LAUSR

BACKGROUND Negative-pressure wound therapy (NPWT) and autologous fat transplantation (AFT) are two clinical modalities for plastic and reconstructive surgery. At present, there are few reports on the combination of these two methods in treating diabetic wounds. This study aimed to explore the effect of this combined therapy on diabetic wound healing. METHODS Full-thickness dorsal cutaneous wounds in rats with streptozotocin-induced diabetes were treated with either NPWT, AFT, or combined therapy. Rats covered with commercial dressings served as the control group. Macroscopic healing kinetics were examined. The levels of inflammation-related factors, such as interleukin-1β (IL-1β), interleukin-6 (IL-6), monocyte chemoattractant protein-1 (MCP-1), Arginase-1, inducible NO synthase (iNOS) and angiogenesis related factors such as vascular endothelial growth factor (VEGF), were measured in the wound tissues on days 3, 7 and 14, and immunohistochemical staining for Arginase-1, iNOS, and CD-31 was performed on days 3, 7 and 14. The length of reepithelialization was investigated on day 14. RESULTS The combined therapy promoted faster wound healing than the other treatments. The expression levels of the proinflammatory factors IL-1β, IL-6, MCP-1, and iNOS were reduced, and Arginase-1 expression was increased compared with those in the other groups. The expression levels of VEGF and CD-31 in the NPWT combined with AFT group were significantly higher than those in the other groups. Reepithelialization was faster in the NPWT combined with AFT group (by day 14) than in the other groups. CONCLUSION Combining NPWT and AFT can enhance diabetic wound healing by improving wound inflammation and increasing wound vascularization.