Tibial cortex transverse transport accelerates wound healing via enhanced angiogenesis and immunomodulation

Bone & Joint Research

article

Yongkang Yang¹  Yucong Li¹  Qi Pan²  Shanshan Bai¹  Haixing Wang¹  Xiao-hua Pan³  Ka-Kin Ling¹  Gang Li¹ 

[1] Department of Orthopaedics & Traumatology, Stem Cells and Regenerative Medicine Laboratory, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital;Department of Pediatric Orthopaedics, South China Hospital, Health Science Center, Shenzhen University;Department of Orthopaedics and Traumatology, The Second Affiliated Hospital of Shenzhen University ,(Shenzhen Bao'an People's Hospital)

关键词: Tibial cortex transverse transport technique;    Wound healing;    Angiogenesis;    Distraction histogenesis;    Immunomodulation;    Tibial cortex;    wound healing;    angiogenesis;    macrophages;    wounds;    rat model;    external fixator;    blood;    blood vessels;    diabetic foot ulcers;   

DOI  :  10.1302/2046-3758.114.BJR-2021-0364.R1

学科分类：骨科学

来源: British Editorial Society Of Bone And Joint Surgery

【 摘 要 】

AimsTreatment for delayed wound healing resulting from peripheral vascular diseases and diabetic foot ulcers remains a challenge. A novel surgical technique named ‘tibial cortex transverse transport’ (TTT) has been developed for treating peripheral ischaemia, with encouraging clinical effects. However, its underlying mechanisms remain unclear. In the present study, we explored the potential biological mechanisms of TTT surgery using various techniques in a rat TTT animal model.MethodsA novel rat model of TTT was established with a designed external fixator, and effects on wound healing were investigated. Laser speckle perfusion imaging, vessel perfusion, histology, and immunohistochemistry were used to evaluate the wound healing processes.ResultsGross and histological examinations showed that TTT technique accelerated wound closure and enhanced the quality of the newly formed skin tissues. In the TTT group, haematoxylin and eosin (H&E) staining demonstrated a better epidermis and dermis recovery, while immunohistochemical staining showed that TTT technique promoted local collagen deposition. The TTT technique also benefited to angiogenesis and immunomodulation. In the TTT group, blood flow in the wound area was higher than that of other groups according to laser speckle imaging with more blood vessels observed. Enhanced neovascularization was seen in the TTT group with double immune-labelling of CD31 and α-Smooth Muscle Actin (α-SMA). The number of M2 macrophages at the wound site in the TTT group was also increased.ConclusionThe TTT technique accelerated wound healing through enhanced angiogenesis and immunomodulation.

【 授权许可】

CC BY-NC