The effect of abdominal sepsis in the healing of skin on diabetic rats

Background/purpose: There is an increasing discussion concerning the deleterious effect of hyperglycemia on the wound healing.  Patients with sepsis are subjected not only to high risk of death, but are also vulnerable to developing problems related to deficient healing. The aim of this study was to examine the interference of abdominal sepsis and diabetes on the healing of skin in a rat experimental model. Methods : Wistar rats ( Rattus norvegicus ) weighing 282±34g randomly distributed into 4 groups of 6 animals each. Twelve animals were subjected to abdominal sepsis with cecal ligation and puncture (CLP) and 12 without sepsis. Six animals from each subgroup had induction of diabetes induced with streptozotocin 50 mg/kg, i.p. and six were non-diabetic. Six days after sepsis induction, a tensile strength test of skin scar from  abdominal wall and histopatology of skin wound were carried out. Results: The tensile strength showed a significant difference between groups. The control group rats had a tensile strength of 219.0±12.4 gf/cm2, significantly higher than in the diabetes group (185.2±5,9gf/cm2) and in the sepsis group (107.0±9,8mg/cm2) respectively. The group of animals subjected to sepsis + diabetes had the lowest mean tensile strength (86.3±6,6gf/cm2), significantly lower than the results from other groups (p<0.0001). The isolated sepsis was more detrimental to wound healing than the isolated diabetes. The existence of the two comorbidities resulted in the lower tensile strength of the scar tissue. The control group rats exhibited an inflammatory reaction score (4.67±0.16) significantly lower (p=0.002) than the scores exhibited by the sepsis + diabetes group (5.98 ± 0.27), the sepsis group (5.04 ± 0.23) and the diabetes group (4.95 ± 0.32). Conclusion: Sepsis and diabetes, alone or in combination, negatively influenced the healing of skin wounds in rats. Therefore, the data indicates that sepsis and diabetes may operate as deleterious to the wound healing.