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Pressure ulcers
Pressure injuries
Animal studies
Diabetic foot ulcers

Histological and clinical evaluation of wound healing in pressure ulcers: a novel animal model

01 June 2021
Research

Abstract

Objective:

Pressure ulcers (PUs) are a major healthcare problem, commonly associated with older people, patients who are bedbound and patients with diabetes. The impact of PUs can decrease patients' quality of life, and lead to high morbidity and mortality rates. In this study, we aimed to describe a novel PU model that simulates pressure ulcers in humans to provide a research tool for new drug testing.

Method:

Diabetes was induced using streptozocin in 75 adult Sprague Dawley rats. To create the PU, skin was sandwiched between two magnets, one of them implanted below the panniculus carnosus muscle and the other above the skin. The model was tested on nondiabetic rats and diabetic rats, each with pressure ulcers, compared to nondiabetic rats with excisional wounds.

Results:

Results showed that the PU model in diabetic (p-value<0.000001) and non-diabetic rats (p-value<0.05) exhibited significantly delayed healing (no healing over 21 days) compared with the excisional wound that was completely healed by day 21.

Conclusion:

Diabetic rats showed significant changes in intact skin compared with non-diabetic rats, as well as a significant delay in the healing process compared with the non-diabetic group. By effectively impairing the skin contraction otherwise seen in the rats, and thereby delaying healing and making it similar to that seen in hard-to-heal PUs in humans, this model provides an effective tool for wound healing research.

Pressure ulcers (PUs) are major complications of chronic diseases such as diabetes, venous and arterial insufficiency, and dysfunction of the microvascular system.1,2,3 Over the past few decades, the prevalence of hard-to-heal ulcers has dramatically increased, creating a huge financial burden on healthcare systems.4,5 As the prevalence of diabetes increases, the incidence of diabetic complications is expected to increase.6,7,8,9,10

The main causative factors involved in the pathogenesis of PUs are mechanical pressure, shear and friction forces, and moisture.11 The normal healing process of the skin is characterised by the following phases: coagulation, acute inflammation, proliferation and remodelling.11 In hard-to-heal ulcers, the healing process is impaired due to tissue ischaemia, poor lymphatic drainage and infection, which eventually impairs granulation tissue formation and prolongs wound repair. Here, we focus mainly on hard-to-heal PUs in uncontrolled diabetes.

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animal wound model
diabetic ulcer
pressure ulcer
wound healing