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目的观察封闭负压引流技术(vacuum-assisted closure,VAC)治疗慢性创面前后创缘组织中C-ski及Smad3表达的改变,从创面愈合启动方面探讨VAC促进创面愈合的机制。方法临床选取慢性创面病例14例,分别于治疗前,治疗后1、4、7d取创缘全层皮肤组织,应用免疫组织化学检测样本组织的C-ski及Smad3的表达变化,应用RT-PCR检测样本组织中C-ski mRNA和Smad3mRNA的变化。结果治疗前创缘组织中C-ski的表达较少,治疗后逐渐增加,治疗后第4天起较治疗前显著增加(P<0.05)。相反,治疗前创缘组织中Smad3的表达较多,治疗1d后轻微减少,治疗4d和7d后显著减少(P<0.05),C-ski mRNA和Smad3mRNA的表达趋势同其蛋白一样。C-ski阳性表达与Smad3阳性表达呈显著负相关(r=-0.873,P<0.01)。结论VAC治疗后,能够使创缘组织中的C-ski表达增加并且抑制了Smad3的表达。
Objective To observe the changes of C-ski and Smad3 in wound margin before and after the treatment of vacuum-assisted closure (VAC), and to explore the mechanism of VAC promoting wound healing from the aspect of wound healing. Methods Fourteen cases of chronic wounds were selected clinically, and the full-thickness wounds of wounds were harvested at 1, 4 and 7 days after treatment. The expressions of C-ski and Smad3 were detected by immunohistochemical staining. The changes of C-ski mRNA and Smad3 mRNA in samples were detected. Results Before treatment, the expression of C-ski in wound margin was less, and gradually increased after treatment. The level of C-ski increased significantly from the 4th day after treatment (P <0.05). On the contrary, the expression of Smad3 was significantly increased in the wound margin before treatment, slightly decreased after 1 day of treatment, and significantly decreased 4 days and 7 days after treatment (P <0.05). The expression of C-ski mRNA and Smad3 mRNA was the same as that of the protein. There was a significant negative correlation between C-ski positive expression and Smad3 positive expression (r = -0.873, P <0.01). Conclusions VAC treatment can increase the expression of C-ski in wound margin and inhibit the expression of Smad3.