A Prospective Study of Clinical Factors (BMI, DM) In?uencing Healing of Abdominal Incisions Correlated with Tissue Expression of MMP2, MMP9 and TIMP

Clinical Factors Influencing Healing of Abdominal Incisions

Abstract

Background: There is a dynamic and reciprocal interaction among ECM and involving cells, cytokines, growth factors and proteases (MMP/TIMP). The controlled degradation of ECM by extracellular proteases particularly MMP/TIMP and serene proteases forms the basis of wound healing. To study clinical factors (BMI, DM) influencing healing of acute abdominal surgical wounds as graded by tissue expression of MMP 2, MMP 9 and TIMP. Subjects and Methods: The present study was conducted in 46 patients in the Department of General Surgery, Kamineni Hospitals, L.B. Nagar, Hyderabad. Results: Type II DM was found in 63 % of patients and found to be having significantly affecting wound healing (p = 0.0017). Wound healing was delayed in uncontrolled DM. Diabetics with healed wound had increased expression of MMP-2 and decreased expression of MMP-9 while Diabetics with non-healed had strong expression of MMP-9 and TIMP as compared to MMP-2. Obesity was seen in 47.82 % of patients and significantly affected wound healing (p = 0.0022). Obese patients with healed wounds had increased expression of MMP-2 and MMP 9 with decreased TIMP levels. Conclusion: The present study strongly supported tissue expression of MMP-2, MMP-9 and TIMP 2 balance between 7-14 days as a good predictor of wound healing in abdominal laprotomy wounds.