Key result
Type 2 diabetes linked to a ~14-fold greater risk of delayed wound healing after laparotomy.
Why the study?
Clinical factors such as BMI and diabetes mellitus influence healing of acute abdominal surgical wounds, but their correlation with tissue expression of MMP2, MMP9, and TIMP is not well characterized.
Do clinical factors (BMI, DM) influence healing of acute abdominal surgical wounds and correlate with tissue expression of MMP2, MMP9, and TIMP?
Observational (n=46)
No
Do clinical factors (BMI, DM) influence healing of acute abdominal surgical wounds and correlate with tissue expression of MMP2, MMP9, and TIMP?
Odds Ratio: 14.25 (95% CI 2.7032–75.1181)
Absolute Event Rate: 35% vs 11.76%
p-value: p=0.0017
Tissue expression of MMP-2, MMP-9, and TIMP between 7-14 days is a good predictor of wound healing in abdominal laparotomy wounds, which is significantly affected by diabetes and obesity.
DM and obesity were associated with delayed abdominal wound healing and distinct MMP/TIMP patterns; leaves open whether these markers predict outcomes or guide management in prospective cohorts.
Background: There is a dynamic and reciprocal interaction among ECM and involving cells, cytokines, growth factors and proteases (MMP/TIMP). The controlled degradation of ECM by extracellular proteases particularly MMP/TIMP and serene proteases forms the basis of wound healing. To study clinical factors (BMI, DM) influencing healing of acute abdominal surgical wounds as graded by tissue expression of MMP 2, MMP 9 and TIMP. Subjects and Methods: The present study was conducted in 46 patients in the Department of General Surgery, Kamineni Hospitals, L.B. Nagar, Hyderabad. Results: Type II DM was found in 63 % of patients and found to be having significantly affecting wound healing (p = 0.0017). Wound healing was delayed in uncontrolled DM. Diabetics with healed wound had increased expression of MMP-2 and decreased expression of MMP-9 while Diabetics with non-healed had strong expression of MMP-9 and TIMP as compared to MMP-2. Obesity was seen in 47.82 % of patients and significantly affected wound healing (p = 0.0022). Obese patients with healed wounds had increased expression of MMP-2 and MMP – 9 with decreased TIMP levels. Conclusion: The present study strongly supported tissue expression of MMP-2, MMP-9 and TIMP 2 balance between 7-14 days as a good predictor of wound healing in abdominal laprotomy wounds.
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Cholleti et al. (2020) conducted an observational in Acute abdominal surgical wounds (n=46). Type II Diabetes Mellitus vs. Non-diabetic patients was evaluated on Delayed wound healing (>2 weeks) (OR 14.25, 95% CI 2.7032-75.1181, p=0.0017). Type II diabetes mellitus significantly increased the risk of delayed wound healing in patients undergoing laparotomy (OR 14.25) compared to non-diabetic patients.
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