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Changes in gene expression in pressure ulcers debrided by different approaches - a pilot study
A Samadian1, M Kratochvílová, A Hokynková
1Department of Physiology, Faculty of Medicine, Masaryk University, Brno, Czech Republic, Department of Burns and Plastic Surgery, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic. alicah@post.cz.
This study compared gene expression in pressure ulcers (PUs) treated with sharp debridement versus the Versajet® hydrosurgery system. Preliminary findings indicate no significant gene expression differences, except for NFE2L2, between the two PU treatment methods.
Area of Science:
- Wound Healing Research
- Molecular Biology
- Surgical Innovation
Background:
- Pressure ulcers (PUs) are chronic wounds often requiring surgical intervention for deep categories (III and IV).
- Sharp surgical debridement is a standard treatment, but the Versajet® hydrosurgery system offers advantages for tangential excision.
- Understanding molecular responses to different debridement methods is crucial for optimizing PU treatment.
Purpose of the Study:
- To compare the gene expression profiles of pressure ulcers (PUs) following debridement by sharp surgical methods versus the Versajet® hydrosurgery system.
- To investigate the expression of genes related to oxidative stress, cell proliferation, and angiogenesis in PUs treated with these distinct debridement techniques.
- To explore potential correlations between gene expression patterns and the healing process in PUs.
Main Methods:
- Gene expression analysis of NFE2L2, ACTA2, NFKB1, VEGFA, MKI67, HMOX1, HMOX2, HIF1A, and SOD2 in PU tissue samples.
- Utilized sharp surgical debridement and Versajet® hydrosurgery system for wound debridement in five patients.
- Employed ACTB and PSMB as housekeeping genes for normalization.
Main Results:
- Preliminary results show no significant differences in overall gene expression between the two debridement methods, with the exception of NFE2L2.
- Despite macroscopic differences in wound appearance, molecular responses did not significantly diverge initially.
- Identified significant correlations between the expression of HIF1A and SOD2, VEGFA and SOD2, and VEGFA and HIF1A.
Conclusions:
- The choice of debridement method (sharp surgical vs. Versajet®) may not significantly alter the expression of most studied genes in early-stage PU treatment.
- Observed correlations suggest a potential link between hypoxia (HIF1A), oxidative stress (SOD2), and angiogenesis (VEGFA) in pressure ulcer healing.
- Further research with a larger patient cohort is warranted to confirm these preliminary findings and elucidate the molecular mechanisms underlying PU healing.
