Effects of suspension moxibustion of different temperature on pressure ulcer wound repair via ultrastructure under transmission electron microscopy
Objective It is to observe the effects of suspension moxibustion of different temperature on the ultrastructure of pressure ulcer wounds in rats,and to clarify the optimal intervention temperature of the moxibustion in promoting the re-pair of pressure ulcer wounds,with a view to providing theoretical evidences for the treatment of pressure ulcers and chronic refractory wounds with moxibustion in clinic.Methods A total of 133 healthy adult female SD rats were taken,in which 3 rats were randomly selected as the blank control group,while the remaining 130 rats were used to establish models of stage 2-3 pressure ulcer by ischemia-reperfusion injury.The 125 successfully model rats were randomly divided into model control group,hydrogel group,low-temperature moxibustion intervention group,medium-temperature moxibustion intervention group and high-temperature moxibustion intervention group,with 25 rats in each group.The model control group and blank control group were treated with iodophor only;the hydrogel group were treated with iodophor and then covered with hydrogel wound dressing on the wounds;the low,medium,and high temperature moxibustion intervention groups were treated with iodophor and then were respectively treated with suspended moxibustion to the center of the wounds at 38-41 ℃,43-46 ℃,and 48-51 ℃(the surface temperature of skin wounds was detected by infrared camera),once daily,15 min per time.Af-ter 1,3,5,7,and 10 days of intervention,the ultrastructure of the pressure ulcer tissues in rats of each modeling group and the normal skin tissues of rats in the blank control group were observed undertransmission electron microscopy.Resutls Compared with the blank control group,the rats in each modeling group were suffered from epidermal detachment or damage and dermal damage after modeling.①Epidermal repair:the recovery of structure and function of the basal cells in the pres-sure ulcer wounds of the model control group were slower,and most of the basal cells were basically restored to normal only with fewer organelles whose function was low after 10 days of intervention.After 5 days of intervention,most of the basal cells in the low and majority of the basal cells in the medium temperature moxibustion group were basically restored to nor-mal,furthermore,the status of mitochondria in majority of the basal cells were good with clearer structure in the medium temperature group,after 10 days of intervention,the number of mitochondria in the basal cells were increased,with dense collagen fibers and complete newborn epidermis,the repair was superior to that of the low temperature group.After 5 days of intervention in the hydrogel group,the mitochondria in some basal cells was swelling;after 7 days,the organelles in most basal cells were increased,and the mitochondrial structure gradually returned to normal.After 7 days of intervention in the high temperature moxibustion group,some mitochondrial autophagy was found,which was slightly worse than that in the hydrogel group.②Dermal repair:after 5 days of intervention in the model control group,the dermis was highly infiltra-ted with inflammatory cells with degeneration of fibroblasts;after 7 days of intervention,there were still a few inflammatory cells in the dermis,with proliferation of fibroblasts and functional recovery,and a small number of collagen fibers were rel-atively dense;after 10 days,dermal fibroblasts proliferated significantly,there were lymphocytes in the dermis with recov-ery from dermal injury,and some of the collagen fibers were relatively dense.After 1 days of intervention in the medium temperature moxibustion intervention group,a large number of inflammatory cells infiltrated the dermis;after 5 days of in-tervention,non-fresh granulocytes infiltrated the dermis,a large number of fibroblasts were actively proliferating,and most of the collagen fibers were relatively dense;after 7 days of intervention,most of the dermal fibroblasts were increased and active,and collagen fibers were relatively dense;and after 10 days of intervention,the dermal fibroblasts were much ac-tive,and collagen fibers were dense.A similar trend was observed in the low temperature moxibustion group,dermal fibro-blasts also proliferated to different degrees,their functions were gradually restored,and collagen fibers were gradually densely arranged after 5,7,and 10 days of intervention in the hydrogel group and the high temperature moxibustion inter-vention group,but the repair situation was poorer than that in the medium-temperature group.Conclusion Moxibustion in-tervention of different temperatures and hydrogel can overall advance the peak of acute inflammatory infiltration in pressure ulcer wounds,promote the smooth transition of pressure ulcer wounds from the inflammatory injury stage to the proliferation and repair stage,and subsequently accelerate the pressure ulcer wound repair process.There were some differences in pres-sure ulcer wound repair after the intervention of different temperatures,among which 38-41 ℃ and 43-46 ℃ were more fa-vorable to promote the residual epidermal repair,neoepidermal generation and superficial dermal repair of pressure ulcer tissues,and the temperature of 43-46 ℃ was more advantageous.
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