Moist-Exposed Burn Ointment Promotes Angiogenesis During Full-Thickness Wound Healing by Activating the SDF-1/CXCR4 Axis in a Hyperglycaemic Rat Model.

The mechanism by which moist-exposed burn ointment (MEBO) promotes wound healing in diabetic foot ulcers (DFUs) remains unclear. To elucidate this mechanism, we investigated the role of stromal cell-derived factor-1 (SDF-1) in MEBO's ability to enhance ulcer healing and neovascularisation using a full-thickness wound model in hyperglycaemic rats. On post-wounding days 3, 7, and 14, the wound healing rates were significantly higher in the MEBO group compared to the model group and Vaseline group (p < 0.05). Additionally, the MEBO group exhibited increased epidermal layer thickness and enhanced collagen fibre deposition relative to the model group and Vaseline group (p < 0.05). Furthermore, the number of CD31-positive cells and microvascular density (MVD) were significantly elevated in the MEBO group compared to the model group and Vaseline group (p < 0.05). Flow cytometric analysis also demonstrated that the proportion of CD45-, CD34+, and VEGFR2+ cells in the wound area of the MEBO-treated group was significantly higher compared to the model group and Vaseline group. Expression levels of SDF-1, HIF-1α were also markedly higher in the MEBO group compared to the model group and Vaseline group (p < 0.05). Finally, a significant increase in double-positive CXCR4 and CD31 cells was observed exclusively in the MEBO group of hyperglycaemic rats (p < 0.05). These findings suggest that MEBO therapy promotes angiogenesis and accelerates wound healing through activation of the SDF-1/CXCR4 axis during wound healing in diabetics.