TY - JOUR
T1 - Local use of insulin in wounds of diabetic patients
T2 - Higher temperature, fibrosis, and angiogenesis
AU - Martínez-Jiménez, Mario Aurelio
AU - Aguilar-García, Jorge
AU - Valdés-Rodríguez, Rodrigo
AU - Metlich-Medlich, Marco Antonio
AU - Dietsch, Laura Judith Porro
AU - Gaitán-Gaona, Francisco Israel
AU - Kolosovas-Machuca, Eleazar Samuel
AU - González, Francisco Javier
AU - Sánchez-Aguilar, Jesús Martín
PY - 2013/12
Y1 - 2013/12
N2 - BACKGROUND: Clinical trials have shown the effectiveness of systemic and local insulin therapy in improving wound healing. Diabetic wounds remain a challenge for healthcare providers. Impaired angiogenesis and reduced granulation tissue formation contribute to inadequate wound healing. The aim of this study was to investigate the effect of local insulin administration in acute and chronic diabetic wounds. METHODS: Eight diabetic patients presenting with full-thickness wounds, of different causes, were included in this study. Five wounds were due to necrobiosis, one to trauma, and two to postneoplasm resection. All wounds were treated with regular bedside treatment. In addition, half of the wound surface was treated with insulin and the other half did not receive insulin. Thermographic and biopsy specimens of the two sides were obtained on days 0 and 14. The presence of fibrosis, change in temperature, and amount of blood were evaluated. RESULTS: Significant differences in the number of vessels were observed on the insulin-treated side (96 ± 47) when compared with the no-insulin side (32.88 ± 45) (p < 0.026). The percentage of fibrosis (insulin: 44.42 ± 30.42 percent versus no insulin: 12.38 ± 36.17 percent; p < 0.047) and the mean temperature (insulin: 1.27 ± 1.12 C versus no-insulin: 0.13 ± 1.22 C; p < 0.001) were also significantly different between sides. No adverse events related to the study occurred. CONCLUSION: The use of local insulin improves the formation of new blood vessels, increases fibrosis, and correlates with increased temperature.
AB - BACKGROUND: Clinical trials have shown the effectiveness of systemic and local insulin therapy in improving wound healing. Diabetic wounds remain a challenge for healthcare providers. Impaired angiogenesis and reduced granulation tissue formation contribute to inadequate wound healing. The aim of this study was to investigate the effect of local insulin administration in acute and chronic diabetic wounds. METHODS: Eight diabetic patients presenting with full-thickness wounds, of different causes, were included in this study. Five wounds were due to necrobiosis, one to trauma, and two to postneoplasm resection. All wounds were treated with regular bedside treatment. In addition, half of the wound surface was treated with insulin and the other half did not receive insulin. Thermographic and biopsy specimens of the two sides were obtained on days 0 and 14. The presence of fibrosis, change in temperature, and amount of blood were evaluated. RESULTS: Significant differences in the number of vessels were observed on the insulin-treated side (96 ± 47) when compared with the no-insulin side (32.88 ± 45) (p < 0.026). The percentage of fibrosis (insulin: 44.42 ± 30.42 percent versus no insulin: 12.38 ± 36.17 percent; p < 0.047) and the mean temperature (insulin: 1.27 ± 1.12 C versus no-insulin: 0.13 ± 1.22 C; p < 0.001) were also significantly different between sides. No adverse events related to the study occurred. CONCLUSION: The use of local insulin improves the formation of new blood vessels, increases fibrosis, and correlates with increased temperature.
UR - https://www.scopus.com/pages/publications/84889011346
UR - https://www.scopus.com/pages/publications/84889011346#tab=citedBy
U2 - 10.1097/PRS.0b013e3182a806f0
DO - 10.1097/PRS.0b013e3182a806f0
M3 - Article
C2 - 24281606
AN - SCOPUS:84889011346
SN - 0032-1052
VL - 132
SP - 1015e-1019e
JO - Plastic and reconstructive surgery
JF - Plastic and reconstructive surgery
IS - 6
ER -