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BMC Genomics  2007 

A set of genes previously implicated in the hypoxia response might be an important modulator in the rat ear tissue response to mechanical stretch

DOI: 10.1186/1471-2164-8-430

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With the use of AE, the hypoxia gene set was the most important at a highly significant level. A co-expression network analysis showed that important co-regulated members of the hypoxia pathway include a glucose transporter (slc2a8), heme oxygenase, and nitric oxide synthase2 among others.It appears that the hypoxia pathway may be an important modulator of response of soft tissue to forces. This finding gives us insights not only into the underlying biology, but also into clinical interventions that could be designed to mimic within wounded tissue the effects of forces without all the negative effects that forces themselves create.Worldwide, wounds pose a major health issue. Lower extremity ulcers alone cost the US Medicare system $1.5 billion. Unless wound therapies see a large improvement, we will see escalating treatment costs and morbidity as the population ages and as the incidence of diabetes and obesity increases. An understanding of the mechanisms underlying wound healing will shed light on how normal physiology adapts to changes in the normal homeostatic environment. The vacuum assisted closure (VAC) device (KCI, San Antonio Texas) is a relatively new modality in wound healing. Although the device has been shown to accelerate wound healing, its mode of action remains to be proven convincingly. Figure 1 shows the application of the device. This involves packing a polyurethane sponge into the wound bed and then sealing the wound including the sponge with an occlusive dressing that has one outlet tube going to a vacuum (a vacuum of about 115 mmHg is applied through the tube). Theories about how this device obtains its efficacy range from a reduction in bacterial load [1] to a reduction in edema. The blowup in Figure 1 shows that with the application of the vacuum the skin is pulled into the intra-strut spacings of the sponge thereby stretching the skin.In an earlier publication, we have used a numerical model to show how the imposition of the vacuum forces the


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