Clinical observation of low dose insulin local injection for promotion of adipose derived stem cell transplantation survival and improvement of diabetic wound healing

doi:10.3877/cma.j.issn.1673-9450.2023.04.007

Abstract

Abstract:

Objective

To analyze the clinical effect of low dose insulin local injection for survival of adipose derived stem cells (ADSCs) and transplanted flap and diabetic chronic refractory wound healing.

Methods

A total of 110 diabetic patients with chronic ulcer difficult healing wounds from June 2017 to January 2019 were enrolled and divided randomly into blank group, control group, low dose group (0.5 U insulin), medium dose group (1.0 U insulin) and high dose group (2.0 U insulin), each group of 22 cases. The patients all got free skin flap transplantation and local injection of ADSCs for four weeks. Compared wound healing degree, survival rate of skin flaps and blood flow of wound, expressions of HSP-90, VEGF, TGF-β and IL-1 in healing-unhealed interface tissue detected by ELISA, microvessel number detected by CD31 immunohistochemistry and blood sugar level measured by glucose oxidase method among the groups after two and four weeks.

Results

The wound healing degree, survival rate of skin flaps and blood flow of wound after two and four weeks in low dose group were all significantly higher than the other groups, expressions of HSP-90, VEGF, TGF-β and IL-1 were higher, and microvessel number were more than the other groups(P<0.05). While there was no significant difference in blood sugar level among the groups (P>0.05).

Conclusion

It can greatly promote survival of ADSCs and transplanted flap, improve quality of wound healing in diabetic chronic refractory wound with low dose insulin local injection, which may be related to higher expressions of HSP-90, VEGF, TGF-β, IL-1 and microvessel number, without influence of blood sugar, and has better safety and efficacy.

Key words: Insulin, Adipose derived stem cells, Diabetic, Chronic refractory wound

Manqing Jia, Jing Bian, Yeping Zhou. Clinical observation of low dose insulin local injection for promotion of adipose derived stem cell transplantation survival and improvement of diabetic wound healing[J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2023, 18(04): 312-316.

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Figures/Tables 10

References 22

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组别	例数	男/女(例)	年龄(岁，±s)	糖尿病病程(年，±s)	创面时间(月，±s)	创面面积(cm²，±s)	左/右下肢(例)
对照组	22	12/10	64.5±8.6	8.9±3.3	4.2±0.6	11.3±3.5	11/11
盐水组	22	10/12	64.3±8.4	9.2±3.5	4.1±0.4	11.1±3.3	12/10
小剂量组	22	13/9	63.8±7.6	9.5±3.6	4.3±0.7	10.8±3.6	14/8
中剂量组	22	14/8	63.6±7.5	9.1±3.7	4.4±0.9	11.6±3.9	13/9
高剂量组	22	11/11	65.1±8.9	8.8±3.4	4.3±0.6	11.9±3.8	15/7
F值/χ²值		1.833	0.425	0.658	0.528	0.857	1.880
P值		0.766	0.563	0.321	0.406	0.169	0.758

组别	例数	男/女(例)	年龄(岁，±s)	糖尿病病程(年，±s)	创面时间(月，±s)	创面面积(cm²，±s)	左/右下肢(例)
对照组	22	12/10	64.5±8.6	8.9±3.3	4.2±0.6	11.3±3.5	11/11
盐水组	22	10/12	64.3±8.4	9.2±3.5	4.1±0.4	11.1±3.3	12/10
小剂量组	22	13/9	63.8±7.6	9.5±3.6	4.3±0.7	10.8±3.6	14/8
中剂量组	22	14/8	63.6±7.5	9.1±3.7	4.4±0.9	11.6±3.9	13/9
高剂量组	22	11/11	65.1±8.9	8.8±3.4	4.3±0.6	11.9±3.8	15/7
F值/χ²值		1.833	0.425	0.658	0.528	0.857	1.880
P值		0.766	0.563	0.321	0.406	0.169	0.758

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