Topical insulin improves postoperative wound healing in controlled diabetic patients through regulating the expression of E-Cadherin and Ki67: an open-label randomized controlled-trial
Abstract Background Diabetic patients are at a significantly higher risk of delayed and impaired wound healing, with increased susceptibility to wound infections and dehiscence. The pathophysiology of abnormal wound healing in diabetes is multifactorial, involving impaired vascularization, reduced c...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SpringerOpen
2025-06-01
|
| Series: | Future Journal of Pharmaceutical Sciences |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s43094-025-00830-6 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849420547047292928 |
|---|---|
| author | Mahmoud Ahmed Khattab Omnia Azmy Nabeh Sara Adel Mahmoud Abdelazeem Mohamed M. Naser Lamiaa Mohammed Matter |
| author_facet | Mahmoud Ahmed Khattab Omnia Azmy Nabeh Sara Adel Mahmoud Abdelazeem Mohamed M. Naser Lamiaa Mohammed Matter |
| author_sort | Mahmoud Ahmed Khattab |
| collection | DOAJ |
| description | Abstract Background Diabetic patients are at a significantly higher risk of delayed and impaired wound healing, with increased susceptibility to wound infections and dehiscence. The pathophysiology of abnormal wound healing in diabetes is multifactorial, involving impaired vascularization, reduced cellular proliferation, and prolonged inflammation, all associated with hyperglycemia. This randomized controlled trial (ClinicalTrials.gov registration: NCT06400082) included 74 type 2 diabetic patients undergoing elective abdominal surgeries with wound lengths ≥ 10 cm. Patients were randomized into two equal groups to receive either topical saline dressings or topical regular insulin. Wound dressing and assessments were performed daily until complete closure. Outcomes included percentage reduction in wound surface area, healing days, and unit healing time (UHT). Skin sections were collected on days 0 and 7 to evaluate e-cadherin, Ki67, IL-6, 8-hydroxy-2’-deoxyguanosine (8-OHdG), and histological architecture. Results Topical insulin significantly enhanced wound healing outcomes, demonstrating a greater percentage reduction in wound surface area (p < 0.001) and a lower UHT at day 7 in the insulin group (4450.00 [3000.00–5460.00]) compared to the saline group (2594.00 [2090.00–7560.00]), p = 0.001). Insulin-treated wounds exhibited increased tissue expression of collagen, e-cadherin, and Ki67, along with significantly reduced levels of IL-6 and 8-OHdG (p < 0.05). Conclusion Topical insulin is a promising therapeutic strategy for improving postoperative wound healing in diabetic patients. It enhances tissue repair by modulating inflammation, oxidative stress, and cellular proliferation. |
| format | Article |
| id | doaj-art-d958497d70444bb2b1bddc23536f8f7f |
| institution | Kabale University |
| issn | 2314-7253 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Future Journal of Pharmaceutical Sciences |
| spelling | doaj-art-d958497d70444bb2b1bddc23536f8f7f2025-08-20T03:31:44ZengSpringerOpenFuture Journal of Pharmaceutical Sciences2314-72532025-06-0111111210.1186/s43094-025-00830-6Topical insulin improves postoperative wound healing in controlled diabetic patients through regulating the expression of E-Cadherin and Ki67: an open-label randomized controlled-trialMahmoud Ahmed Khattab0Omnia Azmy Nabeh1Sara Adel2Mahmoud Abdelazeem3Mohamed M. Naser4Lamiaa Mohammed Matter5Department of Medical Pharmacology, Faculty of Medicine Kasr Alainy, Cairo UniversityDepartment of Medical Pharmacology, Faculty of Medicine Kasr Alainy, Cairo UniversityHistology Department, Faculty of Medicine Kasr Alainy, Cairo UniversitySurgery Department, Faculty of Medicine Kasr Alainy, Cairo UniversityFaculty of Medicine Kasr Alainy, Cairo UniversityDepartment of Medical Pharmacology, Faculty of Medicine Kasr Alainy, Cairo UniversityAbstract Background Diabetic patients are at a significantly higher risk of delayed and impaired wound healing, with increased susceptibility to wound infections and dehiscence. The pathophysiology of abnormal wound healing in diabetes is multifactorial, involving impaired vascularization, reduced cellular proliferation, and prolonged inflammation, all associated with hyperglycemia. This randomized controlled trial (ClinicalTrials.gov registration: NCT06400082) included 74 type 2 diabetic patients undergoing elective abdominal surgeries with wound lengths ≥ 10 cm. Patients were randomized into two equal groups to receive either topical saline dressings or topical regular insulin. Wound dressing and assessments were performed daily until complete closure. Outcomes included percentage reduction in wound surface area, healing days, and unit healing time (UHT). Skin sections were collected on days 0 and 7 to evaluate e-cadherin, Ki67, IL-6, 8-hydroxy-2’-deoxyguanosine (8-OHdG), and histological architecture. Results Topical insulin significantly enhanced wound healing outcomes, demonstrating a greater percentage reduction in wound surface area (p < 0.001) and a lower UHT at day 7 in the insulin group (4450.00 [3000.00–5460.00]) compared to the saline group (2594.00 [2090.00–7560.00]), p = 0.001). Insulin-treated wounds exhibited increased tissue expression of collagen, e-cadherin, and Ki67, along with significantly reduced levels of IL-6 and 8-OHdG (p < 0.05). Conclusion Topical insulin is a promising therapeutic strategy for improving postoperative wound healing in diabetic patients. It enhances tissue repair by modulating inflammation, oxidative stress, and cellular proliferation.https://doi.org/10.1186/s43094-025-00830-6DiabetesE-cadherinHealingInsulin, Ki67Postoperative wound |
| spellingShingle | Mahmoud Ahmed Khattab Omnia Azmy Nabeh Sara Adel Mahmoud Abdelazeem Mohamed M. Naser Lamiaa Mohammed Matter Topical insulin improves postoperative wound healing in controlled diabetic patients through regulating the expression of E-Cadherin and Ki67: an open-label randomized controlled-trial Future Journal of Pharmaceutical Sciences Diabetes E-cadherin Healing Insulin, Ki67 Postoperative wound |
| title | Topical insulin improves postoperative wound healing in controlled diabetic patients through regulating the expression of E-Cadherin and Ki67: an open-label randomized controlled-trial |
| title_full | Topical insulin improves postoperative wound healing in controlled diabetic patients through regulating the expression of E-Cadherin and Ki67: an open-label randomized controlled-trial |
| title_fullStr | Topical insulin improves postoperative wound healing in controlled diabetic patients through regulating the expression of E-Cadherin and Ki67: an open-label randomized controlled-trial |
| title_full_unstemmed | Topical insulin improves postoperative wound healing in controlled diabetic patients through regulating the expression of E-Cadherin and Ki67: an open-label randomized controlled-trial |
| title_short | Topical insulin improves postoperative wound healing in controlled diabetic patients through regulating the expression of E-Cadherin and Ki67: an open-label randomized controlled-trial |
| title_sort | topical insulin improves postoperative wound healing in controlled diabetic patients through regulating the expression of e cadherin and ki67 an open label randomized controlled trial |
| topic | Diabetes E-cadherin Healing Insulin, Ki67 Postoperative wound |
| url | https://doi.org/10.1186/s43094-025-00830-6 |
| work_keys_str_mv | AT mahmoudahmedkhattab topicalinsulinimprovespostoperativewoundhealingincontrolleddiabeticpatientsthroughregulatingtheexpressionofecadherinandki67anopenlabelrandomizedcontrolledtrial AT omniaazmynabeh topicalinsulinimprovespostoperativewoundhealingincontrolleddiabeticpatientsthroughregulatingtheexpressionofecadherinandki67anopenlabelrandomizedcontrolledtrial AT saraadel topicalinsulinimprovespostoperativewoundhealingincontrolleddiabeticpatientsthroughregulatingtheexpressionofecadherinandki67anopenlabelrandomizedcontrolledtrial AT mahmoudabdelazeem topicalinsulinimprovespostoperativewoundhealingincontrolleddiabeticpatientsthroughregulatingtheexpressionofecadherinandki67anopenlabelrandomizedcontrolledtrial AT mohamedmnaser topicalinsulinimprovespostoperativewoundhealingincontrolleddiabeticpatientsthroughregulatingtheexpressionofecadherinandki67anopenlabelrandomizedcontrolledtrial AT lamiaamohammedmatter topicalinsulinimprovespostoperativewoundhealingincontrolleddiabeticpatientsthroughregulatingtheexpressionofecadherinandki67anopenlabelrandomizedcontrolledtrial |