Effect of Vacuum-Assisted Closure Combined with Open Bone Grafting to Promote Rabbit Bone Graft Vascularization

Background Patients with composite bone non-union and soft tissue defects are difficult to treat. Vacuum-assisted closure (VAC) combined with open bone grafting is one of the most effective treatments at present. The aim of the present study was to preliminarily investigate the effect and mechanism of VAC combined with open bone grafting to promote rabbit bone graft vascularization, and to propose a theoretical basis for clinical work. Material/Methods Twenty-four New Zealand white rabbits were randomly divided into an experimental and a control group. Allogeneic bones were grafted and banded with the proximal femur with a suture. The experimental group had VAC whereas the control group had normal wound closure. The bone vascularization rate was compared based on X-ray imaging, fluorescent bone labeling (labeled tetracycline hydrochloride and calcein), calcium content in the callus, and expression of fibroblast growth factor-2 (FGF-2) in bone allografts by Western blot analysis at the 4th, 8th, and 12th week after surgery. Results At the 4th, 8th, and 12th week after surgery, the results of the tests demonstrated that the callus was larger, contained more calcium (p<0.05), and expressed FGF-2 at higher levels (p<0.05) in the experimental group than in the control group. Fluorescent bone labeling showed the distance between the two fluorescent ribbons was significantly shorter in the control group than in the experimental group at the 8th and 12th week after surgery. Conclusions VAC combined with open bone grafting promoted rabbit bone graft vascularization.

[1]  J. Hartman,et al.  Use of Incisional Negative Pressure Wound Therapy on Closed Median Sternal Incisions after Cardiothoracic Surgery: Clinical Evidence and Consensus Recommendations , 2014, Medical science monitor : international medical journal of experimental and clinical research.

[2]  H. Bae,et al.  Prolyl Isomerase Pin1-mediated Conformational Change and Subnuclear Focal Accumulation of Runx2 Are Crucial for Fibroblast Growth Factor 2 (FGF2)-induced Osteoblast Differentiation* , 2014, The Journal of Biological Chemistry.

[3]  L. Charles,et al.  Fibroblast growth factor-2 isoform (low molecular weight/18 kDa) overexpression in preosteoblast cells promotes bone regeneration in critical size calvarial defects in male mice. , 2014, Endocrinology.

[4]  Wei Jin,et al.  One-stage reconstruction with open bone grafting and vacuum-assisted closure for infected tibial non-union , 2013, Archives of medical science : AMS.

[5]  A. Mavrogenis,et al.  Papineau debridement, Ilizarov bone transport, and negative-pressure wound closure for septic bone defects of the tibia , 2014, European Journal of Orthopaedic Surgery & Traumatology.

[6]  Zonghuan Li,et al.  Combination of negative pressure wound therapy with open bone grafting for bone and soft tissue defects. , 2013, Molecular medicine reports.

[7]  Bin Yu,et al.  Free flap transplantation combined with skin grafting and vacuum sealing drainage for repair of circumferential or sub-circumferential soft-tissue wounds of the lower leg , 2013, Medical science monitor : international medical journal of experimental and clinical research.

[8]  M. Hurley,et al.  Fibroblast growth factor-2, bone homeostasis and fracture repair. , 2013, Current pharmaceutical design.

[9]  Chunbo Yang,et al.  Reconstruction of orbital defects by implantation of antigen-free bovine cancellous bone scaffold combined with bone marrow mesenchymal stem cells in rats , 2013, Graefe's Archive for Clinical and Experimental Ophthalmology.

[10]  B. Oh,et al.  Comparison of negative pressure wound therapy and secondary intention healing after excision of acral lentiginous melanoma on the foot , 2013, British Journal of Dermatology.

[11]  Xueyong Li,et al.  Treatment of Infected Soft Tissue Blast Injury in Swine by Regulated Negative Pressure Wound Therapy , 2013, Annals of surgery.

[12]  M. Kurosaka,et al.  Local Transplantation of Ex Vivo Expanded Bone Marrow-Derived CD34-Positive Cells Accelerates Fracture Healing , 2012, Cell transplantation.

[13]  C. Alfano,et al.  Evaluation of negative pressure vacuum-assisted system in acute and chronic wounds closure: our experience. , 2012, Il Giornale di chirurgia.

[14]  W. Obremskey,et al.  Use of Negative‐pressure Wound Therapy in Orthopaedic Trauma , 2012, The Journal of the American Academy of Orthopaedic Surgeons.

[15]  D. Alhan,et al.  THE ROLE OF NEGATIVE PRESSURE WOUND THERAPY IN THE TREATMENT OF FOURTH-DEGREE BURNS , 2012 .

[16]  A. Blum,et al.  Vascular inflammation and endothelial dysfunction in fracture healing. , 2012, American journal of orthopedics.

[17]  Wade R. Smith,et al.  Delayed flap reconstruction with vacuum-assisted closure management of the open IIIB tibial fracture. , 2011, The Journal of trauma.

[18]  P. Bordei Locally applied platelet-derived growth factor accelerates fracture healing. , 2011, The Journal of bone and joint surgery. British volume.

[19]  S. Hajdu,et al.  Elevated transforming growth factor-beta 1 (TGF-β1) levels in human fracture healing☆ , 2011, Injury.

[20]  T. Zgonis,et al.  Combined distraction osteogenesis and Papineau technique for an open fracture management of the distal lower extremity. , 2010, Clinics in podiatric medicine and surgery.

[21]  M. Bumbasirevic,et al.  War-related infected tibial nonunion with bone and soft-tissue loss treated with bone transport using the Ilizarov method , 2010, Archives of Orthopaedic and Trauma Surgery.

[22]  Georg N Duda,et al.  Differential regulation of blood vessel formation between standard and delayed bone healing , 2009, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[23]  R E Horch,et al.  Evaluation of processed bovine cancellous bone matrix seeded with syngenic osteoblasts in a critical size calvarial defect rat model , 2006, Journal of cellular and molecular medicine.

[24]  D. Orgill,et al.  Lower Extremity Trauma: Trends in the Management of Soft-Tissue Reconstruction of Open Tibia-Fibula Fractures , 2006, Plastic and reconstructive surgery.

[25]  R. Marti,et al.  Long-term results of multiple-stage treatment for posttraumatic osteomyelitis of the tibia. , 2004, The Journal of trauma.

[26]  C. Ratliff,et al.  Quantifying Bacterial Bioburden During Negative Pressure Wound Therapy: Does the Wound VAC Enhance Bacterial Clearance? , 2004, Annals of plastic surgery.

[27]  L. Papineau,et al.  Ostéomyélite chronique: excision et greffe de spongieux à l'air libre après mises à plat extensives , 2004, International Orthopaedics.

[28]  C. Cohen,et al.  Vacuum‐Assisted Closure in the Treatment of Complex Gynecologic Wound Failures , 2002, Obstetrics and gynecology.

[29]  M. Hinsenkamp,et al.  Treatment of chronic osteomyelitis using the Papineau technique , 1998, International Orthopaedics.

[30]  V. Vécsei,et al.  The use of negative pressure to promote the healing of tissue defects: a clinical trial using the vacuum sealing technique. , 1997, British journal of plastic surgery.

[31]  M. Saleh,et al.  Circular frames in the management of infected tibial non-union: a modification of the Papineau technique. , 1996, Injury.

[32]  A. Emami,et al.  Infected tibial nonunion. Good results after open cancellous bone grafting in 37 cases. , 1995, Acta orthopaedica Scandinavica.

[33]  R. Sherman,et al.  Results of bone grafting for infected tibial nonunion. , 1995, Clinical orthopaedics and related research.

[34]  C. Shih,et al.  Semiopen cancellous bone grafting. A 2 step method for closing small infected tibial bone defects. , 1994, Clinical orthopaedics and related research.

[35]  L. Kinzl,et al.  [Vacuum sealing as treatment of soft tissue damage in open fractures]. , 1993, Der Unfallchirurg.

[36]  E. E. Johnson,et al.  The treatment of infected nonunions and segmental defects of the tibia by the methods of Ilizarov. , 1992, Clinical orthopaedics and related research.

[37]  A. Minami,et al.  Treatment of Infected Segmental Defect of Long Bone with Vascularized Bone Transfer , 1992, Journal of reconstructive microsurgery.

[38]  J. Shuster,et al.  The influence of skeletal implants on incidence of infection. Experiments in a canine model. , 1985, The Journal of bone and joint surgery. American volume.

[39]  J F Connolly,et al.  A multicenter study of the treatment of non-union with constant direct current. , 1981, The Journal of bone and joint surgery. American volume.

[40]  L. Papineau,et al.  [Chronic osteomyelitis: open excision and grafting after saucerization (author's transl)]. , 1979, International orthopaedics.

[41]  C. Brighton,et al.  Direct-current stimulation of non-union and congenital pseudarthrosis. Exploration of its clinical application. , 1975, The Journal of bone and joint surgery. American volume.

[42]  Papineau Lj [Excision-graft with deliberately delayed closing in chronic osteomyelitis]. , 1973 .

[43]  L. Papineau [Excision-graft with deliberately delayed closing in chronic osteomyelitis]. , 1973, La Nouvelle presse medicale.