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Local Insulin Improves Wound Healing: A Systematic Review and Bayesian Network Meta-Analysis
Jose L Ramirez-GarciaLuna1,2, Karla Rangel-Berridi1, Amy Bergeron1
1From the McGill University Health Centre.
Plastic and Reconstructive Surgery
|March 20, 2023
Summary
Local insulin effectively promotes wound healing, accelerating closure and improving tissue regeneration. This systematic review found no significant adverse events, supporting its safety and efficacy in wound care.
Area of Science:
- Wound healing research
- Regenerative medicine
- Pharmacological interventions
Background:
- Wounds represent a significant health burden requiring effective healing strategies.
- Clinical evidence suggests local insulin aids wound repair, but requires further validation.
- Safety, particularly hypoglycemia, and comparative effectiveness of local insulin need comprehensive analysis.
Approach:
- Systematic review and Bayesian network meta-analysis (NMA) of human studies.
- Searched multiple databases (Medline, CENTRAL, Embase, Scopus, LILACS) and gray literature.
- Extracted data on glucose, adverse events, wound healing outcomes, and neoangiogenesis.
Key Points:
- Network meta-analysis included 23 studies with 1240 patients.
- Local insulin showed a minimal blood glucose change (-1.8 mg/dL) and no significant adverse events.
- Demonstrated significant improvements in wound size reduction (-27%), healing rate (+23 mm/day), and complete closure (OR 20).
- Observed significant increases in neoangiogenesis (+30 vessels/mm²) and granulation tissue (+25%).
Conclusions:
- Local insulin application is a safe and effective strategy for promoting wound healing.
- The findings support insulin's pro-healing effects through enhanced vascularization and cellular activity.
- Further clinical trials can build upon these findings for optimized wound treatment protocols.
