Compare the effectiveness of extracorporeal shockwave and hyperbaric oxygen therapy on enhancing wound healing in a streptozotocin‐induced diabetic rodent model

• Published in: The Kaohsiung journal of medical sciences Vol. 39; no. 11; pp. 1135 - 1144
• Main Authors: Chen, Rong‐Fu, Lin, Yun‐Nan, Liu, Keng‐Fan, Lee, Chia‐Chun, Hu, Chieh‐Ju, Wang, Chun‐Ting, Wang, Ching‐Jen, Kuo, Yur‐Ren
• Format: Journal Article
• Language: English
• Published: China (Republic : 1949- ) John Wiley & Sons, Inc 01.11.2023; Wiley Publishing Asia Pty Ltd; Wiley
• Subjects: Analysis; Angiogenesis; Animals; Antibodies; Biopsy; Care and treatment; Clinical trials; Diabetes; Diabetes Mellitus, Experimental - therapy; Diabetic Foot - diagnosis; Diabetic Foot - pathology; Diabetic Foot - therapy; diabetic foot ulcers; diabetic wound healing; Endothelium; extracorporeal shock‐wave therapy; Foot diseases; Glucose; Growth factors; High-Energy Shock Waves; hyperbaric oxygen therapy; Hyperbaric Oxygenation; Ki-67 Antigen; Laboratory animals; Leg ulcers; Neovascularization; Neovascularization, Pathologic; Nitric oxide; Original; Oxygen therapy; Performance evaluation; Rodentia - metabolism; Rodents; Skin; Streptozocin; Streptozocin - pharmacology; streptozotocin; Vascular endothelial growth factor; Vascular Endothelial Growth Factor A - genetics; Vascular Endothelial Growth Factor A - metabolism; Wound healing; Wound Healing - physiology; Wounds and injuries; Germany; Taiwan; diabetic foot ulcers; hyperbaric oxygen therapy; streptozotocin; extracorporeal shock-wave therapy; diabetic wound healing
• ISSN: 1607-551X; 2410-8650; 2410-8650
• DOI: 10.1002/kjm2.12746

Studies have revealed that both extracorporeal shock‐wave therapy (ESWT) and hyperbaric oxygen therapy (HBOT) can accelerate wound healing. This study aimed to compare the effectiveness of ESWT and HBOT in enhancing diabetic wound healing. A dorsal skin defect in a streptozotocin‐induced diabetes rodent model was used. Postoperative wound healing was assessed once every 3 days. Histologic examination was performed with hematoxylin and eosin staining. Proliferation marker protein Ki‐67 (Ki‐67), endothelial nitric oxide synthase (eNOS), vascular endothelial growth factor (VEGF), and 8‐hydroxy‐2‐deoxyguanosine (8‐OHdG) were evaluated with immunohistochemical (IHC) staining. The wound area was significantly reduced in the ESWT and HBOT groups compared to that in the diabetic controls. However, the wound healing time was significantly increased in the HBOT group compared to the ESWT group. Histological findings showed a statistical increase in neovascularization and suppression of the inflammatory response by both HBOT and ESWT compared to the controls. IHC staining revealed a significant increase in Ki‐67, VEGF, and eNOS but suppressed 8‐OHdG expression in the ESWT group compared to the HBOT group. ESWT facilitated diabetic wound healing more effectively than HBOT by suppressing the inflammatory response and enhancing cellular proliferation and neovascularization and tissue regeneration.