Clinical and immunohistopathological aspects of venous ulcers treatment by Low-Intensity Pulsed Ultrasound (LIPUS)

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• 作者：Luí ; siane de Á ; vila Santana^a ; ^b ; ¹ ; ^{luisianeas@gmail.com} ; José ; Marcos Alves^a ; ² ; ^{jma@sc.usp.br} ; Thiago Antô ; nio Moretti Andrade^b ; ³ ; ^{tandrademoretti@yahoo.com.br} ; Joã ; o Kazuyuki Kajiwara^c ; ⁴ ; ^{jkkajiwa@fmrp.us} ; Sé ; rgio Britto Garcia^d ; ⁵ ; ^{sbgarcia@fmrp.usp.br} ; Fernanda Guzzo Gomes^a ; ^b ; ^{feguzzo@gmail.com} ; Marco Andrey Cipriani Frade^b ; ^{mandrey@fmrp.usp.br}
• 关键词：Ultrasound ; Venous ulcer ; Wound healing ; Immunohistochemistry ; Image processing
• 刊名：Ultrasonics
• 出版年：2013
• 出版时间：April, 2013
• 年：2013
• 卷：53
• 期：4
• 页码：870-879
• 全文大小：2058 K

文摘

The immunological mechanisms that are triggered by Low-Intensity Pulsed Ultrasound (LIPUS) in wound healing are unknown. In the present study, experimental groups were used to assess the treatment of chronic venous ulcers with 30 mW/cm² SATA peripheral LIPUS three times per week compared to a daily treatment of 1 % silver sulfadiazine (SDZ). The ulcers of the SDZ group (n = 7) (G1) and LIPUS group (n = 9) (G2) were photographed five times three months, and the images were analyzed using ImageJ software to quantify the total area (S), fibrin/sphacel area (yellow) and granulation area (red). The healing process was evaluated by the wound healing rate (WHR), granulation tissue rate (GTR) and fibrin/sphacel tissue rate (FTR). The ulcers were biopsied on days 1 and 45 and stained for collagen fiber quantification (picrosirius) and CD68⁺ protein and VEGF (vascular endothelial growth factor) expression using HRP-streptavidin (horseradish peroxidase-streptavidin). On day 90, G2 had a mean 41 % decrease in the ulcer area, while no decrease was observed in G1 (p < 0.05). An increased tendency toward positive labeling of collagen fibers and VEGF (p > 0.05) was observed in G2 compared to G1, and the number of CD68⁺ cells was greater in G2 than in G1 (p < 0.05). LIPUS presents superior activity compared to SDZ in stimulating the inflammatory and proliferative (angiogenesis and collagenesis, respectively) phases of chronic venous wound healing.