Effectiveness Evaluation of Microneedling Therapy for Diabetic Ulcer: An Animal Model Study

Abstract

Background:. Diabetic ulcer is an intractable complication seen in nearly 6% of diabetes patients. Some patients with diabetic ulcers cannot avoid femoral amputation by the current standard treatments. Therefore, a novel and effective radical cure therapy is needed. Microneedling is a widely applied wound-healing treatment in cosmetic medicine. In this study, we evaluated the therapeutic effects of microneedling on diabetic ulcers using an animal model. Methods:. Nine- to 10-week-old male C57BL/6J mice with drug-induced diabetes received full-thickness skin removal on the back. The mice with and without microneedling were classified into microneedling and nontreatment groups, respectively. The therapeutic effects of microneedling were assessed by wound closure rate by 14 days after the treatment and histological assessments in the wound. Results:. The wound closure rate was significantly higher in the microneedling group than in the nontreatment groups from 7 days after microneedling (wound closure rate: 63.0 ± 10.2% versus 36.6 ± 12.1%). Histological assessments revealed that microneedling induced infiltration of neutrophils and M1 macrophages into the microhemorrhage region within 12 hours. The macrophages shifted to M2 macrophages 4 days after microneedling. Hyperexpression of transforming growth factor beta 1 was confirmed 7 days after microneedling. After that, the promotion of collagen proliferation and neovascularization were seen 10 and 14 days after microneedling, respectively. Conclusions:. Our data clarified that microneedling was effective for wound healing in an animal model of diabetic ulcer. This study has limitations correlated with small animal models and acute surgical wounds. Future clinical trials are recommended.