Role of Autologous Fat Transplantation Combined with Negative-Pressure Wound Therapy in Treating Rat Diabetic Wounds

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-1 & beta; (IL-1 & beta;), interleukin-6 (IL-6), monocyte chemoattractant protein-1, arginase-1, and inducible nitric oxide synthase (iNOS) and angiogenesis-related factors such as vascular endothelial growth factor, were measured in the wound tissues on days 3, 7, and 14; immunohistochemical staining for arginase-1, iNOS, and CD31 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-1 & beta;, IL-6, monocyte chemoattractant protein-1 (MCP-1), and iNOS were reduced, and arginase-1 expression was increased compared with those in the other groups. The expression levels of vascular endothelial growth factor and CD31 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.Clinical Relevance Statement:The authors designed a randomized controlled trial of diabetic rats to confirm that NPWT can enhance the vascularization and improve inflammation of the diabetic wound after the autologous fat transplantation treatment. This article may provide a new idea for treating diabetic wounds.