The temporary expression pattern in wound fluids and wound-edge biopsies

The local availability of growth factors and oxygen plays an important role in the healing of cutaneous lesions. We were able to quantify the ischemia in a standardized ischemic full-wall flap by measuring the p(ti)O(2), and investigate the healing of defined wounds. The analysis of the immune histo chemical section showed a significantly reduced expression of IGF-I in the wound edge of ischemic wounds. Simultaneously the rate of proliferation was reduced here. Probably the local chronic hypoxia leads to reduced IGF-I sy nthesis and thus to reduced proliferation and delayed wound healing. Furthe r investigation is necessary to confirm this hypothesis. In a clinical stud y of wounds which had been treated with vacuum sealing we could establish n o difference in the concentration of IGF-I in the wound fluid of seriously contaminated wounds in comparison to primary fasciotomy wounds. We therefor e postulate a primary endocrinal secretion for IGF-I in cases of cutaneous wound healing; higher local consumption or reduced serum levels could stimu late the autocrinal local secretion of IGF-I. Further investigation is, how ever, needed in order to confirm this hypothesis.