Effects of local use of insulin on wound healing in non-diabetic patients [Les effets de l’utilisation localisée d’insuline sur la guérison des plaies des patients non diabétiques]
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Background: Clinical trials have shown the positive effects of local insulin therapy in the formation of new vessels and fibrosis in acute and chronic diabetic wounds without major adverse effects. Objective: The aim of this study was to investigate the effects of local insulin use on wound healing in non-diabetic patients. Methods: A randomized, split-plot, double-blind, placebocontrolled trial was conducted. Ten non-diabetic patients with full-thickness acute wounds were recruited (5 due to trauma, 3 to burns, and 2 to pressure). All wounds received standard bedside treatment. Each wound was divided into 2 zones. One side received a standard care plus insulin, while the other received standard care plus injection of saline solution. A biopsy specimen was taken from both sites on days 0 and 14. The amount of blood vessel growth and the percentage of fibrosis were evaluated. Results: A significant difference in the number of new vessels was observed on the insulin-treated site (70.6 [29.21]) compared to saline only (26.5 [34.3]; P <.04). The percentage of fibrosis (insulin 34.7 [28.02] vs saline 27.8 [29.9]) showed no significant difference. No adverse events related to the study occurred. The clinical implications of this study are considerable in terms of the formation of blood vessels but not fibrosis. Conclusion: We suggest that local insulin administration is a safe therapeutic option for angiogenesis in wounds of non-diabetic patients. © 2018 The Author(s).
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Angiogenesis; Fibrosis; Granulation tissue; Insulin; Wound healing
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