroblasts and is vulnerable to the granulation of the wound bed in diabetic ulcers.
effects of free radicals. In the present study, after 10 days
of therapy, the mean level of hydroxyproline (± SD) Financial support and sponsorship
was significantly higher in the LAD group as compared Nil.
to that of the conventional dressing group (LAD vs. Conflicts of interest
conventional = 55.2 ± 25.1 vs. 29.2 ± 13.5 µg/mg of dry There are no conflicts of interest.
weight of tissue, P = 0.000). The concentration of protein
found in the wound’s granulation tissue was higher in REFERENCES
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270 Plast Aesthet Res || Vol 2 || Issue 5 || Sep 15, 2015