Combining Negative Pressure Wound Therapy with Insulin Instillation Reduces Insulin Resistance and Accelerates Healing in Patients with Chronically Infected Wounds

Aim: This study aimed at evaluating the effects of negative pressure wound therapy (NPWT) combined with insulin instillation on wound healing and insulin resistance (IR) in patients with chronically infected wounds. Methods: Sixty-three patients were recruited and randomly divided into three groups (21 cases each) according to treatments: NPWT only; NPWT+insulin; and controls (conventional dressings). Both NPWT treatments lasted for three weeks. Thereafter, wounds’ healing conditions were assessed. At 1 day before and 7, 14, and 21 days posttreatment Interleukin- 6 (IL-6), Interleukin- 2 (IL-2), and Tumor Necrosis Factor-α (TNF-α) serum levels were assessed via specific double-antibody sandwich enzyme-linked immunosorbent assays; and plasma glucose and insulin were quantified via glucose-oxidase and radioimmunoassay, respectively. IR was appraised via homeostasis model assessment (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI). Results: At 7, 14, and 21 days after treatments onset the two NPWT groups had significantly (P = 0.0001) lower IL-6, IL-2, and TNF-α serum levels and HOMA-IR values than controls while wound healing rates were higher (P < 0.001) than controls. Notably, the NPWT+insulin treatment results were better (P < 0.01) than those of NPWT alone. Conclusion: NPWT+insulin instillation improved wound healing, mitigated inflammation, and reduced IR in patients with chronically infected wounds.