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Pratheesh KV, Nair RS, Purnima C, Raj R, Mony MP, Geetha CS, Sobhan PK, Ramesan RM, Nair PD, Thomas LV, Anilkumar TV. An injectable hydrogel of porcine cholecyst extracellular matrix for accelerated wound healing. J Biomed Mater Res A 2024. [PMID: 39381970 DOI: 10.1002/jbm.a.37795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 08/28/2024] [Accepted: 08/31/2024] [Indexed: 10/10/2024]
Abstract
Hydrogel formulations of xenogeneic extracellular matrices have been widely used for topical wound care because of their exceptional tunability over other formulations like lyophilized sheets, powders, non-injectable gels, pastes, and ointments. This is important in the treatment of wounds with irregular shapes and depth. This study identified an injectable hydrogel formulation of porcine cholecyst extracellular matrix (60%) in medical-grade carboxymethyl cellulose (40%) as vehicle and evaluated its biomaterial properties. Further, an in-depth evaluation of in vivo wound healing efficacy was conducted in a rat full-thickness skin excision wound healing model, which revealed that the hydrogel formulation accelerated wound healing process compared to wounds treated with a commercial formulation and untreated wounds. The hydrogel appeared to have promoted a desirable pro-regenerative tissue reaction predominated by Th2 helper lymphocytes and M2 macrophages as well as an effective collagen remodeling indicative of diminished scarring. In conclusion, the porcine cholecyst extracellular matrix injectable hydrogel formulation appeared to be a promising candidate formulation as an advanced wound care biomaterial for faster healing of skin wounds with minimal scarring.
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Affiliation(s)
- Kanakarajan V Pratheesh
- Division of Experimental Pathology, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India
| | - Reshma S Nair
- Division of Experimental Pathology, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India
| | - Chandramohanan Purnima
- Division of Experimental Pathology, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India
| | - Reshmi Raj
- Division of Experimental Pathology, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India
| | - Manjula P Mony
- Division of Experimental Pathology, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India
| | - Chandrika S Geetha
- Division of Experimental Pathology, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India
| | - Praveen K Sobhan
- Division of Tissue Culture, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India
| | - Rekha M Ramesan
- Division of Biosurface Technology, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India
| | - Prabha D Nair
- Division of Tissue Engineering and Regeneration Technologies, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India
| | - Lynda V Thomas
- Division of Tissue Engineering and Regeneration Technologies, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India
| | - Thapasimuthu Vijayamma Anilkumar
- Division of Experimental Pathology, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India
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Zhang Y, Lei Z, Lin B, Lin Z, Dong Y, Ren P, Li X, Bian Y, Zhao C. Split-level folding, step-type tension-relieving suture technique, and the evaluation on scar minimization. J Cosmet Dermatol 2024; 23:2199-2208. [PMID: 38400620 DOI: 10.1111/jocd.16236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 01/21/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND Prevailing tension-reducing suture methods have a spectrum of issues. This study presents a straightforward yet highly efficacious suture technique known as the Split-level Folding, Step-type Tension-relieving Suture technique, which could play a pivotal role in preempting incisional scarring. AIMS To introduce Split-level Folding, Step-type Tension-relieving Suture technique and assess its effect on scar minimization. METHODS A retrospective analysis of 64 patients who underwent treatment utilizing the proposed suturing methodology. Assessment parameters included the Patient and Observer Scar Assessment Scale (POSAS), the Vancouver Scar Scale (VSS), scar width, complications, and all evaluated at 6- and 12-month postoperatively. RESULTS At 12-month follow-up, the POSAS and VSS scores in the normal suture group (32.58 ± 5.43, 3.58 ± 1.39) were considerably higher than the step-type suture group (29.75 ± 3.56, p = 0.0007; 2.78 ± 1.17, p = 0.0006). Moreover, the step-type suture group showcased a significantly narrower average incision scar width (1.62 ± 0.36) than the normal suture group (1.87 ± 0.42, p = 0.0004). This novel tension-relieving suture technique that effectively circumvents the occurrence of persistent localized eversion and other complications often associated with traditional tension-relieving sutures. CONCLUSIONS The Split-level Folding, Step-type Tension-relieving Suture technique emerges as a highly promising option for averting incisional scarring. This suture method works well for incisions on the chest, back, and extremities, resulting in significantly better long-term outcomes.
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Affiliation(s)
- Yuheng Zhang
- Department of Burn and Plastic Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
- Department of Orthopedics, Western Theater Air Force Hospital of PLA, Chengdu, China
| | - Zhanjun Lei
- Department of Burn and Plastic Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Bin Lin
- Department of Burn and Plastic Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Zhixiao Lin
- Department of Burn and Plastic Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
- Department of Burn and Plastic Surgery, No. 923 Hospital of Joint Logistic Support Force of PLA, Nanning, China
| | - Yuchen Dong
- Department of Burn and Plastic Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Pan Ren
- Department of Burn and Plastic Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Xueyong Li
- Department of Burn and Plastic Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Yongqian Bian
- Department of Burn and Plastic Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Congying Zhao
- Department of Burn and Plastic Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
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Min P, Zhang S, Sinaki DG, Yao P, Hu F, Wang X, Zhou D, Chai J, Zhang Y. Using Zhang's supertension-relieving suture technique with slowly-absorbable barbed sutures in the management of pathological scars: a multicenter retrospective study. BURNS & TRAUMA 2023; 11:tkad026. [PMID: 37334139 PMCID: PMC10271604 DOI: 10.1093/burnst/tkad026] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 02/06/2023] [Accepted: 04/23/2023] [Indexed: 06/20/2023]
Abstract
Background An ideal tension-relieving suture should be efficient for >3 months to retrieve normal tensile strength. Most preexisting suturing techniques provided tension elimination followed by relapse and scar proliferation due to absorption and cut-through of the sutures. This study introduces a simple but effective suture technique developed by a senior author (ZYX) to solve this problem. Methods A total of 120 patients with pathological scar (PS) had intervention treatment with the proposed suturing strategy at three centers from January 2018 to January 2021. A slowly absorbable 2-0 barbed suture was used for subcutaneous tension relieving with a set-back from the wound edge and a horizontal interval between proposed inserting points of 1 cm. The Patient and Observer Scar Assessment Scale (POSAS), scar width, perfusion and eversion of the wound edge were evaluated at 3-, 6- and 12-month follow-up. The time needed to place the tension-relieving suture was recorded and relapse was monitored for 18 months postoperatively. Results In total, 76 trunks, 32 extremities and 12 cervical PS were included, with an average subcutaneous tension-relieving suture time of 5 min. The Patient and Observer Scar Assessment Scale (POSAS) score decreased from 84.70 ± 7.06 preoperatively to 28.83 ± 3.09, 26.14 ± 1.92 and 24.71 ± 2.00 at 3, 6 and 12 months postoperatively, respectively (p < 0.0001). The scar widths were 0.17 ± 0.08, 0.25 ± 0.09 and 0.33 ± 0.10 cm, respectively, with perfusion significantly decreased from 213.64 ± 14.97 to 112.23 ± 8.18 at 6 months (p < 0.0001). The wound edge flattened out during the first 3 months in most cases with only two scar relapses. Conclusions Zhang's suture technique provides a rapid and long-lasting tension-relieving effect with ideal scar appearances and lower relapse rates in the surgical management of PS.
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Affiliation(s)
| | | | - Dorsa Gholamali Sinaki
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 639 ZhiZaoJu Road, Huangpu District, Shanghai, 200011, China
| | - Ping Yao
- Department of Plastic Surgery, Hangzhou Plastic Surgery Hospital, 168 Shangtang Road, Xiacheng District, Hangzhou, 310000, Zhejiang, China
| | - Fuhua Hu
- Department of Plastic Surgery, Hangzhou Plastic Surgery Hospital, 168 Shangtang Road, Xiacheng District, Hangzhou, 310000, Zhejiang, China
| | - Xin Wang
- Department of Plastic and Reconstructive Surgery, Ningbo Sixth Hospital, 1059 East Zhongshan Road, Yinzhou District, Ningbo, 315040, Zhejiang, China
| | - Danya Zhou
- Department of Plastic and Reconstructive Surgery, Ningbo Sixth Hospital, 1059 East Zhongshan Road, Yinzhou District, Ningbo, 315040, Zhejiang, China
| | - Jun Chai
- Correspondence. Jun Chai, ; Yixin Zhang,
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Vakil AU, Petryk NM, Du C, Howes B, Stinfort D, Serinelli S, Gitto L, Ramezani M, Beaman HT, Monroe MBB. In vitro and in vivo degradation correlations for polyurethane foams with tunable degradation rates. J Biomed Mater Res A 2023; 111:580-595. [PMID: 36752708 DOI: 10.1002/jbm.a.37504] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 12/19/2022] [Accepted: 01/13/2023] [Indexed: 02/09/2023]
Abstract
Polyurethane foams present a tunable biomaterial platform with potential for use in a range of regenerative medicine applications. Achieving a balance between scaffold degradation rates and tissue ingrowth is vital for successful wound healing, and significant in vivo testing is required to understand these processes. Vigorous in vitro testing can minimize the number of animals that are required to gather reliable data; however, it is difficult to accurately select in vitro degradation conditions that can effectively mimic in vivo results. To that end, we performed a comprehensive in vitro assessment of the degradation of porous shape memory polyurethane foams with tunable degradation rates using varying concentrations of hydrogen peroxide to identify the medium that closely mimics measured in vivo degradation rates. Material degradation was studied over 12 weeks in vitro in 1%, 2%, or 3% hydrogen peroxide and in vivo in subcutaneous pockets in Sprague Dawley rats. We found that the in vitro degradation conditions that best predicted in vivo degradation rates varied based on the number of mechanisms by which the polymer degraded and the polymer hydrophilicity. Namely, more hydrophilic materials that degrade by both hydrolysis and oxidation require lower concentrations of hydrogen peroxide (1%) to mimic in vivo rates, while more hydrophobic scaffolds that degrade by oxidation alone require higher concentrations of hydrogen peroxide (3%) to model in vivo degradation. This information can be used to rationally select in vitro degradation conditions that accurately identify in vivo degradation rates prior to characterization in an animal model.
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Affiliation(s)
- Anand Utpal Vakil
- Department of Biomedical and Chemical Engineering and BioInspired Syracuse, Institute for Material and Living Systems, Syracuse University, Syracuse, New York, USA
| | - Natalie Marie Petryk
- Department of Biomedical and Chemical Engineering and BioInspired Syracuse, Institute for Material and Living Systems, Syracuse University, Syracuse, New York, USA
| | - Changling Du
- Department of Biomedical and Chemical Engineering and BioInspired Syracuse, Institute for Material and Living Systems, Syracuse University, Syracuse, New York, USA
| | - Bryanna Howes
- Department of Chemistry, Le Moyne College, Syracuse, New York, USA
| | | | | | - Lorenzo Gitto
- SUNY Upstate Medical University, Syracuse, New York, USA
| | - Maryam Ramezani
- Department of Biomedical and Chemical Engineering and BioInspired Syracuse, Institute for Material and Living Systems, Syracuse University, Syracuse, New York, USA
| | - Henry T Beaman
- Department of Biomedical and Chemical Engineering and BioInspired Syracuse, Institute for Material and Living Systems, Syracuse University, Syracuse, New York, USA
| | - Mary Beth Browning Monroe
- Department of Biomedical and Chemical Engineering and BioInspired Syracuse, Institute for Material and Living Systems, Syracuse University, Syracuse, New York, USA
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Gao Z, Qi Q, Li R, Li C, Xie X, Hou G. A nanofiber/sponge double-layered composite membrane capable of inhibiting infection and promoting blood coagulation during wound healing. Colloids Surf B Biointerfaces 2023; 224:113209. [PMID: 36842393 DOI: 10.1016/j.colsurfb.2023.113209] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 02/08/2023] [Accepted: 02/15/2023] [Indexed: 02/18/2023]
Abstract
Uncontrolled bleeding and bacterial infections cause severe damage to the wounds and remain a clinical challenge. Here, we developed a nanofiber/sponge bilayered composite membrane (QCP) containing quaternized silicone (QP12) and quaternized chitosan (QCS12) by joint approaches of electrospinning and freeze-drying and investigated their potential for wound dressing. The QCP was composed of a sponge (QCC) containing collagen (COL) and QCS12 and a nanofibrous membrane (MQP) containing poly-ε-caprolactone (PCL) and QP12. The QCP composite membrane possessed feasible permeability (0.22 ± 0.01 g/(cm2·24 h)), available thermal stability, suitable mechanical properties with natural skin, and in vivo hemostatic efficiency. The bonds of the N-quaternary and Schiff base endow composite membranes with significant anti-microbial invasion, potentially enhancing the wound healing process with an eligible microenvironment. Meanwhile, QCP evinced fine hemocompatibility, low cytotoxicity, negligible skin irritation, and other desirable biosafety as an excellent wound dressing. QCP promoted collagen deposition and re-epithelization to accelerate healing and suppress scars in the full-thickness acute wound models. Furthermore, the evaluation in the chronic skin incision model of diabetes mellitus manifested high healing efficiency with a certain resistance to bacterial infection of the composite membrane. Taken together, the QCP composite membrane may be a potential antibacterial and hemostatic wound dressing.
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Affiliation(s)
- Zhongfei Gao
- Department of Microbiology, College of Life Science, Key Laboratory for Agriculture Microbiology, Shandong Agricultural University, Tai'an 271018, People's Republic of China; School of Pharmacy, Key Laboratory of Prescription Effect and Clinical Evaluation of State Administration of Traditional Chinese Medicine of China, Binzhou Medical University, Yantai 264003, People's Republic of China
| | - Qinbing Qi
- School of Pharmacy, Key Laboratory of Prescription Effect and Clinical Evaluation of State Administration of Traditional Chinese Medicine of China, Binzhou Medical University, Yantai 264003, People's Republic of China
| | - Rongkai Li
- School of Pharmacy, Key Laboratory of Prescription Effect and Clinical Evaluation of State Administration of Traditional Chinese Medicine of China, Binzhou Medical University, Yantai 264003, People's Republic of China
| | - Chengbo Li
- School of Pharmacy, Key Laboratory of Prescription Effect and Clinical Evaluation of State Administration of Traditional Chinese Medicine of China, Binzhou Medical University, Yantai 264003, People's Republic of China
| | - Xianrui Xie
- School of Pharmacy, Key Laboratory of Prescription Effect and Clinical Evaluation of State Administration of Traditional Chinese Medicine of China, Binzhou Medical University, Yantai 264003, People's Republic of China.
| | - Guige Hou
- Department of Microbiology, College of Life Science, Key Laboratory for Agriculture Microbiology, Shandong Agricultural University, Tai'an 271018, People's Republic of China; School of Pharmacy, Key Laboratory of Prescription Effect and Clinical Evaluation of State Administration of Traditional Chinese Medicine of China, Binzhou Medical University, Yantai 264003, People's Republic of China.
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Wound Healing and Therapy in Soft Tissue Defects of the Hand and Foot from a Surgical Point of View. Med Sci (Basel) 2021; 9:medsci9040071. [PMID: 34842788 PMCID: PMC8628974 DOI: 10.3390/medsci9040071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 11/10/2021] [Indexed: 01/02/2023] Open
Abstract
Wounds and tissue defects of the hand and foot often lead to severe functional impairment of the affected extremity. Next to general principles of wound healing, special functional and anatomic considerations must be taken into account in the treatment of wounds in these anatomical regions to achieve a satisfactory reconstructive result. In this article, we outline the concept of wound healing and focus on the special aspects to be considered in wounds of the hand and foot. An overview of different treatment and dressing techniques is given with special emphasis on the reconstruction of damaged structures by plastic surgical means.
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Pitts G, Custer M, Foister RD, Uhl T. The hand therapist's role in the prevention and management of upper extemity injuries in the modern mass production industrial setting. J Hand Ther 2021; 34:237-249. [PMID: 34034914 DOI: 10.1016/j.jht.2021.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND This case study presents the role of an onsite hand therapist (Certified Hand Therapist, Occupational Therapist, Physical Therapist) in an industrial setting and the services that can be provided in this comprehensive care model. Onsite hand therapists can impact on Occupational Safety and Health Administration (OSHA) first aid programs and can provide state of the art treatment for the injured worker in both a direct and indirect capacity. PURPOSE The purpose of this case study article is to review the many potential services the hand therapist can offer to facilitate the return-to-work of injured employees and provide employers with a proactive case management and state-of-the-art ergonomic prevention, improving profit margins and facilitating safe work environments. STUDY DESIGN A Case Study design demonstrating the diverse and positive impact of hand therapy on the mass production industrial setting. METHODS Novel to this approach is a description of outcome instruments (QuickDASH) administered in a periodic manner to understand the trajectory of change in patient-level disability throughout the rehabilitation process. The Optimal Screening for Prediction of Referral and Outcome (OSPRO-YF) is utilized to help predict the functional outcome for the injured worker. Case studies on common upper extremity pathologies will be discussed, demonstrating the benefits of onsite hand therapy with enhanced treatment and case management. RESULTS The utilization of the QuickDASH and the OSPRO-YF creates a process to determine the progression of injured workers in therapy, the trajectory of change in patient-level disability and to observe when changes occurred. An example of the periodic assessment approach is described in a case study to identify when the most significant change occurred and creating a mechanism to determine if patients were progressing as expected. CONCLUSIONS Inherent in this case study process is a fluidity in which the therapist can monitor patient progress and adjust the rehabilitation process that benefits both the patient and the industrial setting. A hierarchical functional level system is presented to describe an appropriate intervention strategy to coincide with a patient's progression of wound healing which can be provided by a hand therapist with specialized knowledge.
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Affiliation(s)
- Greg Pitts
- Commonwealth Hand Therapy, Lexington Kentucky 40504, Auerbach School of Occupational Therapy, Spalding University, Louisville, KY, USA.
| | - Melba Custer
- Auerbach School of Occupational Therapy, Spalding University, Chair, Research Ethics Committee REC, Louisville, KY, USA
| | | | - Tim Uhl
- Department of Physical Therapy, University of Kentucky, Lexington, KY, USA
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Luo R, Dai J, Zhang J, Li Z. Accelerated Skin Wound Healing by Electrical Stimulation. Adv Healthc Mater 2021; 10:e2100557. [PMID: 33945225 DOI: 10.1002/adhm.202100557] [Citation(s) in RCA: 114] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/06/2021] [Indexed: 01/28/2023]
Abstract
When the integrity of the skin got damaged, an endogenous electric field will be generated in the wound and a series of physiological reactions will be initiated to close the wound. The existence of the endogenous electric field of the wound has a promoting effect on all stages of wound healing. For wounds that cannot heal on their own, the exogenous electric field can assist the treatment. In this review, the effects of exogenous electrical stimulation on wound healing, such as the inflammation phase, blood flow, cell proliferation and migration, and the wound scarring is overviewed. This article also reviews the new electrical stimulation methods that have emerged in recent years, such as small power supplies, nanogenerators (NGs), and other physical, chemical or biological strategies. These new electrical stimulation methods and devices are safe, low-cost, stable, and small in size. The challenge and perspective are discussed for the future trends of the electrical stimulation treatment in accelerating skin wound healing.
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Affiliation(s)
- Ruizeng Luo
- College of Chemistry and Chemical Engineering Center of Nanoenergy Research Guangxi University Nanning 530004 China
| | - Jieyu Dai
- College of Chemistry and Chemical Engineering Center of Nanoenergy Research Guangxi University Nanning 530004 China
| | - Jiaping Zhang
- Department of Plastic Surgery State Key Laboratory of Trauma, Burns and Combined Injury Southwest Hospital Third Military Medical University (Army Medical University) Chongqing 400038 China
| | - Zhou Li
- College of Chemistry and Chemical Engineering Center of Nanoenergy Research Guangxi University Nanning 530004 China
- CAS Center for Excellence in Nanoscience Beijing Key Laboratory of Micro–Nano Energy and Sensor Beijing Institute of Nanoenergy and Nanosystems Chinese Academy of Sciences Beijing 100083 China
- School of Nanoscience and Technology University of Chinese Academy of Sciences Beijing 100049 China
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Lafci Büyükkahraman M, Sabine GK, Kojouharov HV, Chen-Charpentier BM, McMahan SR, Liao J. Using models to advance medicine: mathematical modeling of post-myocardial infarction left ventricular remodeling. Comput Methods Biomech Biomed Engin 2021; 25:298-307. [PMID: 34266318 DOI: 10.1080/10255842.2021.1953487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The heart is an organ with limited capacity for regeneration and repair. The irreversible cell death and corresponding diminished ability of the heart to repair after myocardial infarction (MI), is a leading cause of morbidity and mortality worldwide. In this paper, a new mathematical model is presented to study the left ventricular (LV) remodeling and associated events after MI. The model accurately describes and predicts the interactions among heart cells and the immune system post-MI in the absence of medical interventions. The resulting system of nonlinear ordinary differential equations is studied both analytically and numerically in order to demonstrate the functionality and performance of the new model. To the best of our knowledge, this model is the only one of its kind to consider and correctly apply all of the known factors in diseased heart LV modeling. This model has the potential to provide researchers with a predictive computational tool to better understand the MI pathology and develop various cell-based treatment options, with benefits of lowering the cost and reducing the development time.
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Affiliation(s)
- Mehtap Lafci Büyükkahraman
- Department of Mathematics, The University of Texas at Arlington, Arlington, TX, USA.,Department of Mathematics, Uşak University, Uşak, Turkey
| | - Gavin K Sabine
- Department of Mathematics, The University of Texas at Arlington, Arlington, TX, USA
| | - Hristo V Kojouharov
- Department of Mathematics, The University of Texas at Arlington, Arlington, TX, USA
| | | | - Sara R McMahan
- Department of Bioengineering, The University of Texas at Arlington, Arlington, TX, USA
| | - Jun Liao
- Department of Bioengineering, The University of Texas at Arlington, Arlington, TX, USA
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Hooshmand S, Mollazadeh S, Akrami N, Ghanad M, El-Fiqi A, Baino F, Nazarnezhad S, Kargozar S. Mesoporous Silica Nanoparticles and Mesoporous Bioactive Glasses for Wound Management: From Skin Regeneration to Cancer Therapy. MATERIALS (BASEL, SWITZERLAND) 2021; 14:3337. [PMID: 34204198 PMCID: PMC8235211 DOI: 10.3390/ma14123337] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 06/10/2021] [Accepted: 06/11/2021] [Indexed: 12/23/2022]
Abstract
Exploring new therapies for managing skin wounds is under progress and, in this regard, mesoporous silica nanoparticles (MSNs) and mesoporous bioactive glasses (MBGs) offer great opportunities in treating acute, chronic, and malignant wounds. In general, therapeutic effectiveness of both MSNs and MBGs in different formulations (fine powder, fibers, composites etc.) has been proved over all the four stages of normal wound healing including hemostasis, inflammation, proliferation, and remodeling. The main merits of these porous substances can be summarized as their excellent biocompatibility and the ability of loading and delivering a wide range of both hydrophobic and hydrophilic bioactive molecules and chemicals. In addition, doping with inorganic elements (e.g., Cu, Ga, and Ta) into MSNs and MBGs structure is a feasible and practical approach to prepare customized materials for improved skin regeneration. Nowadays, MSNs and MBGs could be utilized in the concept of targeted therapy of skin malignancies (e.g., melanoma) by grafting of specific ligands. Since potential effects of various parameters including the chemical composition, particle size/morphology, textural properties, and surface chemistry should be comprehensively determined via cellular in vitro and in vivo assays, it seems still too early to draw a conclusion on ultimate efficacy of MSNs and MBGs in skin regeneration. In this regard, there are some concerns over the final fate of MSNs and MBGs in the wound site plus optimal dosages for achieving the best outcomes that deserve careful investigation in the future.
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Affiliation(s)
- Sara Hooshmand
- Pharmacological Research Center of Medicinal Plants, Mashhad University of Medical Sciences, Mashhad 917794-8564, Iran;
- Department of Pharmacology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad 917794-8564, Iran
| | - Sahar Mollazadeh
- Department of Materials Engineering, Faculty of Engineering, Ferdowsi University of Mashhad (FUM), Azadi Sq., Mashhad 917794-8564, Iran; (S.M.); (N.A.); (M.G.)
| | - Negar Akrami
- Department of Materials Engineering, Faculty of Engineering, Ferdowsi University of Mashhad (FUM), Azadi Sq., Mashhad 917794-8564, Iran; (S.M.); (N.A.); (M.G.)
| | - Mehrnoosh Ghanad
- Department of Materials Engineering, Faculty of Engineering, Ferdowsi University of Mashhad (FUM), Azadi Sq., Mashhad 917794-8564, Iran; (S.M.); (N.A.); (M.G.)
| | - Ahmed El-Fiqi
- Glass Research Department, National Research Centre, Cairo 12622, Egypt;
| | - Francesco Baino
- Institute of Materials Physics and Engineering, Applied Science and Technology Department, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Torino, Italy
| | - Simin Nazarnezhad
- Tissue Engineering Research Group (TERG), Department of Anatomy and Cell Biology, School of Medicine, Mashhad University of Medical Sciences, Mashhad 917794-8564, Iran;
| | - Saeid Kargozar
- Tissue Engineering Research Group (TERG), Department of Anatomy and Cell Biology, School of Medicine, Mashhad University of Medical Sciences, Mashhad 917794-8564, Iran;
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Ma D, Chen L, Shi J, Zhao Y, Vasani S, Chen K, Romana‐Souza B, Henkin J, DiPietro LA. Pigment epithelium‐derived factor attenuates angiogenesis and collagen deposition in hypertrophic scars. Wound Repair Regen 2020; 28:684-695. [DOI: 10.1111/wrr.12828] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 04/28/2020] [Accepted: 05/05/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Da Ma
- Guangdong Provincial Key Laboratory of Stomatology, Stomatological Hospital Guanghua School of Stomatology, SunYat‐sen University Guangzhou Guangdong China
| | - Lin Chen
- Center for Wound Healing and Tissue Regeneration, College of Dentistry University of Illinois at Chicago Chicago Illinois USA
| | - Junhe Shi
- Center for Wound Healing and Tissue Regeneration, College of Dentistry University of Illinois at Chicago Chicago Illinois USA
| | - Yan Zhao
- Center for Wound Healing and Tissue Regeneration, College of Dentistry University of Illinois at Chicago Chicago Illinois USA
| | - Shruti Vasani
- Center for Wound Healing and Tissue Regeneration, College of Dentistry University of Illinois at Chicago Chicago Illinois USA
| | - Kevin Chen
- Center for Wound Healing and Tissue Regeneration, College of Dentistry University of Illinois at Chicago Chicago Illinois USA
| | - Bruna Romana‐Souza
- Tissue Repair Laboratory State University of Rio de Janeiro Rio de Janeiro Brazil
| | - Jack Henkin
- Center for Developmental Therapeutics and Department of Chemistry Northwestern University Evanston Illinois USA
| | - Luisa A. DiPietro
- Center for Wound Healing and Tissue Regeneration, College of Dentistry University of Illinois at Chicago Chicago Illinois USA
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12
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Rennekampff HO, Tenenhaus M. Theoretical basis for optimal surgical incision planning to reduce hypertrophic scar formation. Med Hypotheses 2020; 140:109672. [PMID: 32197119 DOI: 10.1016/j.mehy.2020.109672] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 02/29/2020] [Accepted: 03/10/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND After approximately 24 weeks of gestation, human cutaneous wounds and incisions heal by scar formation. Continued or unregulated stimulation of tissue fibroblasts is thought to lead to an activated state with ongoing collagen deposition resulting in a visible hypertrophic scar. There is evidence that mechanical forces as sensed by fibroblasts lead to downstream events such as excessive extracellular matrix deposition. Mechanical forces acting on the wound fibroblast are exerted by underlying muscles as well as intrinsic forces found in the dermal component of the surrounding skin. Under static conditions, collagen is oriented parallel to the direction of strain. In an effort to minimize resultant scar formation various and often contradictory lines of non-extension, lines of least tension, have been described for planning optimal surgical incisions. HYPOTHESIS We hypothesize that it is possible to avoid longitudinal stretch on incisions and thereby minimize resultant pathologic scars if defined anatomical considerations are respected. We hypothesize that placement of skin incisions parallel to lines of minimal longitudinal stretch, non-invasively measured by orientation of collagen orientation would in turn result in minimal scar formation. EVIDENCE Historical recommendations often derived from human post mortem studies and animal experiments have shed some light on cutaneously observed lines of non-extension. Theoretical considerations of non-extension lines have suggested possible directions of surgical incisions. Post surgical analysis of dermatological interventions have similarly added to our understanding of possible non-extension lines. Measuring anisotropy in the skin can determine collagen orientation in the skin and may therefore allow one to objectively place incisions parallel to non-extension lines. To date no randomized clinical study in humans has addressed whether such an approach would lead to less scarring. A study involving volunteers examining many body areas seems ethically challenged. CONCLUSION The hypothesis, although not proven, is supported by available evidence. If our hypothesis that measurable cutaneous collagen orientation guided incisions improved scar formation then surgical incision planning would deservedly require more clinical attention. Preoperative measurement or at least pre-closure assessment of anisotropy prior to surgical incision placement or closure would notably reduce the incidence of hypertrophic scars.
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Affiliation(s)
- H O Rennekampff
- Dept of Plastic Surgery, Hand and Burn Surgery, RheinMaas Klinikum, Aachen/Wuerselen, Germany.
| | - M Tenenhaus
- Dept of Plastic Surgery, Hand and Burn Surgery, RheinMaas Klinikum, Aachen/Wuerselen, Germany
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Effects of submucosal PRP injection on wound healing in endonasal surgeries: an experimental study. Eur Arch Otorhinolaryngol 2020; 277:1681-1689. [PMID: 32144565 DOI: 10.1007/s00405-020-05884-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 02/21/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE To investigate the effects of submucosal platelet-rich plasma (PRP) injection on nasal mucosal wound healing after endoscopic sinus surgery. METHODS 24 New Zealand white rabbits were randomly divided into three groups. To mimic surgery, injury was created using 3-mm punch forceps on ventral turbinate mucosa for all groups. Submucosal PRP was injected to the damaged mucosa in the first group (PRP group, n = 8), where 0.9% saline solution to the second group (saline group, n = 8) and no injection to the third one (control group, n = 8). All the animals were sacrificed 14 days after surgery; histopathological examination and hydroxyproline measurements were performed on the mucosa of all groups. RESULTS Neutrophils, goblet cells, and collagen intensity were found significantly lower (p < 0.05) in PRP group than the control group. Also, the number of ciliary and goblet cells, and collagen intensity were found significantly lower (p < 0.05) in PRP group, than the saline group. In PRP group, hydroxyproline levels were found (p < 0.05) significantly lower than the saline and the control group, and no significant difference was found between the saline group and the control group (p > 0.05). CONCLUSION There are many studies in literature showing the positive effects of PRP on wound healing. The results of this study also demonstrated positive effects of PRP on the nasal mucosa. According to these results, PRP injection to the injured nasal mucosa showed anti-inflammatory, mucus-softening, and synechia-reducing effects. Therefore, submucosal PRP injection after endonasal surgeries can be considered an effective application for maintaining nasal physiology.
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14
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Goodarzi G, Maniati M, Qujeq D. The role of microRNAs in the healing of diabetic ulcers. Int Wound J 2019; 16:621-633. [PMID: 30821119 PMCID: PMC7949391 DOI: 10.1111/iwj.13070] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Accepted: 12/28/2018] [Indexed: 12/17/2022] Open
Abstract
MicroRNAs (miRNAs) are small protected molecules with a length of 18 to 25 nucleotides. Many studies have recently been conducted on miRNAs, illustrating their role in regulating many biological, physiological, and pathological activities, such as maintaining cellular signalling and regulating cellular pathways. The main role of miRNAs is to regulate the expression of genes after translation, which can lead to the destruction or suppression of translation by binding to mRNAs. As any change in the regulation of miRNAs is associated with several physiological abnormalities, such as type 2 diabetes and its complications, these molecules can be used for therapeutic purposes or as biomarkers for the diagnosis of diseases such as diabetes and its complications. In this review article, we will discuss important findings about the miRNAs and the role of these molecules in different phases of the wound-healing process of chronic wounds, especially diabetic ulcer.
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Affiliation(s)
- Golnaz Goodarzi
- Department of Medical Biochemistry and Biotechnology, School of MedicineNorth Khorasan University of Medical SciencesBojnurdIran
| | - Mahmood Maniati
- School of MedicineAhvaz Jundishapur University of Medical SciencesAhvazIran
| | - Durdi Qujeq
- Cellular and Molecular Biology Research Center (CMBRC), Health Research InstituteBabol University of Medical SciencesBabolIran
- Dental Materials Research Center, Institute of HealthBabol University of Medical SciencesBabolIran
- Cancer Research Center, Health Research InstituteBabol University of Medical SciencesBabolIran
- Department of Clinical Biochemistry, School of MedicineBabol University of Medical SciencesBabolIran
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15
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Moiemen N, Mathers J, Jones L, Bishop J, Kinghorn P, Monahan M, Calvert M, Slinn G, Gardiner F, Bamford A, Wright S, Litchfield I, Andrews N, Turner K, Grant M, Deeks J. Pressure garment to prevent abnormal scarring after burn injury in adults and children: the PEGASUS feasibility RCT and mixed-methods study. Health Technol Assess 2019; 22:1-162. [PMID: 29947328 DOI: 10.3310/hta22360] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Eleven million people suffer a fire-related injury worldwide every year, and 71% have significant scarring. Pressure garment therapy (PGT) is a standard part of burn scar management, but there is little evidence of its clinical effectiveness or cost-effectiveness. OBJECTIVE To identify the barriers to, and the facilitators of, conducting a randomised controlled trial (RCT) of burn scar management with and without PGT and test whether or not such a trial is feasible. DESIGN Web-based surveys, semistructured individual interviews, a pilot RCT including a health economic evaluation and embedded process evaluation. SETTING UK NHS burns services. Interviews and the pilot trial were run in seven burns services. PARTICIPANTS Thirty NHS burns services and 245 staff provided survey responses and 15 staff participated in individual interviews. Face-to-face interviews were held with 24 adult patients and 16 parents of paediatric patients who had undergone PGT. The pilot trial recruited 88 participants (57 adults and 31 children) who were at risk of hypertrophic scarring and were considered suitable for scar management therapy. Interviews were held with 34 participants soon after recruitment, with 23 participants at 12 months and with eight staff from six sites at the end of the trial. INTERVENTIONS The intervention was standard care with pressure garments. The control was standard care comprising scar management techniques involving demonstration and recommendations to undertake massage three or four times per day with moisturiser, silicone treatment, stretching and other exercises. MAIN OUTCOME MEASURES Feasibility was assessed by eligibility rates, consent rates, retention in allocated arms, adherence with treatment and follow-up and completion of outcome assessments. The outcomes from interview-based studies were core outcome domains and barriers to, and facilitators of, trial participation and delivery. RESULTS NHS burns services treat 2845 patients per annum (1476 paediatric and 1369 adult) and use pressure garments for 6-18 months, costing £2,171,184. The majority of staff perceived a need for a RCT of PGT, but often lacked equipoise around the research question and PGT as a treatment. Strong views about the use of PGT have the potential to influence the conduct of a full-scale RCT. A range of outcome domains was identified as important via the qualitative research: perceptions of appearance, specific scar characteristics, function, pain and itch, broader psychosocial outcomes and treatment burden. The outcome tools evaluated in the pilot trial did not cover all of these domains. The planned 88 participants were recruited: the eligibility rate was 88% [95% confidence interval (CI) 83% to 92%], the consent rate was 47% (95% CI 40% to 55%). Five (6%) participants withdrew, 14 (16%) were lost to follow-up and 8 (9%) crossed over. Adherence was as in clinical practice. Completion of outcomes was high for adult patients but poorer from parents of paediatric patients, particularly for quality of life. Sections on range of movement and willingness to pay were found to be challenging and poorly completed. LIMITATIONS The Brisbane Burn Scar Impact Profile appears more suitable in terms of conceptual coverage than the outcome scales that were used in the trial but was not available at the time of the study. CONCLUSIONS A definitive RCT of PGT in burn scar management appears feasible. However, staff attitudes to the use of pressure garments may lead to biases, and the provision of training and support to sites and an ongoing assessment of trial processes are required. FUTURE WORK We recommend that any future trial include an in-depth mixed-methods recruitment investigation and a process evaluation to account for this. TRIAL REGISTRATION Current Controlled Trials ISRCTN34483199. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 22, No. 36. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Naiem Moiemen
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Jonathan Mathers
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Laura Jones
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Jonathan Bishop
- Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, UK
| | - Philip Kinghorn
- Health Economics Unit, University of Birmingham, Birmingham, UK
| | - Mark Monahan
- Health Economics Unit, University of Birmingham, Birmingham, UK
| | - Melanie Calvert
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Gemma Slinn
- Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, UK
| | - Fay Gardiner
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Amy Bamford
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Susan Wright
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Ian Litchfield
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Nicole Andrews
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Karen Turner
- Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, UK
| | - Margaret Grant
- Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, UK
| | - Jonathan Deeks
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK.,Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, UK
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16
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Soliman AM, Teoh SL, Ghafar NA, Das S. Molecular Concept of Diabetic Wound Healing: Effective Role of Herbal Remedies. Mini Rev Med Chem 2019; 19:381-394. [PMID: 30360709 DOI: 10.2174/1389557518666181025155204] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 04/26/2017] [Accepted: 07/13/2017] [Indexed: 01/13/2023]
Abstract
The incidence of diabetes mellitus (DM) is on the rise, worldwide. One of the main complications in DM is delayed wound healing and it often requires amputation. Various drugs were used to treat DM but they presented with adverse effects. Often, patients failed to comply with such treatment. This opened the door for complementary and alternative medicine. In the present review, we explored the molecular concept of wound healing occurring in different stages with special emphasis to DM. We also highlighted the potential herbal products such as NF3 (Chinese 2-Herb Formula), Zicao, Jing Wan Hong ointment, Aleo vera, mixture of Adiantum capillus-veneris, Commiphora molmol, Aloe vera, and henna, Phenol-rich compound sweet gel, Jinchuang ointment, San-huang-sheng-fu (S) oil, Yi Bu A Jie extract, Astragali Radix (AR) and Rehmanniae Radix (RR), Yiqi Huayu, Tangzu yuyang ointment, Shengji Huayu recipe, Angelica sinensis, Lithospermun erythrorhison, Hippophae rhamnoides L., Curcuma longa and Momordica charantia that could be used effectively to treat DM wounds. Future clinical trials are needed for designing potential drugs which may be effective in treating DM wounds.
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Affiliation(s)
- Amro Mohamed Soliman
- Department of Anatomy, Faculty of Medicine, 18th Floor, Pre-Clinical Block, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif 56000, Kuala Lumpur, Malaysia
| | - Seong Lin Teoh
- Department of Anatomy, Faculty of Medicine, 18th Floor, Pre-Clinical Block, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif 56000, Kuala Lumpur, Malaysia
| | - Norzana Abd Ghafar
- Department of Anatomy, Faculty of Medicine, 18th Floor, Pre-Clinical Block, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif 56000, Kuala Lumpur, Malaysia
| | - Srijit Das
- Department of Anatomy, Faculty of Medicine, 18th Floor, Pre-Clinical Block, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif 56000, Kuala Lumpur, Malaysia
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17
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Wang Q, Qian Z, Liu B, Liu J, Zhang L, Xu J. In vitro and in vivo evaluation of new PRP antibacterial moisturizing dressings for infectious wound repair. JOURNAL OF BIOMATERIALS SCIENCE-POLYMER EDITION 2019; 30:462-485. [PMID: 30755095 DOI: 10.1080/09205063.2019.1582270] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Qianxin Wang
- Medical School of Chinese PLA, Beijing, China
- Department of Stomatology, The Chinese PLA General Hospital, Beijing, China
| | - Zhiyong Qian
- School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Bo Liu
- Medical School of Chinese PLA, Beijing, China
| | - Jinglong Liu
- Former Lishi Road Outpatient Department, Chinese PLA Rocket Army General Hospital, Beijing, China
| | - Liang Zhang
- Medical School of Chinese PLA, Beijing, China
| | - Juan Xu
- Medical School of Chinese PLA, Beijing, China
- Department of Stomatology, The Chinese PLA General Hospital, Beijing, China
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18
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Synthesis and fabrication of a keratin-conjugated insulin hydrogel for the enhancement of wound healing. Colloids Surf B Biointerfaces 2019; 175:436-444. [DOI: 10.1016/j.colsurfb.2018.12.020] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 12/08/2018] [Accepted: 12/10/2018] [Indexed: 12/30/2022]
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19
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Directing fibroblast self-assembly to fabricate highly-aligned, collagen-rich matrices. Acta Biomater 2018; 81:70-79. [PMID: 30267883 DOI: 10.1016/j.actbio.2018.09.030] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 08/28/2018] [Accepted: 09/19/2018] [Indexed: 11/24/2022]
Abstract
Extracellular matrix composition and organization play a crucial role in numerous biological processes ranging from cell migration, differentiation, survival and metastasis. Consequently, there have been significant efforts towards the development of biomaterials and in vitro models that recapitulate the complexity of native tissue architecture. Here, we demonstrate an approach to fabricating highly aligned cell-derived tissue constructs via the self-assembly of human dermal fibroblasts. By optimizing mold geometry, cell seeding density, and media composition we can direct human dermal fibroblasts to adhere to one another around a non-adhesive agarose peg to facilitate the development of cell-mediated circumferential tension. By removing serum and adding ascorbic acid and l-proline, we tempered fibroblast contractility to enable the formation of stable tissue constructs. Similarly, we show that the alignment of cells and the ECM they synthesize can be modulated by changes to seeding density and that constructs seeded with the lowest number of cells have the highest degree of fibrillar collagen alignment. Finally, we show that this highly aligned, tissue engineered construct can be decellularized and that when re-seeded with fibroblasts, it provides instructive cues which enable cells to adhere to and align in the direction of the remaining collagen fiber network. STATEMENT OF SIGNIFICANCE: Cell and extracellular matrix organization is directly related to biological function including cell signaling and tissue mechanics. Changes to this organization are often associated with injury or disease. The majority of in vitro tissue engineering models investigating cell and matrix organization rely on the addition of stress-shielding exogenous proteins and polymers and, or the application of external forces to promote alignment. Here we present a completely cell-based approach that relies on the development of cell-mediated tension to direct anisotropic cellular alignment and matrix synthesis using human dermal fibroblasts. A major challenge with this approach is excessive cellular contractility that results in necking and failure of the tissue construct. While other groups have tried to overcome this challenge by simply adding more cells, here we show that matrix alignment is inversely related to cell seeding density. To engineer tissue constructs with the highest degree of alignment, we optimized media components to reduce cellular contractility and promote collagen synthesis such that fibroblast toroids remained stable for at least 28 days in culture. We subsequently showed that these collagen-rich tissue constructs could be decellularized while maintaining their collagen microstructure and that cells adhered to and responded to the decellularized cell-derived matrix by aligning and elongating along the collagen fibers. The complexity of cell-derived matrices has been shown to better recapitulate in vivo tissue architecture and composition. This study provides a straight-forward approach to fabricating instructive cell-derived matrices with a high degree of uniaxial alignment generated purely by cell-mediated tension.
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20
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Chu J, Shi P, Deng X, Jin Y, Liu H, Chen M, Han X, Liu H. Dynamic multiphoton imaging of acellular dermal matrix scaffolds seeded with mesenchymal stem cells in diabetic wound healing. JOURNAL OF BIOPHOTONICS 2018; 11:e201700336. [PMID: 29575792 DOI: 10.1002/jbio.201700336] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 03/08/2018] [Indexed: 06/08/2023]
Abstract
Significantly effective therapies need to be developed for chronic nonhealing diabetic wounds. In this work, the topical transplantation of mesenchymal stem cell (MSC) seeded on an acellular dermal matrix (ADM) scaffold is proposed as a novel therapeutic strategy for diabetic cutaneous wound healing. GFP-labeled MSCs were cocultured with an ADM scaffold that was decellularized from normal mouse skin. These cultures were subsequently transplanted as a whole into the full-thickness cutaneous wound site in streptozotocin-induced diabetic mice. Wounds treated with MSC-ADM demonstrated an increased percentage of wound closure. The treatment of MSC-ADM also greatly increased angiogenesis and rapidly completed the reepithelialization of newly formed skin on diabetic mice. More importantly, multiphoton microscopy was used for the intravital and dynamic monitoring of collagen type I (Col-I) fibers synthesis via second harmonic generation imaging. The synthesis of Col-I fibers during diabetic wound healing is of great significance for revealing wound repair mechanisms. In addition, the activity of GFP-labeled MSCs during wound healing was simultaneously traced via two-photon excitation fluorescence imaging. Our research offers a novel advanced nonlinear optical imaging method for monitoring the diabetic wound healing process while the ADM and MSCs interact in situ. Schematic of dynamic imaging of ADM scaffolds seeded with mesenchymal stem cells in diabetic wound healing using multiphoton microscopy. PMT, photo-multiplier tube.
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Affiliation(s)
- Jing Chu
- Department of College of Biophotonics, South China Normal University, Guangzhou, China
| | - Panpan Shi
- Department of College of Biophotonics, South China Normal University, Guangzhou, China
| | - Xiaoyuan Deng
- Department of College of Biophotonics, South China Normal University, Guangzhou, China
| | - Ying Jin
- Department of College of Biophotonics, South China Normal University, Guangzhou, China
| | - Hao Liu
- Department of College of Biophotonics, South China Normal University, Guangzhou, China
| | - Maosheng Chen
- Department of College of Biophotonics, South China Normal University, Guangzhou, China
| | - Xue Han
- Department of College of Biophotonics, South China Normal University, Guangzhou, China
| | - Hanping Liu
- Department of College of Biophotonics, South China Normal University, Guangzhou, China
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21
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DeBruler DM, Blackstone BN, McFarland KL, Baumann ME, Supp DM, Bailey JK, Powell HM. Effect of skin graft thickness on scar development in a porcine burn model. Burns 2018; 44:917-930. [PMID: 29661554 DOI: 10.1016/j.burns.2017.11.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 11/16/2017] [Accepted: 11/20/2017] [Indexed: 12/13/2022]
Abstract
Animal models provide a way to investigate scar therapies in a controlled environment. It is necessary to produce uniform, reproducible scars with high anatomic and biologic similarity to human scars to better evaluate the efficacy of treatment strategies and to develop new treatments. In this study, scar development and maturation were assessed in a porcine full-thickness burn model with immediate excision and split-thickness autograft coverage. Red Duroc pigs were treated with split-thickness autografts of varying thickness: 0.026in. ("thin") or 0.058in. ("thick"). Additionally, the thin skin grafts were meshed and expanded at 1:1.5 or 1:4 to evaluate the role of skin expansion in scar formation. Overall, the burn-excise-autograft model resulted in thick, raised scars. Treatment with thick split-thickness skin grafts resulted in less contraction and reduced scarring as well as improved biomechanics. Thin skin autograft expansion at a 1:4 ratio tended to result in scars that contracted more with increased scar height compared to the 1:1.5 expansion ratio. All treatment groups showed Matrix Metalloproteinase 2 (MMP2) and Transforming Growth Factor β1 (TGF-β1) expression that increased over time and peaked 4 weeks after grafting. Burns treated with thick split-thickness grafts showed decreased expression of pro-inflammatory genes 1 week after grafting, including insulin-like growth factor 1 (IGF-1) and TGF-β1, compared to wounds treated with thin split-thickness grafts. Overall, the burn-excise-autograft model using split-thickness autograft meshed and expanded to 1:1.5 or 1:4, resulted in thick, raised scars similar in appearance and structure to human hypertrophic scars. This model can be used in future studies to study burn treatment outcomes and new therapies.
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Affiliation(s)
- Danielle M DeBruler
- Department of Materials Science and Engineering, The Ohio State University, Columbus, OH, United States
| | - Britani N Blackstone
- Department of Materials Science and Engineering, The Ohio State University, Columbus, OH, United States
| | - Kevin L McFarland
- Research Department, Shriners Hospitals for Children, Cincinnati, OH, United States
| | - Molly E Baumann
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, United States
| | - Dorothy M Supp
- Research Department, Shriners Hospitals for Children, Cincinnati, OH, United States; Department of Surgery, University of Cincinnati, Cincinnati, OH, United States
| | - J Kevin Bailey
- Department of Surgery, Division of Critical Care, Trauma and Burns, The Ohio State University, Columbus, OH, United States
| | - Heather M Powell
- Department of Materials Science and Engineering, The Ohio State University, Columbus, OH, United States; Department of Biomedical Engineering, The Ohio State University, Columbus, OH, United States.
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22
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miRNA delivery for skin wound healing. Adv Drug Deliv Rev 2018; 129:308-318. [PMID: 29273517 DOI: 10.1016/j.addr.2017.12.011] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 11/24/2017] [Accepted: 12/16/2017] [Indexed: 12/13/2022]
Abstract
The wound healing has remained a worldwide challenge as one of significant public health problems. Pathological scars and chronic wounds caused by injury, aging or diabetes lead to impaired tissue repair and regeneration. Due to the unique biological wound environment, the wound healing is a highly complicated process, efficient and targeted treatments are still lacking. Hence, research-driven to discover more efficient therapeutics is a highly urgent demand. Recently, the research results have revealed that microRNA (miRNA) is a promising tool in therapeutic and diagnostic fields because miRNA is an essential regulator in cellular physiology and pathology. Therefore, new technologies for wound healing based on miRNA have been developed and miRNA delivery has become a significant research topic in the field of gene delivery.
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23
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Frequency of Shoulder Corticosteroid Injections for Pain and Stiffness After Shoulder Surgery and Their Potential to Enhance Outcomes with Physiotherapy: A Retrospective Study. Pain Ther 2017; 6:45-60. [PMID: 28185130 PMCID: PMC5447542 DOI: 10.1007/s40122-017-0065-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Indexed: 11/03/2022] Open
Abstract
Introduction What is the rate of injecting patients with shoulder corticosteroid injections to alleviate excessive stiffness and pain within 6 months after shoulder surgery? Methods Retrospective 10-year review of a shoulder surgeon’s practice. Participants included 754 patients who had 945 non-arthroplasty shoulder surgeries. Outcome measures included the rate of injections, diagnoses, patient characteristics, and efficacy via questionnaire. Results Approximately one in five patients received a subacromial and/or glenohumeral corticosteroid injection. Over 95% of patients stated that the injections helped reduce shoulder pain and increased function 6 weeks post-injection. Twenty-two percent of cases (208/945) received glenohumeral and/or subacromial injections. The 208 injected cases had these diagnoses: rotator cuff tear (28% of injected patients), subacromial impingement (20%), glenohumeral instability (16%), subacromial impingement with acromioclavicular osteoarthritis (10%), adhesive capsulitis (7%), SLAP lesion (5%), biceps tendinopathy (3%), glenohumeral instability with subacromial impingement (3%), proximal humerus fracture (2%), calcific tendinitis (2%), and less common conditions (4%). Diagnoses among those with the highest rates of injected patients per diagnosis included: SLAP lesions (40%), calcific tendinitis (40%), adhesive capsulitis (29%), subacromial impingement (28%), proximal humerus fracture (24%), rotator cuff tear (19%), and glenohumeral instability (16%). Significant differences (p < 0.03) were found between patients who did and did not receive injections with respect to age (more likely younger patients with cuff tear) and sex (more likely female with subacromial impingement and instability) but not for diabetes or arthroscopic vs. open procedures. Conclusion This is the first study to establish the rates of postoperative shoulder corticosteroid injections within the first 6 months after various non-arthroplasty shoulder surgeries for patients with high pain/stiffness. These data will be useful for establishing guidelines for using corticosteroid injections along with physiotherapy.
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24
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Phospholipase Cε deficiency delays the early stage of cutaneous wound healing and attenuates scar formation in mice. Biochem Biophys Res Commun 2017; 484:144-151. [PMID: 28093232 DOI: 10.1016/j.bbrc.2017.01.054] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 01/09/2017] [Accepted: 01/11/2017] [Indexed: 12/31/2022]
Abstract
This study aimed to investigate the role of phospholipase Cε (PLCε) in the skin wound healing process. PLCε, an effect factor of Ras/Rap small G protein, plays a crucial role in skin inflammation by regulating inflammatory cytokines. Inflammatory responses are closely associated with wound healing. Full-thickness skin wounds were made in the PLCε knockout (KO) and wild-type (WT) mice, and the healing process was analyzed. The macroscopic wound closure rate declined in the PLCε KO mice on days 3, 4, and 5 after wounding, following the decreased expression of interleukin (IL)-6, chemokine (C-X-C motif) ligand (Cxcl)-1, Cxcl-2, and chemokine (C-C motif) ligand (Ccl) 20. The proliferation rate of epidermal keratinocytes was not affected by PLCε, but silencing of PLCε resulted in the delayed migration of keratinocytes. Moreover, the scars were found to be much smaller in the PLCε KO mice than in the WT mice. The mRNA expression of Ccl20, collagen (Col) 6a1, and Col17a1 decreased in the PLCε KO mice. These results were in agreement with a previous hypothesis that PLCε might delay the early stage of cutaneous wound healing by inhibiting the migration of keratinocytes, and decrease the expression of Col6a1, Col17a1, and Ccl20 by inhibiting the inflammatory response to reduce scar formation. This study shed light on a novel role of PLCε in wound healing and provided new therapeutic approaches to target PLCε for diminishing scar formation after injury.
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The Effect of Round Window Sealants on Delayed Hearing Loss in a Guinea Pig Model of Cochlear Implantation. Otol Neurotol 2016; 37:1024-31. [DOI: 10.1097/mao.0000000000001132] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Nam K, Maruyama CL, Trump BG, Buchmann L, Hunt JP, Monroe MM, Baker OJ. Post-Irradiated Human Submandibular Glands Display High Collagen Deposition, Disorganized Cell Junctions, and an Increased Number of Adipocytes. J Histochem Cytochem 2016; 64:343-52. [PMID: 27126825 DOI: 10.1369/0022155416646089] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 04/01/2016] [Indexed: 12/13/2022] Open
Abstract
Salivary glands are vital for maintaining oral health. Head and neck radiation therapy is one of the most common causes of salivary gland hypofunction. Little is known about the structural changes that occur in salivary glands after radiation therapy. The aim of this study is to understand the structural changes that occur in post-irradiated human (submandibular gland [SMG]) as compared with untreated ones. We determined changes in epithelial polarity, presence of collagen deposition, and alteration in adipose tissue. We used formalin-fixed paraffin-embedded human SMG from two female subjects exposed to head and neck irradiation. We utilized hematoxylin and eosin staining and Masson's Trichrome staining. The immunostained tissue sections were examined using confocal microscopy. The number and size of adipocytes per tissue section were calculated using ImageJ, Prism, and SPSS software. Post-irradiated human SMG displayed high collagen deposition, disorganized cell junctions, and an increased number of adipocytes as compared with non-irradiated controls. These findings are important to improve our understanding of the individual risk and variation in radiation-related salivary gland dysfunction.
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Affiliation(s)
- Kihoon Nam
- School of Dentistry, University of Utah, Salt Lake City, Utah (KN, CLM, BGT, OJB)
| | - Christina L Maruyama
- School of Dentistry, University of Utah, Salt Lake City, Utah (KN, CLM, BGT, OJB)
| | - Bryan G Trump
- School of Dentistry, University of Utah, Salt Lake City, Utah (KN, CLM, BGT, OJB)
| | - Luke Buchmann
- Division of Otolaryngology, Department of Surgery, University of Utah, Salt Lake City, Utah (LB, JPH, MMM)
| | - Jason P Hunt
- Division of Otolaryngology, Department of Surgery, University of Utah, Salt Lake City, Utah (LB, JPH, MMM)
| | - Marcus M Monroe
- Division of Otolaryngology, Department of Surgery, University of Utah, Salt Lake City, Utah (LB, JPH, MMM)
| | - Olga J Baker
- School of Dentistry, University of Utah, Salt Lake City, Utah (KN, CLM, BGT, OJB)
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Ud‐Din S, Greaves NS, Sebastian A, Baguneid M, Bayat A. Noninvasive device readouts validated by immunohistochemical analysis enable objective quantitative assessment of acute wound healing in human skin. Wound Repair Regen 2015; 23:901-14. [DOI: 10.1111/wrr.12344] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 06/18/2015] [Indexed: 01/30/2023]
Affiliation(s)
- Sara Ud‐Din
- Plastic and Reconstructive Surgery Research, Manchester Institute of Biotechnology, University of ManchesterManchester United Kingdom
- University Hospital of South Manchester NHS Foundation Trust, Institute of Inflammation and Repair, Faculty of Medical and Human Sciences, University of Manchester, Manchester Academic Health Science CentreManchester United Kingdom
| | - Nicholas S. Greaves
- Plastic and Reconstructive Surgery Research, Manchester Institute of Biotechnology, University of ManchesterManchester United Kingdom
- University Hospital of South Manchester NHS Foundation Trust, Institute of Inflammation and Repair, Faculty of Medical and Human Sciences, University of Manchester, Manchester Academic Health Science CentreManchester United Kingdom
| | - Anil Sebastian
- Plastic and Reconstructive Surgery Research, Manchester Institute of Biotechnology, University of ManchesterManchester United Kingdom
| | - Mohamed Baguneid
- University Hospital of South Manchester NHS Foundation Trust, Institute of Inflammation and Repair, Faculty of Medical and Human Sciences, University of Manchester, Manchester Academic Health Science CentreManchester United Kingdom
| | - Ardeshir Bayat
- Plastic and Reconstructive Surgery Research, Manchester Institute of Biotechnology, University of ManchesterManchester United Kingdom
- University Hospital of South Manchester NHS Foundation Trust, Institute of Inflammation and Repair, Faculty of Medical and Human Sciences, University of Manchester, Manchester Academic Health Science CentreManchester United Kingdom
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Curbing Inflammation in Skin Wound Healing: A Review. Int J Inflam 2015; 2015:316235. [PMID: 26356299 PMCID: PMC4556061 DOI: 10.1155/2015/316235] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Revised: 07/24/2015] [Accepted: 07/27/2015] [Indexed: 12/15/2022] Open
Abstract
Wound healing is a complex regulated process that results in skin scar formation in postnatal mammals. Chronic wounds are major medical problems that can confer devastating consequences. Currently, there are no treatments to prevent scarring. In the early fetus wounds heal without scarring and the healing process is characterized by relatively less inflammation compared to adults; therefore, research aimed at reducing the inflammatory process related to wound healing might speed healing and improve the final scar appearance.
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Cell Autonomous and Non-Autonomous Effects of Senescent Cells in the Skin. J Invest Dermatol 2015; 135:1722-1726. [PMID: 25855157 PMCID: PMC4466004 DOI: 10.1038/jid.2015.108] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Revised: 02/26/2015] [Accepted: 03/07/2015] [Indexed: 01/08/2023]
Abstract
Human and mouse skin accumulate senescent cells in both the epidermis and dermis during aging. When chronically present, senescent cells are thought to enhance the age-dependent deterioration of the skin during extrinsic and intrinsic aging. However, when transiently present, senescent cells promote optimal wound healing. Here, we review recent studies on how senescent cells and the senescence-associated secretory phenotype (SASP) contribute to different physiological and pathophysiological conditions in the skin with a focus on some of the cell autonomous and non-autonomous functions of senescent cells in the context of skin aging and wound healing.
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Choi Y, Cox C, Lally K, Li Y. The strategy and method in modulating finger regeneration. Regen Med 2015; 9:231-42. [PMID: 24750063 DOI: 10.2217/rme.13.98] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The tip of the human finger can regenerate if the amputation is distal to the nail bed, usually in young children. Studies in regeneration of rodent digits have shown that regeneration occurs if the amputation is distal to the mid-third phalanx for certain ages. The digit contains many different components, such as muscle, tendon, bone, skin, nerves and blood vessels, which must all be regrown in the proper location in order to restore functionality. The mechanism behind the complex healing/regeneration processes is still under investigation; however, improvements in injured finger regeneration have been gradually developing in animal models over the past few years. This review discusses a few strategies and methods to possibly enhance digit regeneration beyond current natural limits, focusing on aspects including scarless wound healing, cell-based treatments, tissue engineering and electrical stimulation.
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Affiliation(s)
- Yohan Choi
- Children's Regenerative Medicine, Department of Pediatric Surgery, University of Texas Medical School at Houston, TX 77030, USA
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The effects on dermal wound healing using novel peptide modified by bone morphogenic protein-2. Tissue Eng Regen Med 2014. [DOI: 10.1007/s13770-014-0037-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Sahu K, Sharma M, Sharma P, Verma Y, Rao KD, Bansal H, Dube A, Gupta PK. Effect of poly-L-lysine-chlorin P6-mediated antimicrobial photodynamic treatment on collagen restoration in bacteria-infected wounds. Photomed Laser Surg 2013; 32:23-9. [PMID: 24359264 DOI: 10.1089/pho.2013.3577] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVE The purpose of this work was to study the effect of poly-L-lysine-conjugated chlorin P6 (pl-cp6)-mediated antimicrobial photodynamic treatment (APDT) on collagen remodeling of murine excisional wounds infected with methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa (PAO). BACKGROUND DATA Bacterial infection of wounds leads to compromised collagen remodelling. APDT-induced inactivation of bacteria and bacterial proteases are expected to restore collagen remodeling in wounds. However, published reports on the effect of PDT on wound healing are somewhat contradictory. One of the reasons for these observations could be the random sampling of wound repair outcomes by invasive technques such as histology. METHODS Post-wounding time-dependent changes in collagen restoration were monitored noninvasively using polarization sensitive optical coherence tomography (PSOCT) and compared with histology and hydroxyproline level. Immunoblotting was performed to study matrix metalloproteinase (MMP) level. RESULTS As indicated by retardance measurements from PSOCT images and immunoblotting, bacteria-infected wounds showed slower collagen restoration and higher MMP-8, 9 expression, than did uninfected wounds. In contrast, in infected wounds treated with pl-cp6 and light, retardance was higher (approximately twofold) compared with wounds treated with pl-cp6 alone. These results were consistent with lower MMP-8, 9 level on day 5, more ordered collagen matrix, and higher hydroxyproline content (approximately threefold) on day 18, observed in photodynamically treated wounds, compared with that of untreated infected wounds. CONCLUSIONS APDT expedites healing in bacteria-infected wounds in mice by attenuating collagen degradation and by enhancing epithelialization, hydroxyproline content, and collagen remodelling.
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Affiliation(s)
- Khageswar Sahu
- 1 Laser Biomedical Applications and Instrumentation Division , Raja Ramanna Centre for Advanced Technology, Madhya Pradesh, India
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Kawasaki L, Mushahwar VK, Ho C, Dukelow SP, Chan LLH, Chan KM. The mechanisms and evidence of efficacy of electrical stimulation for healing of pressure ulcer: A systematic review. Wound Repair Regen 2013; 22:161-73. [DOI: 10.1111/wrr.12134] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2013] [Accepted: 10/10/2013] [Indexed: 12/16/2022]
Affiliation(s)
- Lisa Kawasaki
- Centre for Neuroscience; University of Alberta; Edmonton Alberta Canada
- Alberta Innovates-Health Solutions Interdisciplinary Team in Smart Neural Prostheses; Edmonton Alberta Canada
| | - Vivian K. Mushahwar
- Centre for Neuroscience; University of Alberta; Edmonton Alberta Canada
- Division of Physical Medicine and Rehabilitation; University of Alberta; Edmonton Alberta Canada
- Alberta Innovates-Health Solutions Interdisciplinary Team in Smart Neural Prostheses; Edmonton Alberta Canada
| | - Chester Ho
- Division of Physical Medicine and Rehabilitation; University of Calgary; Calgary Alberta Canada
- Alberta Innovates-Health Solutions Interdisciplinary Team in Smart Neural Prostheses; Edmonton Alberta Canada
| | - Sean P. Dukelow
- Division of Physical Medicine and Rehabilitation; University of Calgary; Calgary Alberta Canada
- Alberta Innovates-Health Solutions Interdisciplinary Team in Smart Neural Prostheses; Edmonton Alberta Canada
| | - Leo L. H. Chan
- School of Medicine; University of Glasgow; Glasgow United Kingdom
| | - K. Ming Chan
- Centre for Neuroscience; University of Alberta; Edmonton Alberta Canada
- Division of Physical Medicine and Rehabilitation; University of Alberta; Edmonton Alberta Canada
- Alberta Innovates-Health Solutions Interdisciplinary Team in Smart Neural Prostheses; Edmonton Alberta Canada
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The role of wound healing and its everyday application in plastic surgery: a practical perspective and systematic review. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2013; 1. [PMID: 25289204 PMCID: PMC4174176 DOI: 10.1097/gox.0b013e31828ff9f4] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND After surgery it is often recommended that patients should refrain from strenuous physical activity for 4-6 weeks. This recommendation is based on the time course of wound healing. Here, we present an overview of incisional wound healing with a focus on 2 principles that guide our postoperative recommendations: the gain of tensile strength of a wound over time and the effect of mechanical stress on wound healing. METHODS A systematic search of the English literature was conducted using OVID, Cochrane databases, and PubMed. Inclusion criteria consisted of articles discussing the dynamics of incisional wound healing, and exclusion criteria consisted of articles discussing nonincisional wounds. RESULTS Experiments as early as 1929 laid the groundwork for our postoperative activity recommendations. Research using animal models has shown that the gain in tensile strength of a surgical wound is sigmoidal in trajectory, reaching maximal strength approximately 6 weeks postoperatively. Although human and clinical data are limited, the principles gained from laboratory investigation have provided important insights into the relationship among mechanical stress, collagen dynamics, and the time course of wound healing. CONCLUSION Our postoperative activity recommendations are based on a series of animal studies. Clinical research supporting these recommendations is minimal, with the most relevant clinical data stemming from early motion protocols in the orthopedic literature. We must seek to establish clinical data to support our postoperative activity recommendations so that we can maximize the physiologic relationships between wound healing and mechanical stress.
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Shih B, Sultan MJ, Chaudhry IH, Tan KT, Johal KS, Marstan A, Tsai M, Baguneid M, Bayat A. Identification of biomarkers in sequential biopsies of patients with chronic wounds receiving simultaneous acute wounds: a genetic, histological, and noninvasive imaging study. Wound Repair Regen 2013; 20:757-69. [PMID: 22985042 DOI: 10.1111/j.1524-475x.2012.00832.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Chronic wounds are common and lead to significant patient morbidity. A better understanding of their pathogenesis and relevant biomarkers are required. We compared acute and chronic wounds in the same individual using noninvasive imaging including spectrophotometric intracutaneous analysis (SIAscopy) and full-field laser perfusion imaging. Gene expression analysis was also performed on sequential biopsies. Whole genome gene expression microarray analysis (44k), quantitative polymerase chain reaction, and immunohistochemistry were carried out to determine gene expression levels in tissue biopsies. Fifteen Caucasian patients with chronic venous ulcers had biopsies of the wound edges and simultaneously had an acute wound created on their upper arm on days 0, 7, and 14. SIAscopy revealed increased levels of melanin (p < 0.001), reduced levels of collagen (p < 0.001), and hemoglobin (p = 0.022) in chronic wounds. Microarray and subsequent quantitative polymerase chain reaction analysis confirmed an overall differential expression in acute and chronic wounds for several genes. Significantly higher levels of inhibin, beta A (INHBA) expression were confirmed in the dermis of chronic wounds (p < 0.05). Additionally, INHBA and thrombospondin 1 messenger RNA levels significantly correlated with SIAscopy measurements (p < 0.05). This unique study has showed aberrant expression of INHBA in chronic wounds using a sequential biopsy model of chronic vs. acute wounds in the same individual.
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Affiliation(s)
- Barbara Shih
- Plastic and Reconstructive Surgery Research, Manchester Interdisciplinary Biocentre, University of Manchester, Manchester, UK
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Bayraktar C, Atmaca S, Guvenc D, Karayigit MO, Atmaca E, Yarim M, Aksoy A. Is it really necessary to delay intranasal steroid treatment after FESS? An animal study. Otolaryngol Head Neck Surg 2012; 148:314-23. [PMID: 23232827 DOI: 10.1177/0194599812470430] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The aim of this study is to investigate the effect of early intranasal steroid administration on wound healing after sinus surgery. STUDY DESIGN Randomized, placebo-controlled, blinded animal study. SETTING Animal laboratory. SUBJECTS AND METHODS Forty-two male New Zealand rabbits underwent bilateral 3-mm punch resection of the concha nasalis ventralis. The animals were divided into 3 groups: saline, late steroid, and early steroid. The saline group received saline drops, the late steroid group received saline drops for 7 days followed by intranasal mometasone furoate 50 µg/nostril/d, and the early steroid group received intranasal mometasone furoate (same dose) starting on postoperative day 1. The animals were sacrificed on postoperative days 10 and 21. Left nasal specimens were examined histopathologically with hematoxylin-eosin and matrix metalloproteinase-9 (MMP-9) stains. Right nasal specimens were examined with high-performance liquid chromatography, and hydroxyproline levels were measured as mg/g in wet tissue. RESULTS Late steroid and early steroid groups were similar with regard to MMP-9 staining on days 10 and 21. On day 10, the early steroid group revealed significantly intense MMP-9 staining when compared with the saline group, and the late steroid and early steroid groups revealed significant fibrosis when compared with the saline group. Hydroxyproline levels were similar in all groups on day 10. The early steroid group revealed significantly higher hydroxyproline levels when compared with the late steroid group on day 21. CONCLUSION Our findings showed that early intranasal steroid administration after sinus surgery in an animal model has no detrimental effects with regard to wound-healing parameters.
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Affiliation(s)
- Cem Bayraktar
- Department of Otolaryngology-Head & Neck Surgery, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey
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Abstract
A recent study, based on a combination of multidetector computed tomography scanning of an intact specimen with microcomputed tomography and histological analysis of lung tissue samples, reported that the number of terminal bronchioles were reduced from approximately 44,500/lung pair in control (donor) lungs to approximately 4800/lung pair in lungs donated by individuals with very severe (Global initiative for chronic Obstructive Lung Disease stage 4) chronic obstructive pulmonary disease (COPD) treated by lung transplantation. The present short review discusses the hypothesis that a rapid rate of terminal bronchiolar destruction causes the rapid decline in lung function leading to advanced COPD. With respect to why the terminal bronchioles are targeted for destruction, the postulated mechanisms of this destruction and the possibility that new treatments are able to either prevent or reverse the underlying cause of airway obstruction in COPD are addressed.
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Affiliation(s)
- James C Hogg
- University of British Columbia Research Laboratories, St Paul's Hospital, Vancouver, British Columbia.
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Segal RA, Diegelmann RF, Ward KR, Reynolds A. A Differential Equation Model of Collagen Accumulation in a Healing Wound. Bull Math Biol 2012; 74:2165-82. [DOI: 10.1007/s11538-012-9751-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2011] [Accepted: 07/02/2012] [Indexed: 01/09/2023]
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Reinke JM, Sorg H. Wound repair and regeneration. ACTA ACUST UNITED AC 2012; 49:35-43. [PMID: 22797712 DOI: 10.1159/000339613] [Citation(s) in RCA: 1093] [Impact Index Per Article: 91.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2012] [Accepted: 04/28/2012] [Indexed: 12/12/2022]
Abstract
The skin is the biggest organ of the human being and has many functions. Therefore, the healing of a skin wound displays an extraordinary mechanism of cascading cellular functions which is unique in nature. As healing and regeneration processes take place in all parts of the human body, this review focuses on the healing processes of the skin and highlights the classical wound healing phases. While regeneration describes the specific substitution of the tissue, i.e. the superficial epidermis, mucosa or fetal skin, skin repair displays an unspecific form of healing in which the wound heals by fibrosis and scar formation. The first stage of acute wound healing is dedicated to hemostasis and the formation of a provisional wound matrix, which occurs immediately after injury and is completed after some hours. Furthermore, this phase initiates the inflammatory process. The inflammatory phase of the wound healing cascade gets activated during the coagulation phase and can roughly be divided into an early phase with neutrophil recruitment and a late phase with the appearance and transformation of monocytes. In the phase of proliferation the main focus of the healing process lies in the recovering of the wound surface, the formation of granulation tissue and the restoration of the vascular network. Therefore, next to the immigration of local fibroblasts along the fibrin network and the beginning of reepithelialization from the wound edges, neovascularization and angiogenesis get activated by capillary sprouting. The formation of granulation tissue stops through apoptosis of the cells, characterizing a mature wound as avascular as well as acellular. During the maturation of the wound the components of the extracellular matrix undergo certain changes. The physiological endpoint of mammalian wound repair displays the formation of a scar, which is directly linked to the extent of the inflammatory process throughout wound healing.
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Affiliation(s)
- J M Reinke
- Department of Plastic, Hand and Reconstructive Surgery, Hannover Medical School, Hannover, Germany
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Han G, Nguyen LN, Macherla C, Chi Y, Friedman JM, Nosanchuk JD, Martinez LR. Nitric oxide-releasing nanoparticles accelerate wound healing by promoting fibroblast migration and collagen deposition. THE AMERICAN JOURNAL OF PATHOLOGY 2012; 180:1465-73. [PMID: 22306734 DOI: 10.1016/j.ajpath.2011.12.013] [Citation(s) in RCA: 127] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 03/18/2011] [Revised: 11/28/2011] [Accepted: 12/08/2011] [Indexed: 01/13/2023]
Abstract
Wound healing is a complex process that involves coordinated interactions between diverse immunological and biological systems. Long-term wounds remain a challenging clinical problem, affecting approximately 6 million patients per year, with a high economic impact. To exacerbate the problem, these wounds render the individual susceptible to life-threatening microbial infections. Because current therapeutic strategies have proved suboptimal, it is imperative to focus on new therapeutic approaches and the development of technologies for both short- and long-term wound management. In recent years, nitric oxide (NO) has emerged as a critical molecule in wound healing, with NO levels increasing rapidly after skin damage and gradually decreasing as the healing process progresses. In this study, we examined the effects of a novel NO-releasing nanoparticle technology on wound healing in mice. The results show that the NO nanoparticles (NO-np) significantly accelerated wound healing. NO-np modified leukocyte migration and increased tumor growth factor-β production in the wound area, which subsequently promoted angiogenesis to enhance the healing process. By using human dermal fibroblasts, we demonstrate that NO-np increased fibroblast migration and collagen deposition in wounded tissue. Together, these data show that NO-releasing nanoparticles have the ability to modulate and accelerate wound healing in a pleiotropic manner.
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Affiliation(s)
- George Han
- Department of Physiology and Biophysics, Albert Einstein College of Medicine, Bronx, New York, USA
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Hadi M, Sander E, Ruberti J, Barocas VH. Simulated remodeling of loaded collagen networks via strain-dependent enzymatic degradation and constant-rate fiber growth. MECHANICS OF MATERIALS : AN INTERNATIONAL JOURNAL 2012; 44:72-82. [PMID: 22180691 PMCID: PMC3237686 DOI: 10.1016/j.mechmat.2011.07.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Recent work has demonstrated that enzymatic degradation of collagen fibers exhibits strain-dependent kinetics. Conceptualizing how the strain dependence affects remodeling of collagenous tissues is vital to our understanding of collagen management in native and bioengineered tissues. As a first step towards this goal, the current study puts forward a multiscale model for enzymatic degradation and remodeling of collagen networks for two sample geometries we routinely use in experiments as model tissues. The multiscale model, driven by microstructural data from an enzymatic decay experiment, includes an exponential strain-dependent kinetic relation for degradation and constant growth. For a dogbone sample under uniaxial load, the model predicted that the distribution of fiber diameters would spread over the course of degradation because of variation in individual fiber load. In a cross-shaped sample, the central region, which experiences smaller, more isotropic loads, showed more decay and less spread in fiber diameter compared to the arms. There was also a slight shift in average orientation in different regions of the cruciform.
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Affiliation(s)
- M.F. Hadi
- Department of Biomedical Engineering, University of Minnesota, 7-105 Hasselmo Hall, 312 Church St SE, Minneapolis MN 55455, United States
| | - E.A. Sander
- Department of Biomedical Engineering, University of Minnesota, 7-105 Hasselmo Hall, 312 Church St SE, Minneapolis MN 55455, United States
| | - J.W. Ruberti
- Department of Mechanical and Industrial Engineering, Northeastern University, 334 Snell Engineering Center, 360 Huntington Avenue, Boston MA 02115, United States
| | - V. H. Barocas
- Department of Biomedical Engineering, University of Minnesota, 7-105 Hasselmo Hall, 312 Church St SE, Minneapolis MN 55455, United States
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A Morphological and Biochemical Analysis Comparative Study of the Collagen Products Biopad, Promogram, Puracol, and Colactive. Adv Skin Wound Care 2011; 24:208-16. [DOI: 10.1097/01.asw.0000397897.18003.ce] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Rodrigues FV, Hochman B, Wood VT, Simões MJ, Juliano Y, Ferreira LM. Effects of lidocaine with epinephrine or with buffer on wound healing in rat skin. Wound Repair Regen 2011; 19:223-8. [DOI: 10.1111/j.1524-475x.2010.00654.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Abstract
SUMMARY Scar formation is a major medical problem that can have devastating consequences for patients. The adverse physiological and psychological effects of scars are broad, and there are currently no reliable treatments to prevent scarring. In contrast to adult wounds, early gestation fetal skin wounds repair rapidly and in the absence of scar formation. Despite extensive investigation, the exact mechanisms of scarless fetal wound healing remain largely unknown. For some time, it has been known that significant differences exist among the extracellular matrix, inflammatory response, cellular mediators, and gene expression profiles of fetal and postnatal wounds. These differences may have important implications in scarless wound repair.
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Affiliation(s)
- Barrett J Larson
- Stanford, Calif. From the Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic Surgery, Department of Surgery, Stanford University School of Medicine
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Effects of topical application of Calendula officinalis gel on collagen and hydroxyproline content of skin in rats. ACTA ACUST UNITED AC 2010. [DOI: 10.1007/s00580-010-1087-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ismail MM, Ibrahim MM, Youssef EF, El Shorbagy KM. Plyometric training versus resistive exercises after acute lateral ankle sprain. Foot Ankle Int 2010; 31:523-30. [PMID: 20557819 DOI: 10.3113/fai.2010.0523] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Plyometric training is a widely used method to improve performance in healthy athletes. It is highly recommended in the late stage of rehabilitation of many lower limb injuries. However, its effects on muscle strength and function in management of lateral ankle sprain have not been reported. Therefore, the objective of the current study was to determine the effects of plyometric training versus resistive exercises on muscle strength and function following acute lateral ankle sprain. MATERIALS AND METHODS Twenty-two athletes (aged from 20 to 35 years) of both sexes with grade I or II unilateral inversion ankle sprain participated in the study (at least 3 weeks after acute injury). They were randomly assigned to two groups. The first group received plyometric training, whereas the second one received resistive training for 6 weeks. Isokinetic peak torque/body weight for invertors and evertors at 30 degrees/s and 120 degrees/s and functional tests were assessed before and after training. RESULTS Both plyometric and resistive training improve isokinetic evertor and invertor peak torques and functional performance of athletes p < 0.05. There were no significant differences between groups concerning peak torque/body weight for invertors and evertors at both speeds measured p > 0.05. The functional test measures of the plyometric group were significantly higher than that of resistive group. CONCLUSION Plyometrics were more effective than resistive exercises in improving functional performance of athletes after lateral ankle sprain.
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Affiliation(s)
- Manal M Ismail
- Cairo University, Orthopedic Physical Therapy, Bin el Sarayat, Cairo University, Cairo, 12613, Egypt.
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What drives the peripheral lung-remodeling process in chronic obstructive pulmonary disease? Ann Am Thorac Soc 2010; 6:668-72. [PMID: 20008873 DOI: 10.1513/pats.200907-079dp] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The smaller airways (<2 mm in diameter) offer little resistance in normal lungs but become the major site of obstruction in chronic obstructive pulmonary disease (COPD). We examined bronchiolar remodeling in COPD by combining quantitative histology, micro-computed tomography (CT), and gene expression studies. Volumes of bronchiolar tissue, total collagen, collagen-1, and collagen-3 were measured in lung tissue from 52 patients with different levels of COPD severity. Micro-CT was used to measure the number and lumen area of terminal bronchioles in four lungs removed before lung transplantation and in four donor lungs that served as controls. Laser capture microdissection provided 136 paired samples of bronchiolar and surrounding lung tissue from 63 patients and the gene expression of a cluster of tissue repair genes was compared. This study shows that total bronchiolar tissue decreased with progression of COPD and was associated with a reduction in total collagen and relative increase in collagen-3 over collagen-1. The micro-CT studies showed a 10-fold reduction in terminal bronchiolar number and a 100-fold reduction in lumen area. Interestingly, most genes associated with tissue accumulation during repair decreased their expression in both airways and in the surrounding lung as FEV(1) declined, but eight genes previously associated with COPD increased expression in the surrounding lung tissue. Our study shows that small airway remodeling is associated with narrowing and obliteration of the terminal bronchioles that begins before emphysematous destruction in COPD and in relation to differential expression of tissue repair genes in the airways and surrounding lung.
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TIERNEY EMILY, KOUBA DAVIDJ. A Subcutaneous Corset Plication Rapidly and Effectively Relieves Tension on Large Linear Closures. Dermatol Surg 2009; 35:1806-8. [DOI: 10.1111/j.1524-4725.2009.01295.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
The developing fetus has the ability to heal wounds by regenerating normal epidermis and dermis with restoration of the extracellular matrix (ECM) architecture, strength, and function. In contrast, adult wounds heal with fibrosis and scar. Scar tissue remains weaker than normal skin with an altered ECM composition. Despite extensive investigation, the mechanism of fetal wound healing remains largely unknown. We do know that early in gestation, fetal skin is developing at a rapid pace and the ECM is a loose network facilitating cellular migration. Wounding in this unique environment triggers a complex cascade of tightly controlled events culminating in a scarless wound phenotype of fine reticular collagen and abundant hyaluronic acid. Comparison between postnatal and fetal wound healing has revealed differences in inflammatory response, cellular mediators, cytokines, growth factors, and ECM modulators. Investigation into cell signaling pathways and transcription factors has demonstrated differences in secondary messenger phosphorylation patterns and homeobox gene expression. Further research may reveal novel genes essential to scarless repair that can be manipulated in the adult wound and thus ameliorate scar.
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Affiliation(s)
- Edward P Buchanan
- Division Plastic Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, California 94305, USA.
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Bird B, Ball C, Balasuntharam P. Rehabilitation after surgery for Dupuytren's Contracture. Hippokratia 2007. [DOI: 10.1002/14651858.cd006508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Beverlee Bird
- School of Health Sciences and Social Care; Osterley Campus, Borough Road Isleworth, Middlesex UK TW7 5DU
| | - Cathy Ball
- Imperial College London; Kennedy Institute of Rheumatology; 1 Aspenlea Road London UK W6 8LF
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