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Erschienen in: European Journal of Plastic Surgery 5/2020

19.05.2020 | Original Paper

The effect of local insulin injection on the healing process of split thickness skin graft donor site: a randomized, double-blind, placebo control clinical trial

verfasst von: Shahriar Haddady Abianeh, Sohrab Moradi Bajestani, Javad Rahmati, Mohammad Amin Shahrbaf, Nooshin Shirzad

Erschienen in: European Journal of Plastic Surgery | Ausgabe 5/2020

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Abstract

Background

Wound site coverage by a split-thickness skin graft (STSG) is an effective technique after reconstructive surgery. Previous studies have been suggested that insulin is a stimulator for skin wound healing. This study was aimed to determine the effect of local insulin injection on the improvement of STSG donor site wound healing.

Methods

A randomized clinical trial was performed in patients undergoing STSG in 2019. The donor site of patients was divided into control and case segments. Two cubic centimeters of NPH insulin was injected at the case segment with a concentration of 1 IU/ml and normal saline was injected at the control segment by the same volume. The wound site epithelialization area was calculated by ImageJ® software at the 7th, 14th, and the 21st day after the intervention. The epithelialization area of the case and control group was compared by SPSS software.

Results

Epithelialization area was improved at the 21st day compared to 14th day and 7th day. In addition, the amount of epithelialization was significantly higher at the case segment in the 7th, 14th, and the 21st day after the injection with the P values of 0.006, 0.001, and < 0.0001, respectively. Moreover, there was not any sign of hypoglycemia and other complications in patients.

Conclusion

Subdermal injection of insulin may improve the wound site epithelialization in the post-operative period.
Level of evidence: Level I, therapeutic study.
Literatur
1.
Zurück zum Zitat Haktanır NT, Yılmaz G, Bozkurt MF, Demir Y (2016) Effects of insulin-like growth factor-1 on random pattern skin flap survival in rats. Acta Cir Bras 31(8):513–519PubMed Haktanır NT, Yılmaz G, Bozkurt MF, Demir Y (2016) Effects of insulin-like growth factor-1 on random pattern skin flap survival in rats. Acta Cir Bras 31(8):513–519PubMed
2.
Zurück zum Zitat Spear M, Bailey A (2009) Treatment of skin graft donor sites with a unique transparent absorbent acrylic dressing. Plast Surg Nurs 29(4):194–200PubMed Spear M, Bailey A (2009) Treatment of skin graft donor sites with a unique transparent absorbent acrylic dressing. Plast Surg Nurs 29(4):194–200PubMed
3.
Zurück zum Zitat Voineskos SH, Ayeni OA, McKnight L, Thoma A (2009) Systematic review of skin graft donor-site dressings. Plast Reconstr Surg 124(1):298–306PubMed Voineskos SH, Ayeni OA, McKnight L, Thoma A (2009) Systematic review of skin graft donor-site dressings. Plast Reconstr Surg 124(1):298–306PubMed
4.
Zurück zum Zitat Wang PH, Huang BS, Horng HC, Yeh CC, Chen YJ (2018) Wound healing. J Chin Med Assoc 81(2):94–101PubMed Wang PH, Huang BS, Horng HC, Yeh CC, Chen YJ (2018) Wound healing. J Chin Med Assoc 81(2):94–101PubMed
5.
6.
Zurück zum Zitat Jin CE, Xiao L, Ge ZH, Zhan XB, Zhou HX (2015) Role of adiponectin in adipose tissue wound healing. Genet Mol Res 14(3):8883–8891PubMed Jin CE, Xiao L, Ge ZH, Zhan XB, Zhou HX (2015) Role of adiponectin in adipose tissue wound healing. Genet Mol Res 14(3):8883–8891PubMed
7.
Zurück zum Zitat Rieger S, Zhao H, Martin P, Abe K, Lisse TS (2015) The role of nuclear hormone receptors in cutaneous wound repair. Cell Biochem Funct 33(1):1–13PubMed Rieger S, Zhao H, Martin P, Abe K, Lisse TS (2015) The role of nuclear hormone receptors in cutaneous wound repair. Cell Biochem Funct 33(1):1–13PubMed
8.
Zurück zum Zitat Oryan A, Alemzadeh E (2017) Effects of insulin on wound healing: a review of animal and human evidences. Life Sci 174:59–67PubMed Oryan A, Alemzadeh E (2017) Effects of insulin on wound healing: a review of animal and human evidences. Life Sci 174:59–67PubMed
9.
Zurück zum Zitat Sridharan K, Sivaramakrishnan G (2017) Efficacy of topical insulin in wound healing: a preliminary systematic review and meta-analysis of randomized controlled trials. Wound Repair Regen 25(2):279–287PubMed Sridharan K, Sivaramakrishnan G (2017) Efficacy of topical insulin in wound healing: a preliminary systematic review and meta-analysis of randomized controlled trials. Wound Repair Regen 25(2):279–287PubMed
10.
Zurück zum Zitat Stephen S, Agnihotri M, Kaur S (2016) A randomized, controlled trial to assess the effect of topical insulin versus normal saline in pressure ulcer healing. Ostomy Wound Manage 62(6):16–23PubMed Stephen S, Agnihotri M, Kaur S (2016) A randomized, controlled trial to assess the effect of topical insulin versus normal saline in pressure ulcer healing. Ostomy Wound Manage 62(6):16–23PubMed
11.
Zurück zum Zitat Zhang Z, Lv L (2016) Effect of local insulin injection on wound vascularization in patients with diabetic foot ulcer. Exp Ther Med 11(2):397–402PubMed Zhang Z, Lv L (2016) Effect of local insulin injection on wound vascularization in patients with diabetic foot ulcer. Exp Ther Med 11(2):397–402PubMed
12.
Zurück zum Zitat Zhang X-J, Wu X, Wolf SE, Hawkins HK, Chinkes DL, Wolfe RR (2007) Local insulin-zinc injection accelerates skin donor site wound healing. J Surg Res 142(1):90–96PubMed Zhang X-J, Wu X, Wolf SE, Hawkins HK, Chinkes DL, Wolfe RR (2007) Local insulin-zinc injection accelerates skin donor site wound healing. J Surg Res 142(1):90–96PubMed
13.
Zurück zum Zitat Chang AC, Dearman B, Greenwood JE (2011) A comparison of wound area measurement techniques: visitrak versus photography. Eplasty 11:e18 Chang AC, Dearman B, Greenwood JE (2011) A comparison of wound area measurement techniques: visitrak versus photography. Eplasty 11:e18
14.
Zurück zum Zitat Rueden CT, Schindelin J, Hiner MC, DeZonia BE, Walter AE, Arena ET et al (2017) ImageJ2: ImageJ for the next generation of scientific image data. BMC Bioinformatics 18(1):529PubMedPubMedCentral Rueden CT, Schindelin J, Hiner MC, DeZonia BE, Walter AE, Arena ET et al (2017) ImageJ2: ImageJ for the next generation of scientific image data. BMC Bioinformatics 18(1):529PubMedPubMedCentral
15.
Zurück zum Zitat Schneider CA, Rasband WS, Eliceiri KW (2012) NIH image to ImageJ: 25 years of image analysis. Nat Methods 9(7):671–675PubMedPubMedCentral Schneider CA, Rasband WS, Eliceiri KW (2012) NIH image to ImageJ: 25 years of image analysis. Nat Methods 9(7):671–675PubMedPubMedCentral
16.
Zurück zum Zitat Rajyalakshmi R, Prakash WD, Ali MJ, Naik MN (2017) Periorbital biometric measurements using ImageJ software: standardisation of technique and assessment of intra- and interobserver variability. J Cutan Aesthet Surg 10(3):130–135PubMedPubMedCentral Rajyalakshmi R, Prakash WD, Ali MJ, Naik MN (2017) Periorbital biometric measurements using ImageJ software: standardisation of technique and assessment of intra- and interobserver variability. J Cutan Aesthet Surg 10(3):130–135PubMedPubMedCentral
17.
Zurück zum Zitat Rennekampff HO, Fimmers R, Metelmann HR, Schumann H, Tenenhaus M (2015) Reliability of photographic analysis of wound epithelialization assessed in human skin graft donor sites and epidermolysis bullosa wounds. Trials. 16:235PubMedPubMedCentral Rennekampff HO, Fimmers R, Metelmann HR, Schumann H, Tenenhaus M (2015) Reliability of photographic analysis of wound epithelialization assessed in human skin graft donor sites and epidermolysis bullosa wounds. Trials. 16:235PubMedPubMedCentral
18.
Zurück zum Zitat Ollier L (1872) Autogenous skin grafts. Bull Acad Med Paris 1:243–246 Ollier L (1872) Autogenous skin grafts. Bull Acad Med Paris 1:243–246
19.
Zurück zum Zitat Chen JC, Jain SA (2010) Principles of Skin Grafts. InPlastic Surgery Secrets Plus (pp. 677-683). Mosby. Chen JC, Jain SA (2010) Principles of Skin Grafts. InPlastic Surgery Secrets Plus (pp. 677-683). Mosby.
20.
Zurück zum Zitat Hierner R, Degreef H, Vranckx JJ, Garmyn M, Massagé P, van Brussel M (2005) Skin grafting and wound healing—the “dermato-plastic team approach”. Clin Dermatol 23(4):343–352PubMed Hierner R, Degreef H, Vranckx JJ, Garmyn M, Massagé P, van Brussel M (2005) Skin grafting and wound healing—the “dermato-plastic team approach”. Clin Dermatol 23(4):343–352PubMed
21.
Zurück zum Zitat Sagray BA, Lalani S, Mehan V (2011) An alternative coverage for split thickness skin graft donor site wounds. J Foot Ankle Surg 50(3):369–371PubMed Sagray BA, Lalani S, Mehan V (2011) An alternative coverage for split thickness skin graft donor site wounds. J Foot Ankle Surg 50(3):369–371PubMed
22.
Zurück zum Zitat Shichinohe R, Yamamoto Y, Kawashima K, Kimura C, Ono K, Horiuchi K, Yoshida T, Murao N, Hayashi T, Funayama E, Oyama A, Furukawa H (2017) Factors that affected functional outcome after a delayed excision and split-thickness skin graft on the dorsal side of burned hands. J Burn Care Res 38(5):e851–e8e8PubMed Shichinohe R, Yamamoto Y, Kawashima K, Kimura C, Ono K, Horiuchi K, Yoshida T, Murao N, Hayashi T, Funayama E, Oyama A, Furukawa H (2017) Factors that affected functional outcome after a delayed excision and split-thickness skin graft on the dorsal side of burned hands. J Burn Care Res 38(5):e851–e8e8PubMed
23.
Zurück zum Zitat Naeini AT, Oryan A, Dehghani S, Nikahval B (2008) Experimental cutaneous wound healing in rabbits: using continuous microamperage low-voltage electrical stimulation. Comp Clin Pathol 17(3):203–210 Naeini AT, Oryan A, Dehghani S, Nikahval B (2008) Experimental cutaneous wound healing in rabbits: using continuous microamperage low-voltage electrical stimulation. Comp Clin Pathol 17(3):203–210
25.
Zurück zum Zitat Oryan A, Alemzadeh E, Moshiri A (2016) Biological properties and therapeutic activities of honey in wound healing: a narrative review and meta-analysis. J Tissue Viability 25(2):98–118PubMed Oryan A, Alemzadeh E, Moshiri A (2016) Biological properties and therapeutic activities of honey in wound healing: a narrative review and meta-analysis. J Tissue Viability 25(2):98–118PubMed
26.
Zurück zum Zitat Leonov YI, Shkumat M, Klymenko P, Hovorun MY, Guzyk M, Kuchmerovska T et al (2015) Effect of insulin-like growth factor transgene on wound healing in mice with streptozotocin-induced diabetes. Cytol Genet 49(1):19–26 Leonov YI, Shkumat M, Klymenko P, Hovorun MY, Guzyk M, Kuchmerovska T et al (2015) Effect of insulin-like growth factor transgene on wound healing in mice with streptozotocin-induced diabetes. Cytol Genet 49(1):19–26
27.
Zurück zum Zitat Achar RA, Silva TC, Achar E, Martines RB, Machado JL (2014) Use of insulin-like growth factor in the healing of open wounds in diabetic and non-diabetic rats. Acta Cir Bras 29(2):125–131PubMed Achar RA, Silva TC, Achar E, Martines RB, Machado JL (2014) Use of insulin-like growth factor in the healing of open wounds in diabetic and non-diabetic rats. Acta Cir Bras 29(2):125–131PubMed
28.
Zurück zum Zitat Emmerson E, Campbell L, Davies FC, Ross NL, Ashcroft GS, Krust A et al (2012) Insulin-like growth factor-1 promotes wound healing in estrogen-deprived mice: new insights into cutaneous IGF-1R/ERalpha cross talk. J Invest Dermatol 132(12):2838–2848PubMed Emmerson E, Campbell L, Davies FC, Ross NL, Ashcroft GS, Krust A et al (2012) Insulin-like growth factor-1 promotes wound healing in estrogen-deprived mice: new insights into cutaneous IGF-1R/ERalpha cross talk. J Invest Dermatol 132(12):2838–2848PubMed
29.
Zurück zum Zitat Rosenthal R, Wohlleben H, Malek G, Schlichting L, Thieme H, Bowes Rickman C et al (2004) Insulin-like growth factor-1 contributes to neovascularization in age-related macular degeneration. Biochem Biophys Res Commun 323(4):1203–1208PubMed Rosenthal R, Wohlleben H, Malek G, Schlichting L, Thieme H, Bowes Rickman C et al (2004) Insulin-like growth factor-1 contributes to neovascularization in age-related macular degeneration. Biochem Biophys Res Commun 323(4):1203–1208PubMed
30.
Zurück zum Zitat Lambooij AC, van Wely KH, Lindenbergh-Kortleve DJ, Kuijpers RW, Kliffen M, Mooy CM (2003) Insulin-like growth factor-I and its receptor in neovascular age-related macular degeneration. Invest Ophthalmol Vis Sci 44(5):2192–2198PubMed Lambooij AC, van Wely KH, Lindenbergh-Kortleve DJ, Kuijpers RW, Kliffen M, Mooy CM (2003) Insulin-like growth factor-I and its receptor in neovascular age-related macular degeneration. Invest Ophthalmol Vis Sci 44(5):2192–2198PubMed
31.
Zurück zum Zitat Sadagurski M, Yakar S, Weingarten G, Holzenberger M, Rhodes CJ, Breitkreutz D, LeRoith D, Wertheimer E (2006) Insulin-like growth factor 1 receptor signaling regulates skin development and inhibits skin keratinocyte differentiation. Mol Cell Biol 26(7):2675–2687PubMedPubMedCentral Sadagurski M, Yakar S, Weingarten G, Holzenberger M, Rhodes CJ, Breitkreutz D, LeRoith D, Wertheimer E (2006) Insulin-like growth factor 1 receptor signaling regulates skin development and inhibits skin keratinocyte differentiation. Mol Cell Biol 26(7):2675–2687PubMedPubMedCentral
32.
Zurück zum Zitat Tsuboi R, Shi CM, Sato C, Cox GN, Ogawa H (1995) Co-administration of insulin-like growth factor (IGF)-I and IGF-binding protein-1 stimulates wound healing in animal models. J Invest Dermatol 104(2):199–203PubMed Tsuboi R, Shi CM, Sato C, Cox GN, Ogawa H (1995) Co-administration of insulin-like growth factor (IGF)-I and IGF-binding protein-1 stimulates wound healing in animal models. J Invest Dermatol 104(2):199–203PubMed
33.
Zurück zum Zitat Kratz G, Lake M, Gidlund M (1994) Insulin like growth factor-1 and -2 and their role in the re-epithelialisation of wounds; interactions with insulin like growth factor binding protein type 1. Scand J Plast Reconstr Surg Hand Surg 28(2):107–112PubMed Kratz G, Lake M, Gidlund M (1994) Insulin like growth factor-1 and -2 and their role in the re-epithelialisation of wounds; interactions with insulin like growth factor binding protein type 1. Scand J Plast Reconstr Surg Hand Surg 28(2):107–112PubMed
34.
Zurück zum Zitat Hrynyk M, Neufeld RJ (2014) Insulin and wound healing. Burns. 40(8):1433–1446PubMed Hrynyk M, Neufeld RJ (2014) Insulin and wound healing. Burns. 40(8):1433–1446PubMed
35.
Zurück zum Zitat Chen X, Liu Y, Zhang X (2012) Topical insulin application improves healing by regulating the wound inflammatory response. Wound Repair Regen 20(3):425–434PubMed Chen X, Liu Y, Zhang X (2012) Topical insulin application improves healing by regulating the wound inflammatory response. Wound Repair Regen 20(3):425–434PubMed
36.
Zurück zum Zitat Pastar I, Stojadinovic O, Yin NC, Ramirez H, Nusbaum AG, Sawaya A, Patel SB, Khalid L, Isseroff RR, Tomic-Canic M (2014) Epithelialization in wound healing: a comprehensive review. Adv Wound Care 3(7):445–464 Pastar I, Stojadinovic O, Yin NC, Ramirez H, Nusbaum AG, Sawaya A, Patel SB, Khalid L, Isseroff RR, Tomic-Canic M (2014) Epithelialization in wound healing: a comprehensive review. Adv Wound Care 3(7):445–464
37.
Zurück zum Zitat Aljada A, Ghanim H, Mohanty P, Kapur N, Dandona P (2002) Insulin inhibits the pro-inflammatory transcription factor early growth response gene-1 (Egr)-1 expression in mononuclear cells (MNC) and reduces plasma tissue factor (TF) and plasminogen activator inhibitor-1 (PAI-1) concentrations. J Clin Endocrinol Metab 87(3):1419–1422PubMed Aljada A, Ghanim H, Mohanty P, Kapur N, Dandona P (2002) Insulin inhibits the pro-inflammatory transcription factor early growth response gene-1 (Egr)-1 expression in mononuclear cells (MNC) and reduces plasma tissue factor (TF) and plasminogen activator inhibitor-1 (PAI-1) concentrations. J Clin Endocrinol Metab 87(3):1419–1422PubMed
38.
Zurück zum Zitat Jiang H, Torregrossa AC, Potts A, Pierini D, Aranke M, Garg HK, Bryan NS (2014) Dietary nitrite improves insulin signaling through GLUT4 translocation. Free Radic Biol Med 67:51–57PubMed Jiang H, Torregrossa AC, Potts A, Pierini D, Aranke M, Garg HK, Bryan NS (2014) Dietary nitrite improves insulin signaling through GLUT4 translocation. Free Radic Biol Med 67:51–57PubMed
39.
Zurück zum Zitat Dimitriadis G, Mitrou P, Lambadiari V, Maratou E, Raptis SA (2011) Insulin effects in muscle and adipose tissue. Diabetes Res Clin Pract 93(Suppl 1):S52–S59PubMed Dimitriadis G, Mitrou P, Lambadiari V, Maratou E, Raptis SA (2011) Insulin effects in muscle and adipose tissue. Diabetes Res Clin Pract 93(Suppl 1):S52–S59PubMed
40.
Zurück zum Zitat Lima MH, Caricilli AM, de Abreu LL, Araujo EP, Pelegrinelli FF, Thirone AC et al (2012) Topical insulin accelerates wound healing in diabetes by enhancing the AKT and ERK pathways: a double-blind placebo-controlled clinical trial. PLoS One 7(5):e36974PubMedPubMedCentral Lima MH, Caricilli AM, de Abreu LL, Araujo EP, Pelegrinelli FF, Thirone AC et al (2012) Topical insulin accelerates wound healing in diabetes by enhancing the AKT and ERK pathways: a double-blind placebo-controlled clinical trial. PLoS One 7(5):e36974PubMedPubMedCentral
41.
Zurück zum Zitat Scimeca CL, Bharara M, Fisher TK, Giovinco N, Armstrong DG (2010) Novel use of doxycycline in continuous-instillation negative pressure wound therapy as" wound chemotherapy". Foot & ankle specialist 3(4):190-3. Scimeca CL, Bharara M, Fisher TK, Giovinco N, Armstrong DG (2010) Novel use of doxycycline in continuous-instillation negative pressure wound therapy as" wound chemotherapy". Foot & ankle specialist 3(4):190-3.
42.
Zurück zum Zitat Tuvdendorj D, Zhang XJ, Chinkes DL, Aarsland A, Kulp GA, Jeschke MG, Herndon DN (2011) Intensive insulin treatment increases donor site wound protein synthesis in burn patients. Surgery. 149(4):512–518PubMedPubMedCentral Tuvdendorj D, Zhang XJ, Chinkes DL, Aarsland A, Kulp GA, Jeschke MG, Herndon DN (2011) Intensive insulin treatment increases donor site wound protein synthesis in burn patients. Surgery. 149(4):512–518PubMedPubMedCentral
43.
Zurück zum Zitat Hallam M-J, Pitt E, Thomas A, Nduka C (2018) Low-dose insulin as an antiscarring therapy in breast surgery: a randomized controlled trial. Plast Reconstr Surg 141(4):476e–485ePubMed Hallam M-J, Pitt E, Thomas A, Nduka C (2018) Low-dose insulin as an antiscarring therapy in breast surgery: a randomized controlled trial. Plast Reconstr Surg 141(4):476e–485ePubMed
44.
Zurück zum Zitat Martínez-Jiménez MA, Valadez-Castillo FJ, Aguilar-García J, Ramírez-GarciaLuna JL, Gaitán-Gaona FI, Pierdant-Perez M et al (2018) Effects of local use of insulin on wound healing in non-diabetic patients. Plast Surg 26(2):75–79 Martínez-Jiménez MA, Valadez-Castillo FJ, Aguilar-García J, Ramírez-GarciaLuna JL, Gaitán-Gaona FI, Pierdant-Perez M et al (2018) Effects of local use of insulin on wound healing in non-diabetic patients. Plast Surg 26(2):75–79
45.
Zurück zum Zitat Association WM (2001) World Medical Association Declaration of Helsinki. Ethical principles for medical research involving human subjects. Bull World Health Organ 79(4):373 Association WM (2001) World Medical Association Declaration of Helsinki. Ethical principles for medical research involving human subjects. Bull World Health Organ 79(4):373
Metadaten
Titel
The effect of local insulin injection on the healing process of split thickness skin graft donor site: a randomized, double-blind, placebo control clinical trial
verfasst von
Shahriar Haddady Abianeh
Sohrab Moradi Bajestani
Javad Rahmati
Mohammad Amin Shahrbaf
Nooshin Shirzad
Publikationsdatum
19.05.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Plastic Surgery / Ausgabe 5/2020
Print ISSN: 0930-343X
Elektronische ISSN: 1435-0130
DOI
https://doi.org/10.1007/s00238-020-01683-3

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