Journal time. In the latest December 2013 issue of Plastic and Reconstructive Surgery Journal there was another racy article, “Local Use of Insulin in Wounds of Diabetic Patients: Higher Temperature, Fibrosis, and Angiogenesis.” I know, quite a title. But what it is looking at is important.
Diabetes impairs blood flow. We surgeons know diabetics have a harder time healing their wounds. Diabetic patients are at increased risk for wound healing problems, infections, and tissue loss. Studies have shown there is impaired angiogenesis (which means you don’t make new blood vessels to bring blood to the area, which is what helps the tissue heal.) So this study was thoughtful- if you inject insulin in to the healing area, does that help?
Study:
This was a study out of Mexico and Texas. It involved eight diabetic patients with full thickness wounds. They were all treated with regular bedside treatments, but half of the wound got insulin, and the other half did not.
Thermographic and biopsy specimens were taken at days 0 and 14. They looked for presence of fibrosis, change in temperature, and amount of blood.
Findings?
- Significant differences in the number of blood vessels were seen on the insulin treated side.
- Fibrosis was much higher
- And mean temperature was also higher
- There were no adverse events.
So?
This study shows the use of local insulin improves the formation of new blood vessels, increases fibrosis, and has increased temperature. These are all great things for healing. It is a small study, and further research needs to be done before you can do this on a larger stage. Will we someday inject insulin into our abdominoplasty incisions for our diabetic patients to help them heal? It is an interesting thought and question.