Metalloproteinase Expression is Associated with Traumatic Wound Failure

Abstract

Matrix metalloproteinases (MMPs) are crucial in the inflammatory and remodeling phases of wound healing. We previously reported the correla tion between pro-inflammatory cytokines and timing of successful combat-wound closure. We now extend our studies to investigate the correlation between wound-remodeling MMP expression and wound healing. Methods. Thirty-eight wounds in 25 patients with traumatic extremity combat wounds were prospectively studied. Surgical debridement with vacuum-assisted closure (VAC) device application was repeated every 48 to 72h until surgical wound closure. Wound effluent and patient serum were collected at each wound debridement and analyzed for five matrix metalloproteinases using the Luminex multiplex system; Millipore Corp, Billerica, MA. The primary outcome was wound healing within 30 d of definitive wound closure. Impairment was defined as delayed wound closure ( > 21 d from injury) or wound dehiscence. MMP expression was com pared between impaired and normal healing wounds. Results. Elevated levels of serum MMP-2 and MMP-7 and reduced levels of effluent MMP3 were seen in im paired wounds (n = 9) compared with wounds that healed (n = 29;P < 0.001). Receiver operating characteristic (ROC) curve analysis yielded area-under-the-curve (AUC) of0.744, 0.783, and 0.805, respectively. Conclusions. Impaired wound healing is characterized by pro-inflammatory MMP-2 and MMP-7. Serum and effluent concentrations of MMP-2, MMP-3, and MMP-7 can effectively predict the outcome of 1 To whom correspondence and reprint requests should be addressed at Naval Medical Research Center, Regenerative Medicine Department, 503 Robert Grant Ave, Silver Spring, MD 20910. E-mail: Trevor.Brown@med.navy.mil. traumatic war wounds and can potentially provide decision-supportive, objective evidence for the timing of wound closure.

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Document Details

Document Type
Technical Report
Publication Date
Apr 01, 2010
Accession Number
ADA551689

Entities

People

  • Alexander Stojadinovic
  • Douglas K. Tadaki
  • Edward R Utz
  • Eric A. Elster
  • Frederick Gage
  • Jason S. Hawksworth
  • Jonathan A. Forsberg
  • Philip W. Perdue
  • Trevor S. Brown

Organizations

  • Naval Medical Research Center

Tags

DTIC Thesaurus Topics

  • Brain Injuries
  • Casualties
  • Combat Casualty Care
  • Combat Injuries
  • Debridement
  • Dermatologic Agents
  • Health Services
  • Medical Personnel
  • Statistical Analysis
  • Traumatic Amputation
  • Vascular System Injuries
  • Wound Healing
  • Wound Infections
  • Wounds And Injuries

Fields of Study

  • Medicine

Readers

  • Molecular Biology and Genetics
  • Trauma Surgery or Emergency Medicine.

Technology Areas

  • AI & ML