Original ArticleMicrodeformational Wound Therapy Effects on Angiogenesis and Matrix Metalloproteinases in Chronic Wounds of 3 Debilitated PatientsGreene, Arin K. MD, MMSc*; Puder, Mark MD, PhD†; Roy, Roopali PhD†; Arsenault, Danielle BS†; Kwei, Stephanie MD*; Moses, Marsha A. PhD†; Orgill, Dennis P. MD, PhD*Author Information From the *Division of Plastic Surgery, Harvard Plastic Surgery Program, Brigham and Women's Hospital, Boston, MA; and the †Department of Surgery, Vascular Biology Program, Children's Hospital Boston, Harvard Medical School, Boston, MA. Received October 20, 2005, and accepted for publication, after revision, December 28, 2005. This work was supported by National Institutes of Health grants CA83106, CA4558, and DK065298 (MAM) as well as 1K08DK069621-01 (MP). Reprints: Dennis P. Orgill, MD, PhD, Division of Plastic Surgery, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115. E-mail: [email protected]. Annals of Plastic Surgery: April 2006 - Volume 56 - Issue 4 - p 418-422 doi: 10.1097/01.sap.0000202831.43294.02 Buy Metrics AbstractIn Brief The vacuum-assisted closure (VAC) device causes microdeformations of the wound surface in contact with the foam. Because angiogenesis and matrix metalloproteinase (MMP) activity are altered in chronic wounds, we hypothesized that microdeformations stimulate capillary formation and affect MMP activity. A VAC device was used to deliver microdeformational wound therapy (MDWT) to the chronic wounds of 3 debilitated patients. Debrided tissue was obtained from wound areas with and without foam contact. Microvessel density and MMP activity were determined by immunohistochemistry and zymography, respectively. Microvessel density of MDWT-treated wounds was 4.5% (±0.8) compared with areas not covered by foam [1.6% (±0.1)] (P = 0.05) during the first week of treatment and 2.7% (±0.3) compared with untreated tissue [1.3% (±0.1)] (P = 0.03) during the second treatment week. Wounds subjected to MDWT had greater microvessel density compared with the same wound prior to treatment [1.5% (±0.3)] (P = 0.02). MMP-9/NGAL (neutrophil gelatinase-associated lipocalin), MMP-9, latent MMP-2, and active MMP-2 were reduced by 15%–76% in MDWT-treated wounds. MDWT provides a favorable wound-healing environment by increasing angiogenesis and decreasing MMP activity in chronic wounds. Wound biopsies of 3 debilitated patients were treated using VAC therapy with or without contact foam. Those treated with foam demonstrated greater capillary density and diminished MMP activity, suggesting greater microdeformational activity. © 2006 Lippincott Williams & Wilkins, Inc.