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CC BY-NC-ND 4.0 · Arch Plast Surg 2022; 49(02): 275-284
DOI: 10.1055/s-0042-1744427
Research/Experimental
Original Article

Novel Three-Dimensional Knitted Fabric for Pressure Ulcer Prevention: Preliminary Clinical Application and Testing in a Diabetic Mouse Model of Pressure Ulcers

Sungae Kim
1   Department of Dermatology, Keimyung University School of Medicine, Dalseo-gu, Korea
,
Jamin Hong
2   Department of Plastic and Reconstructive Surgery, Keimyung University School of Medicine, Dalseo-gu, Korea
,
Yongseong Lee
3   Department of Research and Development, Song-i Textile Co., Ltd, Daegu, Korea
,
Daegu Son
2   Department of Plastic and Reconstructive Surgery, Keimyung University School of Medicine, Dalseo-gu, Korea
› Institutsangaben Funding This work was supported by the R&D Program (S2097930) funded by the Small and Medium Business Administration (SMBA, Korea).
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Abstract

Background Population aging has led to an increased incidence of pressure ulcers, resulting in a social burden and economic costs. We developed a three-dimensional knitted fabric (3-DKF) with a pressure-reducing function that can be applied topically in the early stages of pressure ulcers to prevent progression.

Methods We evaluated the effects of the 3-DKF in a streptozotocin-induced diabetes mellitus pressure ulcer mouse model, and the fabric was preliminarily applied to patients. Twelve-week-old male C57BL/6 mice were used for the animal experiments. In the pressure ulcer mouse model, an ischemia-reperfusion injury was created using a magnet on the dorsa of the mice. Pressure was measured with BodiTrak before and after applying the 3-DKF to 14 patients at risk of sacral pressure ulcers.

Results In the 3-DKF-applied mice group, the ulcers were shallower and smaller than those in the control group. Compared with the mice in the control group, the 3-DKF group had lower platelet-derived growth factor-α and neutrophil elastase expression, as parameters related to inflammation, and increased levels of transforming growth factor (TGF)-β1, TGF-β3, proliferating cell nuclear antigen, and α-smooth muscle actin, which are related to growth factors and proliferation. Additionally, typical normal tissue staining patterns were observed in the 3-DKF group. In the preliminary clinical analysis, the average skin pressure was 26.2 mm Hg before applying the 3-DKF, but it decreased to an average of 23.4 mm Hg after 3-DKF application.

Conclusion This study demonstrated that the newly developed 3-DKF was effective in preventing pressure ulcers through testing in a pressure ulcer animal model and preliminary clinical application.

Keywords

diabetes complications - pressure ulcer - streptozotocin - polyesters

Author Contributions

S.K. analyzed and interpreted the data and wrote the manuscript. J.H. collected the data and revised the manuscript. Y.L. designed and manufactured the experimental material. D.S. conceived the study, provided the experimental design, and supervised the entire drafting and revision process of the manuscript.


Ethical Approval

The animal experimental protocols were approved by the Animal Experiments Ethics Committee of Keimyung University School of Medicine (approval number: KM-2015–4R1) and complied with the Guide for Care and Use of Laboratory Animals of Keimyung University School of Medicine.




Publikationsverlauf

Artikel online veröffentlicht:
06. April 2022

© 2022. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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