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Sommana C, Banharak S, Sim-Im S, Ransinyo K. Effects of Nursing Program in Preventing Incontinence-Associated Dermatitis by Applying Zinc Oxide and Petroleum Jelly Skin Protection Products Among Older Patients in Semi-Intensive Medical Care Units: A Pilot Study. J Multidiscip Healthc 2024; 17:3619-3636. [PMID: 39081404 PMCID: PMC11287369 DOI: 10.2147/jmdh.s469276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Accepted: 07/15/2024] [Indexed: 08/02/2024] Open
Abstract
Aim Incontinence-associated dermatitis is a common health problem among older clinical patients, causing related severe skin damage such as pressure ulcers, secondary infection, and long length of hospital stay. This pilot study aimed to develop and examine the effects of nursing programs in preventing incontinence-associated dermatitis (IAD) among older patients. Ten older patients at high risk of incontinence-associated dermatitis were included in this study: five patients received a nursing program combined with mixed products, and another five received a nursing program combined with separate use of products. The program was evaluated using a perianal assessment tool (PAT-T) for risk assessment, the incontinence-associated dermatitis invention tool (IADIT-T) for severity assessment, the skin surface pH, and skin surface moisture. The results revealed that the nursing program and skin products are usable and acceptable, provide step-by-step details, and are simple and easy to follow. The nursing program combined with using zinc oxide products followed by petroleum jelly can prevent and decrease the severity of incontinence-associated dermatitis in older patients. Moreover, it can also improve the skin surface pH to a mild acidity appropriate for the skin condition and increase the skin's moisture better the nursing program with mixed skin products. This pilot study confirmed that the developed program can be applied in practice. Moreover, the program could be used to decrease the incidence of IAD and skin surface pH but increase skin moisture. However, future study with a larger sample size and applying a more substantial research design for more accuracy and generalization is needed. Clinical Trial Registration Number OSF https://osf.io/8gj3d.
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Affiliation(s)
- Chakkarin Sommana
- Department of Gerontological Nursing, Faculty of Nursing, Khon Kaen University, Khon Kaen, Thailand
| | - Samoraphop Banharak
- Department of Gerontological Nursing, Faculty of Nursing, Khon Kaen University, Khon Kaen, Thailand
| | - Supin Sim-Im
- Nursing Department, Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand
| | - Khanisorn Ransinyo
- Department of Gerontological Nursing, Faculty of Nursing, Khon Kaen University, Khon Kaen, Thailand
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Dai Y, Inagaki NF, Ueki R, Sando S, Hasegawa K, Ito T. Hepatocyte Growth Factor DNA Aptamer for Prevention of Postoperative Peritoneal Adhesion via Enhancement of Fibrinolysis and Inhibition of Mesothelial Mesenchymal Transition. ACS APPLIED BIO MATERIALS 2024; 7:4679-4689. [PMID: 38963794 DOI: 10.1021/acsabm.4c00507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/06/2024]
Abstract
Postoperative peritoneal adhesion (PPA) is a prevalent complication of abdominal surgery, posing a significant hindrance to postsurgical recovery. Although several strategies have been developed to alleviate and prevent adhesions, their efficacy remains unsatisfactory. For the first time, we studied the therapeutic effect and mechanism of our recently developed thermally stable oligonucleotide-based mimetics of hepatocyte growth factor (HGF DNA aptamer) to prevent PPA. The HGF DNA aptamer effectively inhibited canonical TGF-β1 signaling transduction, partially suppressing mesothelial mesenchymal transition. Additionally, the aptamer, respectively, upregulated and downregulated the expression of tissue plasminogen activator and plasminogen activator inhibitor 1, thereby enhancing fibrinolytic activity. As a pleiotropic factor, the HGF DNA aptamer also enhanced the migratory and proliferative capacities of mesothelial cells. Finally, the aptamer demonstrated a higher level of effectiveness in preventing PPAs than the commercially available antiperitoneal adhesion barrier, Seprafilm. Due to its therapeutic benefits, excellent stability, biosafety, cost-effectiveness, and versatility, the HGF DNA aptamer demonstrates promise for preventing PPA in future clinical settings.
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Affiliation(s)
- Yizhou Dai
- Department of Chemical System Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
- Department of Bioengineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
| | - Natsuko F Inagaki
- Department of Chemical System Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
- Department of Radiology and Biomedical Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Ryosuke Ueki
- Department of Chemistry & Biotechnology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
| | - Shinsuke Sando
- Department of Bioengineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
- Department of Chemistry & Biotechnology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
| | - Kiyoshi Hasegawa
- Hepato-Biliary-Pancreatic Surgery Division, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Taichi Ito
- Department of Chemical System Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
- Department of Bioengineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
- Department of Radiology and Biomedical Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
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Guptha PM, Kanoujia J, Kishore A, Raina N, Wahi A, Gupta PK, Gupta M. A comprehensive review of the application of 3D-bioprinting in chronic wound management. Expert Opin Drug Deliv 2024:1-22. [PMID: 38809187 DOI: 10.1080/17425247.2024.2355184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 05/10/2024] [Indexed: 05/30/2024]
Abstract
INTRODUCTION Chronic wounds require more sophisticated care than standard wound care because they are becoming more severe as a result of diseases like diabetes. By resolving shortcomings in existing methods, 3D-bioprinting offers a viable path toward personalized, mechanically strong, and cell-stimulating wound dressings. AREAS COVERED This review highlights the drawbacks of traditional approaches while navigating the difficulties of managing chronic wounds. The conversation revolves around employing natural biomaterials for customized dressings, with a particular emphasis on 3D-bioprinting. A thorough understanding of the uses of 3D-printed dressings in a range of chronic wound scenarios is provided by insights into recent research and patents. EXPERT OPINION The expert view recognizes wounds as a historical human ailment and emphasizes the growing difficulties and expenses related to wound treatment. The expert acknowledges that 3D printing is revolutionary, but also points out that it is still in its infancy and has the potential to enhance mass production rather than replace it. The review highlights the benefits of 3D printing for wound dressings by providing instances of smart materials that improve treatment results by stimulating angiogenesis, reducing pain, and targeting particular enzymes. The expert advises taking action to convert the technology's prospective advantages into real benefits for patients, even in the face of resistance to change in the healthcare industry. It is believed that the increasing evidence from in-vivo studies is promising and represents a positive change in the treatment of chronic wounds toward sophisticated 3D-printed dressings.
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Affiliation(s)
| | - Jovita Kanoujia
- Amity Institute of Pharmacy, Amity University Madhya Pradesh (AUMP), Gwalior, India
| | - Ankita Kishore
- Amity Institute of Pharmacy, Amity University Madhya Pradesh (AUMP), Gwalior, India
| | - Neha Raina
- Department of Pharmaceutics, School of Pharmaceutical Sciences, Delhi Pharmaceutical Sciences and Research University, New Delhi, India
| | - Abhishek Wahi
- Department of Pharmaceutics, School of Pharmaceutical Sciences, Delhi Pharmaceutical Sciences and Research University, New Delhi, India
| | - Piyush Kumar Gupta
- Department of Life Sciences, Sharda School of Basic Sciences & Research, Sharda University, Greater Noida, India
| | - Madhu Gupta
- Department of Pharmaceutics, School of Pharmaceutical Sciences, Delhi Pharmaceutical Sciences and Research University, New Delhi, India
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Suryani IR, Shujaat S, That MT, Coucke W, Jacobs R. Prediction of wound healing status following dental extraction using Adapted-University of Connecticut osteonecrosis numerical scale: A retrospective study. Health Sci Rep 2024; 7:e2184. [PMID: 38915354 PMCID: PMC11194833 DOI: 10.1002/hsr2.2184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 05/06/2024] [Accepted: 05/22/2024] [Indexed: 06/26/2024] Open
Abstract
Background and Aims There is a scarcity of evidence concerning the use of a prognostic instrument for predicting normal healing, delayed healing, and medication-related osteonecrosis of the jaw (MRONJ) occurrence following tooth extraction in medically compromised patients. The present study aimed to predict healing outcomes following tooth extraction in medically compromised patients using an Adapted-University of Connecticut osteonecrosis numerical scale (A-UCONNS). Methods The digital medical records of medically compromised patients were reviewed, who underwent tooth extraction. The A-UCONNS parameters included the initial pathological condition, dental procedures, comorbidities (smoking habits, type and duration of medication, and type of intervention), and administered antiresorptive (AR) medications. Each parameter was assigned a different weight, and the scores were then accumulated and classified into three categories: minimal risk (less than 10), moderate risk (10-15), and significant risk (16 or more). The patient's healing status was categorized as normal healing, delayed healing, or MRONJ. Results A total of 353 male patients (mean age: 67.4 years) were recruited from a pool of 3977 patients, where 12.46% of patients had delayed wound healing, and 18.69% developed MRONJ. The median A-UCONNS scores for MRONJ were higher based on initial pathology, comorbidity, and AR drugs compared to normal or delayed healing. In addition, a significant relationship existed between A-UCONNS and healing outcomes (p < 0.05), with a unit increase in A-UCONNS associated with 1.347 times higher odds of experiencing MRONJ compared to normal healing. In contrast, a low score was linked to an increased likelihood of normal wound healing. Conclusion The A-UCONNS could act as a promising tool for predicting wound healing outcomes. It can provide clinicians the ability to pinpoint patients at high risk and allow tailoring of patient-specific strategies for improving healing outcomes following tooth extraction.
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Affiliation(s)
- Isti R. Suryani
- Department of Imaging & Pathology, OMFS IMPATH Research Group, Faculty of Medicine, KU Leuven & Oral and Maxillofacial SurgeryUniversity Hospitals LeuvenLeuvenBelgium
- Department of Dentomaxillofacial Radiology, Faculty of DentistryUniversitas Gadjah MadaYogyakartaIndonesia
| | - Sohaib Shujaat
- Department of Imaging & Pathology, OMFS IMPATH Research Group, Faculty of Medicine, KU Leuven & Oral and Maxillofacial SurgeryUniversity Hospitals LeuvenLeuvenBelgium
- King Abdullah International Medical Research Center, Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health SciencesMinistry of National Guard Health AffairsRiyadhSaudi Arabia
| | - Minh T. That
- Department of Imaging & Pathology, OMFS IMPATH Research Group, Faculty of Medicine, KU Leuven & Oral and Maxillofacial SurgeryUniversity Hospitals LeuvenLeuvenBelgium
| | | | - Reinhilde Jacobs
- Department of Imaging & Pathology, OMFS IMPATH Research Group, Faculty of Medicine, KU Leuven & Oral and Maxillofacial SurgeryUniversity Hospitals LeuvenLeuvenBelgium
- Department of Dental MedicineKarolinska InstitutetStockholmSweden
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Murphy C, Banasiewicz T, Duteille F, Ferrando PM, Jerez González JA, Koullias G, Long Z, Nasur R, Salazar Trujillo MA, Bassetto F, Dunk AM, Iafrati M, Jawień A, Matsumura H, O'Connor L, Sanchez V, Wu J. A proactive healing strategy for tackling biofilm-based surgical site complications: Wound Hygiene Surgical. J Wound Care 2024; 33:S1-S30. [PMID: 38787336 DOI: 10.12968/jowc.2024.33.sup5c.s1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Affiliation(s)
- Chris Murphy
- Vascular Nurse Specialist, Ottawa Hospital Limb Preservation Centre, Ottawa, Canada
| | - Tomasz Banasiewicz
- Head of Department of General Endocrine Surgery and Gastrointestinal Oncology, Poznań University of Medical Sciences, Poznań, Poland
| | | | - Pietro Maria Ferrando
- Consultant Plastic and Oncoplastic Surgeon, Plastic Surgery Department and Breast Unit, City of Health and Science, University Hospital of Turin, Italy
| | | | - George Koullias
- Associate Professor of Surgery, Division of Vascular & Endovascular Surgery, Stony Brook University Hospital & Stony Brook Southampton Hospital, USA
| | - Zhang Long
- Chief Surgeon, Associate Professor, Mentor of Master in Surgery, Executive Deputy Director of Wound Healing Center, Department of Interventional Radiology and Vascular Surgery, Peking University Third Hospital, Beijing, China
| | - Reem Nasur
- Consultant Obstetrician, Gynaecologist and Head of Women's Health, Blackpool Teaching Hospitals NHS Foundation Trust, UK
| | - Marco Antonio Salazar Trujillo
- Plastic and Reconstructive Surgeon, Consultant in Advanced Wound Management, Scientific Director of Plastic, Aesthetic and Laser Surgery, Renovarte, Colombia
| | - Franco Bassetto
- Full Professor of Plastic, Reconstructive and Aesthetic Surgery, Chief of the Clinic of Plastic and Reconstructive Surgery, Padova University Hospital, Padova, Italy
| | - Ann Marie Dunk
- RN MN(research) PhD(c) Ghent University, Belgium, Clinical Nurse Consultant, Tissue Viability Unit, Canberra Hospital, Australian Capital Territory, Australia
| | - Mark Iafrati
- Director of the Vanderbilt Wound Center and Professor of Vascular Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Arkadiusz Jawień
- Head of the Department of Vascular Surgery and Angiology, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Hajime Matsumura
- Professor, Chair of the Department of Plastic Surgery and Director of the General Informatics Division, Tokyo Medical University, Tokyo, Japan
| | - Louise O'Connor
- Independent Tissue Viability Nurse Consultant, Manchester, UK
| | - Violeta Sanchez
- Specialist Nurse in Complex Wounds and Pressure Ulcers, Son Llàtzer Hospital, Palma de Mallorca, Spain
| | - Jun Wu
- Professor, Director, Department of Burn and Plastic Surgery, First Affiliated Hospital, Shenzhen University, Shenzhen, China
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Peltier S, Adib Y, Nicosia L, Ly Ka So S, Da Silva C, Serror K, Duciel L, Proust R, Mimoun M, Bagot M, Bensussan A, des Courtils C, Michel L. In vitro effects of wound-dressings on key wound healing properties of dermal fibroblasts. Exp Dermatol 2024; 33:e15098. [PMID: 38770557 DOI: 10.1111/exd.15098] [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: 09/06/2023] [Revised: 04/02/2024] [Accepted: 04/28/2024] [Indexed: 05/22/2024]
Abstract
Healing of complex wounds requires dressings that must, at least, not hinder and should ideally promote the activity of key healing cells, in particular fibroblasts. This in vitro study assessed the effects of three wound-dressings (a pure Ca2+ alginate: Algostéril®, a Ca2+ alginate + carboxymethylcellulose: Biatain alginate® and a polyacrylate impregnated with lipido-colloid matrix: UrgoClean®) on dermal fibroblast activity. The results showed the pure calcium alginate to be non-cytotoxic, whereas the other wound-dressings showed moderate to strong cytotoxicity. The two alginates stimulated fibroblast migration and proliferation, whereas the polyacrylate altered migration and had no effect on proliferation. The pure Ca2+ alginate significantly increased the TGF-β-induced fibroblast activation, which is essential to healing. This activation was confirmed by a significant increase in Vascular endothelial growth factor (VEGF) secretion and a higher collagen production. The other dressings reduced these fibroblast activities. The pure Ca2+ alginate was also able to counteract the inhibitory effect of NK cell supernatants on fibroblast migration. These in vitro results demonstrate that tested wound-dressings are not equivalent for fibroblast activation. Only Algostéril was found to promote all the fibroblast activities tested, which could contribute to its healing efficacy demonstrated in the clinic.
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Affiliation(s)
- S Peltier
- Inserm UMRS_976, Hôpital Saint-Louis, Paris, France
- Université Paris Cité, Paris, France
| | - Y Adib
- Inserm UMRS_976, Hôpital Saint-Louis, Paris, France
- Université Paris Cité, Paris, France
| | - L Nicosia
- Inserm UMRS_976, Hôpital Saint-Louis, Paris, France
- Université Paris Cité, Paris, France
| | - S Ly Ka So
- Inserm UMRS_976, Hôpital Saint-Louis, Paris, France
| | - C Da Silva
- Inserm UMRS_976, Hôpital Saint-Louis, Paris, France
| | - K Serror
- Inserm UMRS_976, Hôpital Saint-Louis, Paris, France
- Université Paris Cité, Paris, France
- Service de Chirurgie plastique, reconstructive et esthétique, APHP, Hôpital Saint-Louis, Paris, France
| | - L Duciel
- Laboratoires Brothier, Nanterre, France
| | - R Proust
- Laboratoires Brothier, Nanterre, France
| | - M Mimoun
- Inserm UMRS_976, Hôpital Saint-Louis, Paris, France
- Université Paris Cité, Paris, France
- Service de Chirurgie plastique, reconstructive et esthétique, APHP, Hôpital Saint-Louis, Paris, France
| | - M Bagot
- Inserm UMRS_976, Hôpital Saint-Louis, Paris, France
- Université Paris Cité, Paris, France
- Service de Dermatologie, APHP, Hôpital Saint Louis, Paris, France
| | - A Bensussan
- Inserm UMRS_976, Hôpital Saint-Louis, Paris, France
- Université Paris Cité, Paris, France
| | | | - Laurence Michel
- Inserm UMRS_976, Hôpital Saint-Louis, Paris, France
- Université Paris Cité, Paris, France
- Service de Dermatologie, APHP, Hôpital Saint Louis, Paris, France
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Ji C, Guo W, Amir H. Experience of diagnosis and treatment of hard-to-heal wounds infected with Acinetobacter baumannii: a case study. J Wound Care 2024; 33:278-285. [PMID: 38573906 DOI: 10.12968/jowc.2024.33.4.278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
OBJECTIVE To explore the efficacy of 0.01% hypochlorous acid (HOCl) in the treatment of hard-to-heal wounds infected by multidrug-resistant Acinetobacter baumannii. METHOD We report a case of hard-to-heal wounds on a patient's forearms that were infected by Acinetobacter baumannii. The wounds were treated with 0.01% HOCl. We reviewed the relevant literature and discussed the definition, epidemiology and pathogenesis of hard-to-heal wounds infected by Acinetobacter baumannii. We also explored the safety and efficacy of 0.01% HOCl for the treatment of hard-to-heal wounds infected with Acinetobacter baumannii. RESULTS After 3-4 weeks of treatment with 0.01% HOCl, the pain and pruritus of the wounds was gradually alleviated, the infection was controlled and the granulation tissue was fresh. The ulcers also shrank and the nutritional condition of the patient improved. In the fifth week, the skin of the patient's right thigh was grafted to repair the wounds, which then healed within 18 days. During the three years of follow-up, the patient had no relapse. CONCLUSION In our case, the 0.01% HOCl seemed to effectively inactivate the bacterial biological biofilm. This helped to promote wound healing, and was non-toxic to the tissues. We consider low-concentration HOCl to be safe and effective for the treatment of hard-to-heal wounds infected with Acinetobacter baumannii.
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Affiliation(s)
- Chaochao Ji
- The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
| | - Wenyong Guo
- Institute of Basic Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Hammad Amir
- The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
- Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
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Altunbek M, Gezek M, Gouveia MET, Camci-Unal G. Development of a Sprayable Hydrogel-Based Wound Dressing: An In Vitro Model. Gels 2024; 10:176. [PMID: 38534594 DOI: 10.3390/gels10030176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 02/16/2024] [Accepted: 02/27/2024] [Indexed: 03/28/2024] Open
Abstract
Hydrogel-based dressings can effectively heal wounds by providing multiple functions, such as antibacterial, anti-inflammatory, and preangiogenic bioactivities. The ability to spray the dressing is important for the rapid and effective coverage of the wound surface. In this study, we developed a sprayable hydrogel-based wound dressing using naturally derived materials: hyaluronic acid and gelatin. We introduced methacrylate groups (HAMA and GelMA) to these materials to enable controllable photocrosslinking and form a stable hydrogel on the wound surface. To achieve sprayability, we evaluated the concentration of GelMA within a range of 5-15% (w/v) and then incorporated 1% (w/v) HAMA. Additionally, we incorporated calcium peroxide into the hydrogel at concentrations ranging from 0 to 12 mg/mL to provide self-oxygenation and antibacterial properties. The results showed that the composite hydrogels were sprayable and could provide oxygen for up to two weeks. The released oxygen relieved metabolic stress in fibroblasts and reduced cell death under hypoxia in in vitro culture. Furthermore, calcium peroxide added antibacterial properties to the wound dressing. In conclusion, the developed sprayable hydrogel dressing has the potential to be advantageous for wound healing due to its practical and conformable application, as well as its self-oxygenating and antibacterial functions.
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Affiliation(s)
- Mine Altunbek
- Department of Chemical Engineering, University of Massachusetts Lowell, 1 University Avenue, Lowell, MA 01854, USA
| | - Mert Gezek
- Department of Chemical Engineering, University of Massachusetts Lowell, 1 University Avenue, Lowell, MA 01854, USA
- Biomedical Engineering and Biotechnology Program, University of Massachusetts Lowell, 1 University Avenue, Lowell, MA 01854, USA
| | - Maria Eduarda Torres Gouveia
- Department of Chemical Engineering, University of Massachusetts Lowell, 1 University Avenue, Lowell, MA 01854, USA
| | - Gulden Camci-Unal
- Department of Chemical Engineering, University of Massachusetts Lowell, 1 University Avenue, Lowell, MA 01854, USA
- Department of Surgery, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01605, USA
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9
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Arosa L, Camba-Gómez M, Golubnitschaja O, Conde-Aranda J. Predictive, preventive and personalised approach as a conceptual and technological innovation in primary and secondary care of inflammatory bowel disease benefiting affected individuals and populations. EPMA J 2024; 15:111-123. [PMID: 38463620 PMCID: PMC10923750 DOI: 10.1007/s13167-024-00351-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 01/25/2024] [Indexed: 03/12/2024]
Abstract
Inflammatory bowel disease (IBD) is a global health burden which carries lifelong morbidity affecting all age groups in populations with the disease-specific peak of the age groups ranging between 15 and 35 years, which are of great economic importance for the society. An accelerating incidence of IBD is reported for newly industrialised countries, whereas stabilising incidence but increasing prevalence is typical for countries with a Westernised lifestyle, such as the European area and the USA. Although the aetiology of IBD is largely unknown, the interplay between the genetic, environmental, immunological, and microbial components is decisive for the disease manifestation, course, severity and individual outcomes. Contextually, the creation of an individualised patient profile is crucial for the cost-effective disease management in primary and secondary care of IBD. The proposed pathomechanisms include intestinal pathoflora and dysbiosis, chronic inflammation and mitochondrial impairments, amongst others, which collectively may reveal individual molecular signatures defining IBD subtypes and leading to clinical phenotypes, patient stratification and cost-effective protection against health-to-disease transition and treatments tailored to individualised patient profiles-all the pillars of an advanced 3PM approach. The paradigm change from reactive medical services to predictive diagnostics, cost-effective targeted prevention and treatments tailored to individualised patient profiles in overall IBD management holds a promise to meet patient needs in primary and secondary care, to increase the life-quality of affected individuals and to improve health economy in the area of IBD management. This article analyses current achievements and provides the roadmap for future developments in the area in the context of 3P medicine benefiting society at large.
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Affiliation(s)
- Laura Arosa
- Molecular and Cellular Gastroenterology, Health Research Institute of Santiago de Compostela (IDIS), Laboratory 15, Trav. Choupana S/N, Building C, Level -2, 15706 Santiago de Compostela, Spain
| | - Miguel Camba-Gómez
- Molecular and Cellular Gastroenterology, Health Research Institute of Santiago de Compostela (IDIS), Laboratory 15, Trav. Choupana S/N, Building C, Level -2, 15706 Santiago de Compostela, Spain
| | - Olga Golubnitschaja
- 3P Medicine Research Unit, University Hospital, Rheinische Friedrich-Wilhelms Universität Bonn, 53127 Bonn, Germany
| | - Javier Conde-Aranda
- Molecular and Cellular Gastroenterology, Health Research Institute of Santiago de Compostela (IDIS), Laboratory 15, Trav. Choupana S/N, Building C, Level -2, 15706 Santiago de Compostela, Spain
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10
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Singh H, Chopra H, Singh I, Mohanto S, Ahmed MG, Ghumra S, Seelan A, Survase M, Kumar A, Mishra A, Mishra AK, Kamal MA. Molecular targeted therapies for cutaneous squamous cell carcinoma: recent developments and clinical implications. EXCLI JOURNAL 2024; 23:300-334. [PMID: 38655092 PMCID: PMC11036065 DOI: 10.17179/excli2023-6489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 02/14/2024] [Indexed: 04/26/2024]
Abstract
Cutaneous Squamous Cell Carcinoma (cSCC) is a common and potentially fatal type of skin cancer that poses a significant threat to public health and has a high prevalence rate. Exposure to ultraviolet radiation on the skin surface increases the risk of cSCC, especially in those with genetic syndromes like xerodermapigmentosum and epidermolysis bullosa. Therefore, understanding the molecular pathogenesis of cSCC is critical for developing personalized treatment approaches that are effective in cSCC. This article provides a comprehensive overview of current knowledge of cSCC pathogenesis, emphasizing dysregulated signaling pathways and the significance of molecular profiling. Several limitations and challenges associated with conventional therapies, however, are identified, stressing the need for novel therapeutic strategies. The article further discusses molecular targets and therapeutic approaches, i.e., epidermal growth factor receptor inhibitors, hedgehog pathway inhibitors, and PI3K/AKT/mTOR pathway inhibitors, as well as emerging molecular targets and therapeutic agents. The manuscript explores resistance mechanisms to molecularly targeted therapies and proposes methods to overcome them, including combination strategies, rational design, and optimization. The clinical implications and patient outcomes of molecular-targeted treatments are assessed, including response rates and survival outcomes. The management of adverse events and toxicities in molecular-targeted therapies is crucial and requires careful monitoring and control. The paper further discusses future directions for therapeutic advancement and research in this area, as well as the difficulties and constraints associated with conventional therapies.
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Affiliation(s)
- Harpreet Singh
- School of Pharmaceutical Sciences, IFTM University, Moradabad, U.P., India, 244102
| | - Hitesh Chopra
- Department of Biosciences, Saveetha School of Engineering, Saveetha Institute of Medical and Technical Sciences, Chennai - 602105, Tamil Nadu, India
| | - Inderbir Singh
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
| | - Sourav Mohanto
- Department of Pharmaceutics, Yenepoya Pharmacy College & Research Center, Yenepoya (Deemed to be University), Mangalore, Karnataka, 575018, India
| | - Mohammed Gulzar Ahmed
- Department of Pharmaceutics, Yenepoya Pharmacy College & Research Center, Yenepoya (Deemed to be University), Mangalore, Karnataka, 575018, India
| | - Shruti Ghumra
- Department of Biological Sciences, Sunandan Divatia School of Science, NarseeMonjee Institute of Management Studies (NMIMS), Pherozeshah Mehta Rd, Mumbai, India, 400056
| | - Anmol Seelan
- Mahatma Gandhi Mission, Institute of Biosciences and Technology, Aurangabad, India
| | - Manisha Survase
- Mahatma Gandhi Mission, Institute of Biosciences and Technology, Aurangabad, India
| | - Arvind Kumar
- School of Pharmaceutical Sciences, IFTM University, Moradabad, U.P., India, 244102
| | - Amrita Mishra
- School of Pharmaceutical Sciences, Delhi Pharmaceutical Sciences and Research University, New Delhi, India, 110017
| | - Arun Kumar Mishra
- SOS School of Pharmacy, IFTM University, Moradabad, U.P., India, 244102
| | - Mohammad Amjad Kamal
- Institutes for Systems Genetics, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, China
- King Fahd Medical Research Center, King Abdulaziz University, Saudi Arabia
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Bangladesh
- Enzymoics, 7 Peterlee Place, Hebersham, NSW 2770; Novel Global Community Educational Foundation, Australia
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11
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Yadav JP, Singh AK, Grishina M, Pathak P, Verma A, Kumar V, Kumar P, Patel DK. Insights into the mechanisms of diabetic wounds: pathophysiology, molecular targets, and treatment strategies through conventional and alternative therapies. Inflammopharmacology 2024; 32:149-228. [PMID: 38212535 DOI: 10.1007/s10787-023-01407-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 11/27/2023] [Indexed: 01/13/2024]
Abstract
Diabetes mellitus is a prevalent cause of mortality worldwide and can lead to several secondary issues, including DWs, which are caused by hyperglycemia, diabetic neuropathy, anemia, and ischemia. Roughly 15% of diabetic patient's experience complications related to DWs, with 25% at risk of lower limb amputations. A conventional management protocol is currently used for treating diabetic foot syndrome, which involves therapy using various substances, such as bFGF, pDGF, VEGF, EGF, IGF-I, TGF-β, skin substitutes, cytokine stimulators, cytokine inhibitors, MMPs inhibitors, gene and stem cell therapies, ECM, and angiogenesis stimulators. The protocol also includes wound cleaning, laser therapy, antibiotics, skin substitutes, HOTC therapy, and removing dead tissue. It has been observed that treatment with numerous plants and their active constituents, including Globularia Arabica, Rhus coriaria L., Neolamarckia cadamba, Olea europaea, Salvia kronenburgii, Moringa oleifera, Syzygium aromaticum, Combretum molle, and Myrtus communis, has been found to promote wound healing, reduce inflammation, stimulate angiogenesis, and cytokines production, increase growth factors production, promote keratinocyte production, and encourage fibroblast proliferation. These therapies may also reduce the need for amputations. However, there is still limited information on how to prevent and manage DWs, and further research is needed to fully understand the role of alternative treatments in managing complications of DWs. The conventional management protocol for treating diabetic foot syndrome can be expensive and may cause adverse side effects. Alternative therapies, such as medicinal plants and green synthesis of nano-formulations, may provide efficient and affordable treatments for DWs.
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Affiliation(s)
- Jagat Pal Yadav
- Department of Pharmaceutical Sciences, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj, 211007, India.
- Pharmacology Research Laboratory, Faculty of Pharmaceutical Sciences, Rama University, Kanpur, 209217, India.
- Bioorganic and Medicinal Chemistry Research Laboratory, Department of Pharmaceutical Sciences, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj, 211007, India.
| | - Ankit Kumar Singh
- Department of Pharmaceutical Sciences and Natural Products, Central University of Punjab, Bathinda, 151401, India
| | - Maria Grishina
- Laboratory of Computational Modeling of Drugs, Higher Medical and Biological School, South Ural State University, Chelyabinsk, 454008, Russia
| | - Prateek Pathak
- Department of Pharmaceutical Analysis, Quality Assurance, and Pharmaceutical Chemistry, School of Pharmacy, GITAM (Deemed to Be University), Hyderabad, 502329, India
| | - Amita Verma
- Bioorganic and Medicinal Chemistry Research Laboratory, Department of Pharmaceutical Sciences, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj, 211007, India
| | - Vikas Kumar
- Natural Product Drug Discovery Laboratory, Department of Pharmaceutical Sciences, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj, 211007, India
| | - Pradeep Kumar
- Department of Pharmaceutical Sciences and Natural Products, Central University of Punjab, Bathinda, 151401, India
| | - Dinesh Kumar Patel
- Department of Pharmaceutical Sciences, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj, 211007, India.
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12
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Damle MN, Chaudhari L, Tardalkar K, Bhamare N, Jagdale S, Gaikwad V, Chhabra D, Kumar B, Manuja A, Joshi MG. A biologically functional bioink based on extracellular matrix derived collagen for 3D printing of skin. Int J Biol Macromol 2024; 258:128851. [PMID: 38114005 DOI: 10.1016/j.ijbiomac.2023.128851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 12/12/2023] [Accepted: 12/14/2023] [Indexed: 12/21/2023]
Abstract
Over the past few years, several advancements have been made to develop artificial skin that mimics human skin. Artificial skin manufactured using 3D printing technology that includes all epidermal and dermal components, such as collagen, may offer a viable solution. The skin-specific bioink was derived from digested chicken skin and incorporated into PVA (polyvinyl alcohol) and gelatin. The prepared bioink was further analyzed for its structure, stability, biocompatibility, and wound healing potential in in vitro, in ovo, and in vivo models. The 3D-printed skin showed excellent mechanical properties. In vitro scratch assays showed the proliferation and migration of cells within 24 h. In an in ovo assay, the 3D-printed skin facilitated the attachment of cells to the scaffolds. In the animal study, the quick cellular recruitment at the injury site accelerated wound healing. Further, hydroxyproline content was estimated to be 0.9-1.2 mg/ml, and collagen content was 7.5 %, which confirmed the epithelization. The relative expressions of MMP-9, COMP, TNF-α, and IL-6 genes were found to be increased compared to the control. These results demonstrate that 3D bioprinting represents a suitable technology to generate bioengineered skin for therapeutic and industrial applications in an automated manner.
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Affiliation(s)
- Mrunal N Damle
- Department of Stem Cells & Regenerative Medicine, D Y Patil Education Society (Deemed to be University), E 869, D. Y. Patil Vidyanagar, Kasaba Bawada, Kolhapur 416006, MS, India; Stem Plus Biotech, SMK Commercial Complex, C/S No. 1317/2, Near Shivaji Maharaj Putla, Bus Stand Road, Gaon Bhag, Sangli, MS 416416, India
| | - Leena Chaudhari
- Department of Stem Cells & Regenerative Medicine, D Y Patil Education Society (Deemed to be University), E 869, D. Y. Patil Vidyanagar, Kasaba Bawada, Kolhapur 416006, MS, India
| | - Kishor Tardalkar
- Department of Stem Cells & Regenerative Medicine, D Y Patil Education Society (Deemed to be University), E 869, D. Y. Patil Vidyanagar, Kasaba Bawada, Kolhapur 416006, MS, India
| | - Nilesh Bhamare
- Department of Stem Cells & Regenerative Medicine, D Y Patil Education Society (Deemed to be University), E 869, D. Y. Patil Vidyanagar, Kasaba Bawada, Kolhapur 416006, MS, India
| | - Swapnali Jagdale
- Department of Stem Cells & Regenerative Medicine, D Y Patil Education Society (Deemed to be University), E 869, D. Y. Patil Vidyanagar, Kasaba Bawada, Kolhapur 416006, MS, India
| | - Vaishali Gaikwad
- Department of Surgery, Dr. D Y Patil Medical College, Hospital and Research Institute, Kadamwadi, Kolhapur 41600, Maharashtra, India
| | - Dharvi Chhabra
- ICAR-National Research Centre on Equines, Hisar 125001, Haryana, India
| | - Balvinder Kumar
- ICAR-National Research Centre on Equines, Hisar 125001, Haryana, India
| | - Anju Manuja
- ICAR-National Research Centre on Equines, Hisar 125001, Haryana, India.
| | - Meghnad G Joshi
- Department of Stem Cells & Regenerative Medicine, D Y Patil Education Society (Deemed to be University), E 869, D. Y. Patil Vidyanagar, Kasaba Bawada, Kolhapur 416006, MS, India; Stem Plus Biotech, SMK Commercial Complex, C/S No. 1317/2, Near Shivaji Maharaj Putla, Bus Stand Road, Gaon Bhag, Sangli, MS 416416, India.
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13
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Marques R, de Lopes MVO, Neves‐Amado JD, Ramos PAS, de Sá LO, da Oliveira IMS, da Amado JMC, de Vasconcelos MJM, Salgado PMF, Alves PJP. Integrating factors associated with complex wound healing into a mobile application: Findings from a cohort study. Int Wound J 2024; 21:e14339. [PMID: 37667542 PMCID: PMC10781894 DOI: 10.1111/iwj.14339] [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: 06/15/2023] [Revised: 07/19/2023] [Accepted: 07/20/2023] [Indexed: 09/06/2023] Open
Abstract
Complex, chronic or hard-to-heal wounds are a prevalent health problem worldwide, with significant physical, psychological and social consequences. This study aims to identify factors associated with the healing process of these wounds and develop a mobile application for wound care that incorporates these factors. A prospective multicentre cohort study was conducted in nine health units in Portugal, involving data collection through a mobile application by nurses from April to October 2022. The study followed 46 patients with 57 wounds for up to 5 weeks, conducting six evaluations. Healing time was the main outcome measure, analysed using the Mann-Whitney test and three Cox regression models to calculate risk ratios. The study sample comprised various wound types, with pressure ulcers being the most common (61.4%), followed by venous leg ulcers (17.5%) and diabetic foot ulcers (8.8%). Factors that were found to impair the wound healing process included chronic kidney disease (U = 13.50; p = 0.046), obesity (U = 18.0; p = 0.021), non-adherence to treatment (U = 1.0; p = 0.029) and interference of the wound with daily routines (U = 11.0; p = 0.028). Risk factors for delayed healing over time were identified as bone involvement (RR 3.91; p < 0.001), presence of odour (RR 3.36; p = 0.007), presence of neuropathy (RR 2.49; p = 0.002), use of anti-inflammatory drugs (RR 2.45; p = 0.011), stalled wound (RR 2.26; p = 0.022), greater width (RR 2.03; p = 0.002), greater depth (RR 1.72; p = 0.036) and a high score on the healing scale (RR 1.21; p = 0.001). Integrating the identified risk factors for delayed healing into the assessment of patients and incorporating them into a mobile application can enhance decision-making in wound care.
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Affiliation(s)
- Raquel Marques
- Centre for Interdisciplinary Research in HealthUniversidade Católica Portuguesa, Institute of Health SciencesPortoPortugal
| | | | - João Daniel Neves‐Amado
- Centre for Interdisciplinary Research in HealthUniversidade Católica Portuguesa, Institute of Health SciencesPortoPortugal
- School of Nursing DepartmentUniversidade Católica Portuguesa, Institute of Health SciencesPortoPortugal
| | - Paulo Alexandre Silva Ramos
- Centre for Interdisciplinary Research in HealthUniversidade Católica Portuguesa, Institute of Health SciencesPortoPortugal
- Unidade de Saúde Familiar Corino de AndradePortoPortugal
| | - Luís Octávio de Sá
- Centre for Interdisciplinary Research in HealthUniversidade Católica Portuguesa, Institute of Health SciencesPortoPortugal
- School of Nursing DepartmentUniversidade Católica Portuguesa, Institute of Health SciencesPortoPortugal
| | - Irene Maria Silva da Oliveira
- Centre for Interdisciplinary Research in HealthUniversidade Católica Portuguesa, Institute of Health SciencesPortoPortugal
- School of Nursing DepartmentUniversidade Católica Portuguesa, Institute of Health SciencesPortoPortugal
| | - João Manuel Costa da Amado
- Centre for Interdisciplinary Research in HealthUniversidade Católica Portuguesa, Institute of Health SciencesPortoPortugal
- School of Nursing DepartmentUniversidade Católica Portuguesa, Institute of Health SciencesPortoPortugal
| | | | | | - Paulo Jorge Pereira Alves
- Centre for Interdisciplinary Research in HealthUniversidade Católica Portuguesa, Institute of Health SciencesPortoPortugal
- School of Nursing DepartmentUniversidade Católica Portuguesa, Institute of Health SciencesPortoPortugal
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14
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Jose J, Soni B, Jose S, Kokkatt JK. Medical Management to Treat Chronic Non-healing Ulcers: A Case Series. Cureus 2024; 16:e51449. [PMID: 38169779 PMCID: PMC10758169 DOI: 10.7759/cureus.51449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/01/2024] [Indexed: 01/05/2024] Open
Abstract
INTRODUCTION Chronic non-healing leg ulcers are skin defects below the knee that resist healing for more than six weeks. They cause physical, emotional, and economic burdens to patients and society. OBJECTIVES To introduce an innovative medical strategy that targets the chronic inflammation component in non-healing ulcers (NHUs) with rheumatic features and to evaluate its potential effectiveness in achieving complete healing. METHODS We employed an empirical medical therapy regimen, which combined medications like deflazacort, colchicine, dapsone, hydroxychloroquine, and azathioprine. We retrospectively selected 25 patients with chronic pedal ulcers who underwent our therapy. RESULTS The mean duration of ulcers was 7.84 years, and the time to heal was 5.97 months. Among 25 patients, 19 had atypical ulcers, four had venous ulcers, and two had diabetic neuropathy ulcers. Four patients with venous ulcers additionally underwent endovenous laser ablation. CONCLUSION Our medical strategy showed promising results in healing chronic NHUs with rheumatic features without significant steroid-induced adverse effects.
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Affiliation(s)
- Joseph Jose
- Cardiovascular Medicine, Cardiff Health Centre, Manarcad, IND
| | - Bhanushree Soni
- Preventive Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
| | - Saji Jose
- Cardiovascular Medicine, Cardiff Health Centre, Manarcad, IND
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15
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Li Q, Li Y, Qiao Q, Zhao N, Yang Y, Wang L, Wang Y, Guo C, Guo Y. Oral administration of Bifidobacterium breve improves anti-angiogenic drugs-derived oral mucosal wound healing impairment via upregulation of interleukin-10. Int J Oral Sci 2023; 15:56. [PMID: 38072973 PMCID: PMC10711028 DOI: 10.1038/s41368-023-00263-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 10/31/2023] [Accepted: 11/20/2023] [Indexed: 12/18/2023] Open
Abstract
Recent studies have suggested that long-term application of anti-angiogenic drugs may impair oral mucosal wound healing. This study investigated the effect of sunitinib on oral mucosal healing impairment in mice and the therapeutic potential of Bifidobacterium breve (B. breve). A mouse hard palate mucosal defect model was used to investigate the influence of sunitinib and/or zoledronate on wound healing. The volume and density of the bone under the mucosal defect were assessed by micro-computed tomography (micro-CT). Inflammatory factors were detected by protein microarray analysis and enzyme-linked immunosorbent assay (ELISA). The senescence and biological functions were tested in oral mucosal stem cells (OMSCs) treated with sunitinib. Ligated loop experiments were used to investigate the effect of oral B. breve. Neutralizing antibody for interleukin-10 (IL-10) was used to prove the critical role of IL-10 in the pro-healing process derived from B. breve. Results showed that sunitinib caused oral mucosal wound healing impairment in mice. In vitro, sunitinib induced cellular senescence in OMSCs and affected biological functions such as proliferation, migration, and differentiation. Oral administration of B. breve reduced oral mucosal inflammation and promoted wound healing via intestinal dendritic cells (DCs)-derived IL-10. IL-10 reversed cellular senescence caused by sunitinib in OMSCs, and IL-10 neutralizing antibody blocked the ameliorative effect of B. breve on oral mucosal wound healing under sunitinib treatment conditions. In conclusion, sunitinib induces cellular senescence in OMSCs and causes oral mucosal wound healing impairment and oral administration of B. breve could improve wound healing impairment via intestinal DCs-derived IL-10.
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Affiliation(s)
- Qingxiang Li
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Yuke Li
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Qiao Qiao
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Ning Zhao
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Yuanning Yang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Lin Wang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Yifei Wang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Chuanbin Guo
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China.
| | - Yuxing Guo
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China.
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16
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Xu H, Xiao GZ, Zheng YH, Fu YJ, Zhong SL, Ren DL, Li WR, Lin HC. A magnetic resonance imaging-based decision-making tool for predicting complex anal fistulas healing in the early postoperative period. BMC Gastroenterol 2023; 23:372. [PMID: 37907854 PMCID: PMC10617037 DOI: 10.1186/s12876-023-02963-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 09/18/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND Magnetic resonance imaging (MRI) has excellent accuracy in diagnosing preoperative lesions before anal fistula surgery. However, MRI is not good in identifying early recurrent lesions and effective methods for quantitative assessment of fistula healing are still warranted. This retrospective study aimed to develop and validate a specific MRI-based nomogram model to predict fistula healing during the early postoperative period. METHODS Patients with complex cryptoglandular anal fistulas who underwent surgery between January 2017 and October 2020 were included in this study. MRI features and clinical parameters were analyzed using univariate and multivariate logistic regression analysis. A nomogram for predicting fistula healing was constructed and validated. RESULTS In total, 200 patients were included, of whom 186 (93%) were male, with a median age of 36 (18-65) years. Of the fistulas, 58.5% were classified as transsphincteric and 19.5% as suprasphincteric. The data were randomly divided into the training cohort and testing cohort at a ratio of 7:3. Logistic analysis revealed that CNR, ADC, alcohol intake history, and suprasphincteric fistula were significantly correlated with fistula healing. These four predictors were used to construct a predictive nomogram model in the training cohort. AUC was 0.880 and 0.847 for the training and testing cohorts, respectively. Moreover, the decision and calibration curves showed high coherence between the predicted and actual probabilities of fistula healing. CONCLUSIONS We developed a predictive model and constructed a nomogram to predict fistula healing during the early postoperative period. This model showed good performance and may be clinically utilized for the management of anal fistulas.
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Affiliation(s)
- Hao Xu
- Department of Anorectal, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, 200434, China
- Department of Anorectal Surgery, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Guo-Zhong Xiao
- Department of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Yuancun Er Heng Lu, No. 26, Guangzhou, 510655, China
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
- Guangdong Institute of Gastroenterology, Guangzhou, 510655, China
| | - Yi-Hui Zheng
- Department of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Yuancun Er Heng Lu, No. 26, Guangzhou, 510655, China
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
- Guangdong Institute of Gastroenterology, Guangzhou, 510655, China
| | - Yuan-Ji Fu
- Department of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Yuancun Er Heng Lu, No. 26, Guangzhou, 510655, China
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
- Guangdong Institute of Gastroenterology, Guangzhou, 510655, China
| | - Sheng-Lan Zhong
- Department of Anorectal, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, 200434, China
| | - Dong-Lin Ren
- Department of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Yuancun Er Heng Lu, No. 26, Guangzhou, 510655, China
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
- Guangdong Institute of Gastroenterology, Guangzhou, 510655, China
| | - Wen-Ru Li
- Department of Radiology, The Sixth Affiliated Hospital, Sun Yat-sen University, Yuancun Er Heng Lu, No. 26, Guangzhou, 510655, China.
| | - Hong-Cheng Lin
- Department of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Yuancun Er Heng Lu, No. 26, Guangzhou, 510655, China.
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China.
- Guangdong Institute of Gastroenterology, Guangzhou, 510655, China.
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17
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Knoedler S, Knoedler L, Kauke-Navarro M, Rinkevich Y, Hundeshagen G, Harhaus L, Kneser U, Pomahac B, Orgill DP, Panayi AC. Regulatory T cells in skin regeneration and wound healing. Mil Med Res 2023; 10:49. [PMID: 37867188 PMCID: PMC10591349 DOI: 10.1186/s40779-023-00484-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 10/04/2023] [Indexed: 10/24/2023] Open
Abstract
As the body's integumentary system, the skin is vulnerable to injuries. The subsequent wound healing processes aim to restore dermal and epidermal integrity and functionality. To this end, multiple tissue-resident cells and recruited immune cells cooperate to efficiently repair the injured tissue. Such temporally- and spatially-coordinated interplay necessitates tight regulation to prevent collateral damage such as overshooting immune responses and excessive inflammation. In this context, regulatory T cells (Tregs) hold a key role in balancing immune homeostasis and mediating cutaneous wound healing. A comprehensive understanding of Tregs' multifaceted field of activity may help decipher wound pathologies and, ultimately, establish new treatment modalities. Herein, we review the role of Tregs in orchestrating the regeneration of skin adnexa and catalyzing healthy wound repair. Further, we discuss how Tregs operate during fibrosis, keloidosis, and scarring.
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Affiliation(s)
- Samuel Knoedler
- Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
- Division of Plastic Surgery, Department of Surgery, Yale New Haven Hospital, Yale School of Medicine, New Haven, CT, 06510, USA
- Institute of Regenerative Biology and Medicine, Helmholtz Zentrum München, Munich, 85764, Germany
| | - Leonard Knoedler
- Division of Plastic Surgery, Department of Surgery, Yale New Haven Hospital, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Martin Kauke-Navarro
- Division of Plastic Surgery, Department of Surgery, Yale New Haven Hospital, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Yuval Rinkevich
- Institute of Regenerative Biology and Medicine, Helmholtz Zentrum München, Munich, 85764, Germany
| | - Gabriel Hundeshagen
- Department of Hand, Plastic and Reconstructive Surgery, Microsurgery, Burn Trauma Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwigshafen, 67071, Germany
| | - Leila Harhaus
- Department of Hand, Plastic and Reconstructive Surgery, Microsurgery, Burn Trauma Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwigshafen, 67071, Germany
| | - Ulrich Kneser
- Department of Hand, Plastic and Reconstructive Surgery, Microsurgery, Burn Trauma Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwigshafen, 67071, Germany
| | - Bohdan Pomahac
- Division of Plastic Surgery, Department of Surgery, Yale New Haven Hospital, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Dennis P Orgill
- Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Adriana C Panayi
- Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA.
- Department of Hand, Plastic and Reconstructive Surgery, Microsurgery, Burn Trauma Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwigshafen, 67071, Germany.
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18
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Ingraldi AL, Audet RG, Tabor AJ. The Preparation and Clinical Efficacy of Amnion-Derived Membranes: A Review. J Funct Biomater 2023; 14:531. [PMID: 37888195 PMCID: PMC10607219 DOI: 10.3390/jfb14100531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/13/2023] [Accepted: 10/18/2023] [Indexed: 10/28/2023] Open
Abstract
Biological tissues from various anatomical sources have been utilized for tissue transplantation and have developed into an important source of extracellular scaffolding material for regenerative medicine applications. Tissue scaffolds ideally integrate with host tissue and provide a homeostatic environment for cellular infiltration, growth, differentiation, and tissue resolution. The human amniotic membrane is considered an important source of scaffolding material due to its 3D structural architecture and function and as a source of growth factors and cytokines. This tissue source has been widely studied and used in various areas of tissue repair including intraoral reconstruction, corneal repair, tendon repair, microvascular reconstruction, nerve procedures, burns, and chronic wound treatment. The production of amniotic membrane allografts has not been standardized, resulting in a wide array of amniotic membrane products, including single, dual, and tri-layered products, such as amnion, chorion, amnion-chorion, amnion-amnion, and amnion-chorion-amnion allografts. Since these allografts are not processed using the same methods, they do not necessarily produce the same clinical responses. The aim of this review is to highlight the properties of different human allograft membranes, present the different processing and preservation methods, and discuss their use in tissue engineering and regenerative applications.
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Affiliation(s)
- Alison L. Ingraldi
- Carmell Corporation, Pittsburg, PA 15203, USA;
- Department of Research and Development, Axolotl Biologix, Flagstaff, AZ 86001, USA
- Department of Biological Sciences, Northern Arizona University, Flagstaff, AZ 86011, USA
| | - Robert G. Audet
- Carmell Corporation, Pittsburg, PA 15203, USA;
- Department of Research and Development, Axolotl Biologix, Flagstaff, AZ 86001, USA
- Department of Biological Sciences, Northern Arizona University, Flagstaff, AZ 86011, USA
| | - Aaron J. Tabor
- Carmell Corporation, Pittsburg, PA 15203, USA;
- Department of Research and Development, Axolotl Biologix, Flagstaff, AZ 86001, USA
- Department of Biological Sciences, Northern Arizona University, Flagstaff, AZ 86011, USA
- Department of Clinical Operations, Axolotl Biologix, Flagstaff, AZ 86001, USA
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19
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Alimi Y, Deldar R, Sosin M, Lofthus A, Nijhar K, Bartholomew AJ, Fan KL, Bhanot P. Outcomes of Immediate Multistaged Abdominal Wall Reconstruction of Infected Mesh: Predictors of Surgical Site Complications and Hernia Recurrence. Ann Plast Surg 2023; 91:473-478. [PMID: 37713152 DOI: 10.1097/sap.0000000000003641] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
BACKGROUND Mesh infection is one of the most devastating complications after ventral hernia repair. To date, no clear consensus exists on the optimal timing of definitive abdominal wall reconstruction (AWR) after excision of infected mesh. We evaluated outcomes of immediate multistaged AWR in patients with mesh infection. METHODS We performed a retrospective review of patients with mesh infection who underwent immediate, multistaged AWR, which consisted of exploratory laparotomy with debridement and mesh explantation, followed by definitive AWR during the same admission. Primary outcomes included hernia recurrence and surgical site occurrences, defined as wound dehiscence, surgical site infection, hematoma, and seroma. RESULTS Forty-seven patients with infected mesh were identified. At mean follow-up of 9.5 months, 5 patients (10.6%) experienced hernia recurrence. Higher body mass index (P = 0.006), bridge repair (P = 0.035), and postoperative surgical site infection (P = 0.005) were associated with hernia recurrence. CONCLUSION Immediate multistaged AWR is an effective surgical approach in patients with infected mesh.
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Affiliation(s)
| | | | - Michael Sosin
- Plastic Surgery Arts of New Jersey, New Brunswick, NJ
| | | | | | | | - Kenneth L Fan
- Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, DC
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20
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Jaggarapu MMCS, Ghosh D, Johnston T, Yaron JR, Mangal JL, Inamdar S, Gosangi M, Rege K, Acharya AP. Alpha-ketoglutaric acid based polymeric particles for cutaneous wound healing. J Biomed Mater Res A 2023; 111:1372-1378. [PMID: 36951217 PMCID: PMC10517069 DOI: 10.1002/jbm.a.37539] [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: 01/10/2023] [Revised: 02/18/2023] [Accepted: 03/15/2023] [Indexed: 03/24/2023]
Abstract
Metabolites are not only involved in energy pathways but can also act as signaling molecules. Herein, we demonstrate that polyesters of alpha-ketoglutararte (paKG) can be generated by reacting aKG with aliphatic diols of different lengths, which release aKG in a sustained manner. paKG polymer-based microparticles generated via emulsion-evaporation technique lead to faster keratinocyte wound closures in a scratch assay test. Moreover, paKG microparticles also led to faster wound healing responses in an excisional wound model in live mice. Overall, this study shows that paKG MPs that release aKG in a sustained manner can be used to develop regenerative therapeutic responses.
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Affiliation(s)
- Madhan M. C. S. Jaggarapu
- Chemical Engineering, School for the Engineering of Matter, Transport, and Energy, Arizona State University, Tempe, Arizona 85281, USA
| | - Deepanjan Ghosh
- Biological Design, School for the Engineering of Matter, Transport, and Energy, Arizona State University, Tempe, Arizona 85281, USA
| | - Tyler Johnston
- Molecular Biosciences and Biotechnology, The College of Liberal Arts and Sciences, School of Life Sciences, Arizona State University, Tempe, Arizona 85281, USA
| | - Jordan R. Yaron
- Chemical Engineering, School for the Engineering of Matter, Transport, and Energy, Arizona State University, Tempe, Arizona 85281, USA
| | - Joslyn L. Mangal
- Molecular Biosciences and Biotechnology, The College of Liberal Arts and Sciences, School of Life Sciences, Arizona State University, Tempe, Arizona 85281, USA
| | - Sahil Inamdar
- Chemical Engineering, School for the Engineering of Matter, Transport, and Energy, Arizona State University, Tempe, Arizona 85281, USA
| | - Mallikarjun Gosangi
- Chemical Engineering, School for the Engineering of Matter, Transport, and Energy, Arizona State University, Tempe, Arizona 85281, USA
| | - Kaushal Rege
- Chemical Engineering, School for the Engineering of Matter, Transport, and Energy, Arizona State University, Tempe, Arizona 85281, USA
- Biological Design, School for the Engineering of Matter, Transport, and Energy, Arizona State University, Tempe, Arizona 85281, USA
- Biomedical Engineering, School of Biological and Health Systems Engineering, Arizona State University, Tempe, Arizona 85281, USA
- Materials Science and Engineering, School for the Engineering of Matter, Transport, and Energy, Arizona State University, Tempe, Arizona 85281, USA
- Biodesign Center for Biomaterials Innovation and Translation, Arizona State University, Tempe, Arizona 85281, USA
| | - Abhinav P. Acharya
- Chemical Engineering, School for the Engineering of Matter, Transport, and Energy, Arizona State University, Tempe, Arizona 85281, USA
- Biological Design, School for the Engineering of Matter, Transport, and Energy, Arizona State University, Tempe, Arizona 85281, USA
- Biomedical Engineering, School of Biological and Health Systems Engineering, Arizona State University, Tempe, Arizona 85281, USA
- Materials Science and Engineering, School for the Engineering of Matter, Transport, and Energy, Arizona State University, Tempe, Arizona 85281, USA
- Biodesign Center for Biomaterials Innovation and Translation, Arizona State University, Tempe, Arizona 85281, USA
- Biodesign Center for Immunotherapy, Vaccines and Virotherapy, Arizona State University, Tempe, Arizona 85281, USA
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21
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Chin KY. Editorial: New Strategies for the Diagnosis and Treatment of Multi-Drug Resistant Bacteria or Fungi in Wounds. Front Mol Biosci 2023; 10:1248534. [PMID: 37577748 PMCID: PMC10421745 DOI: 10.3389/fmolb.2023.1248534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 07/24/2023] [Indexed: 08/15/2023] Open
Affiliation(s)
- Kok-Yong Chin
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia
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22
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Farooq MA, Ali S, Sulayman R, Hassan A, Tahir HM, Shahzad H, Fiaz U, Mughal TA, Liaqat I, Mumtaz S, Nauroze T, Mumtaz S. Therapeutic Applications of Garlic and Turmeric for the Diabetic Wound Healing in Mice. J Burn Care Res 2023; 44:800-809. [PMID: 36331804 DOI: 10.1093/jbcr/irac169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
Diabetes is involved in delayed wound healing that can be cured by natural products such as garlic, turmeric, and fibroin extracts. Alloxan monohydrate is used for inducing diabetes in mice. The percent wound contraction of garlic (150 mg/ml), turmeric (100 mg/ml), and fibroin (50 mg/ml), individually and in combinations garlic (150 mg/ml) + fibroin (50 mg/ml), turmeric (100 mg/ml) + fibroin (50 mg/ml), garlic (150 mg/ml) + turmeric (100 mg/ml), and garlic (150 mg/ml) + turmeric (100 mg/ml) + fibroin (50 mg/ml) was checked by evaluating the healing time, % wound contraction and histological analysis. The serum level of MMPs (MMP 2, MMP7, MMP 9), pro-inflammatory cytokines (TNF-α, IL-6, IL-8), and TIMPs were evaluated. With the combination of three extracts (Ga+Tu+Fi) garlic (150 mg/ml), turmeric (100 mg/ml) and fibroin (50 mg/ml), wounds healed in 12 days and had 97.3 ± 2.2% wound contraction. While the positive control (polyfax) and diabetic control (saline) wounds healed in 17- and 19-days with wound contraction of 96.7 ± 1.4% and 96.3 ± 1.1%, respectively. Histological analysis showed that the combination of Ga+Tu+Fi exhibited an increase in the growth of collagen fibers, fibroblasts number, and keratinocytes, and lessened inflammation of blood vessels. The combination of Ga+Tu+Fi significantly alleviated the serum concentration of TNF-α (14.2 ± 0.7 pg/ml), IL-6 (10.0 ± 1.0 pg/ml), IL-8 (16.0 ± 1.5 pg/ml), MMP2 (228.0 ± 18.1 pg/ml), MMP7 (271.0 ± 9.9 pg/ml), and MMP9 (141.0 ± 5.3 pg/ml) to diabetic control. The level of TIMPs (193.0 ± 9.1 pg/ml) was increased significantly with respect to diabetic control. We conclude that the combination of these biomaterials possessed high regenerative and healing capabilities and can be an effective remedy in the healing of chronic wounds in diabetic patients.
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Affiliation(s)
- Muhammad A Farooq
- Applied Entomology and Medical Toxicology Laboratory, Department of Zoology, Government College University, Lahore, Pakistan
| | - Shaukat Ali
- Applied Entomology and Medical Toxicology Laboratory, Department of Zoology, Government College University, Lahore, Pakistan
| | - Rida Sulayman
- Applied Entomology and Medical Toxicology Laboratory, Department of Zoology, Government College University, Lahore, Pakistan
| | - Ali Hassan
- Applied Entomology and Medical Toxicology Laboratory, Department of Zoology, Government College University, Lahore, Pakistan
| | - Hafiz M Tahir
- Applied Entomology and Medical Toxicology Laboratory, Department of Zoology, Government College University, Lahore, Pakistan
| | - Hafsa Shahzad
- Applied Entomology and Medical Toxicology Laboratory, Department of Zoology, Government College University, Lahore, Pakistan
| | - Umaima Fiaz
- Applied Entomology and Medical Toxicology Laboratory, Department of Zoology, Government College University, Lahore, Pakistan
| | - Tafail A Mughal
- Department of Zoology, Women University of Azad Jammu Kashmir, Bagh, Pakistan
| | - Irfana Liaqat
- Applied Entomology and Medical Toxicology Laboratory, Department of Zoology, Government College University, Lahore, Pakistan
| | - Samaira Mumtaz
- Applied Entomology and Medical Toxicology Laboratory, Department of Zoology, Government College University, Lahore, Pakistan
| | - Tooba Nauroze
- Applied Entomology and Medical Toxicology Laboratory, Department of Zoology, Government College University, Lahore, Pakistan
| | - Shumaila Mumtaz
- Applied Entomology and Medical Toxicology Laboratory, Department of Zoology, Government College University, Lahore, Pakistan
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23
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Veličković VM, Spelman T, Clark M, Probst S, Armstrong DG, Steyerberg E. Individualized Risk Prediction for Improved Chronic Wound Management. Adv Wound Care (New Rochelle) 2023; 12:387-398. [PMID: 36070447 PMCID: PMC10125399 DOI: 10.1089/wound.2022.0017] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 08/26/2022] [Indexed: 11/13/2022] Open
Abstract
Significance: Chronic wounds are associated with significant morbidity, marked loss of quality of life, and considerable economic burden. Evidence-based risk prediction to guide improved wound prevention and treatment is limited by the complexity in their etiology, clinical underreporting, and a lack of studies using large high-quality datasets. Recent Advancements: The objective of this review is to summarize key components and challenges in the development of personalized risk prediction tools for both prevention and management of chronic wounds, while highlighting several innovations in the development of better risk stratification. Critical Issues: Regression-based risk prediction approaches remain important for assessment of prognosis and risk stratification in chronic wound management. Advances in statistical computing have boosted the development of several promising machine learning (ML) and other semiautomated classification tools. These methods may be better placed to handle large number of wound healing risk factors from large datasets, potentially resulting in better risk prediction when combined with conventional methods and clinical experience and expertise. Future Directions: Where the number of predictors is large and heterogenous, the correlations between various risk factors complex, and very large data sets are available, ML may prove a powerful adjuvant for risk stratifying patients predisposed to chronic wounds. Conventional regression-based approaches remain important, particularly where the number of predictors is relatively small. Translating estimated risk derived from ML algorithms into practical prediction tools for use in clinical practice remains challenging.
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Affiliation(s)
- Vladica M. Veličković
- HARTMANN GROUP, Heidenheim, Germany
- Institute of Public Health, Medical Decision Making and HTA, UMIT, Hall in Tirol, Austria
| | - Tim Spelman
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
- Burnet Institute, Melbourne, Australia
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Michael Clark
- Welsh Wound Innovation Centre, Pontyclun, United Kingdom
- School of Health, Education and Life Sciences, Birmingham City University, Birmingham, United Kingdom
| | - Sebastian Probst
- Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts, Geneva, Western Switzerland
- Faculty of Medicine Nursing and Health Sciences, Monash University, Melbourne, Australia
- Care Directorate, University Hospital Geneva, Geneva, Switzerland
| | - David G. Armstrong
- Southwestern Academic Limb Salvage Alliance (SALSA), Department of Surgery, Keck School of Medicine, University of Southern California (USC), Los Angeles, California, USA
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24
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Besseling PJ, Krebber MM, Fledderus JO, Teraa M, den Ouden K, van de Kaa M, de Bree PM, Serrero A, Bouten CVC, Dankers PYW, Cox MAJ, Verhaar MC. The effect of chronic kidney disease on tissue formation of in situ tissue-engineered vascular grafts. APL Bioeng 2023; 7:026107. [PMID: 37234843 PMCID: PMC10208679 DOI: 10.1063/5.0138808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
Vascular in situ tissue engineering encompasses a single-step approach with a wide adaptive potential and true off-the-shelf availability for vascular grafts. However, a synchronized balance between breakdown of the scaffold material and neo-tissue formation is essential. Chronic kidney disease (CKD) may influence this balance, lowering the usability of these grafts for vascular access in end-stage CKD patients on dialysis. We aimed to investigate the effects of CKD on in vivo scaffold breakdown and tissue formation in grafts made of electrospun, modular, supramolecular polycarbonate with ureido-pyrimidinone moieties (PC-UPy). We implanted PC-UPy aortic interposition grafts (n = 40) in a rat 5/6th nephrectomy model that mimics systemic conditions in human CKD patients. We studied patency, mechanical stability, extracellular matrix (ECM) components, total cellularity, vascular tissue formation, and vascular calcification in CKD and healthy rats at 2, 4, 8, and 12 weeks post-implantation. Our study shows successful in vivo application of a slow-degrading small-diameter vascular graft that supports adequate in situ vascular tissue formation. Despite systemic inflammation associated with CKD, no influence of CKD on patency (Sham: 95% vs CKD: 100%), mechanical stability, ECM formation (Sirius red+, Sham 16.5% vs CKD 25.0%-p:0.83), tissue composition, and immune cell infiltration was found. We did find a limited increase in vascular calcification at 12 weeks (Sham 0.08% vs CKD 0.80%-p:0.02) in grafts implanted in CKD animals. However, this was not associated with increased stiffness in the explants. Our findings suggest that disease-specific graft design may not be necessary for use in CKD patients on dialysis.
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Affiliation(s)
| | - Merle M. Krebber
- Department of Nephrology and Hypertension, Regenerative Medicine Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Joost O. Fledderus
- Department of Nephrology and Hypertension, Regenerative Medicine Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Krista den Ouden
- Department of Nephrology and Hypertension, Regenerative Medicine Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Melanie van de Kaa
- Department of Nephrology and Hypertension, Regenerative Medicine Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Petra M. de Bree
- Department of Nephrology and Hypertension, Regenerative Medicine Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Carlijn V. C. Bouten
- Department of Biomedical Engineering and Institute for Complex Molecular Systems, TU/e, Eindhoven, The Netherlands
| | - Patricia Y. W. Dankers
- Department of Biomedical Engineering and Institute for Complex Molecular Systems, TU/e, Eindhoven, The Netherlands
| | | | - Marianne C. Verhaar
- Department of Nephrology and Hypertension, Regenerative Medicine Center, University Medical Center Utrecht, Utrecht, The Netherlands
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25
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Adib Y, Boy M, Serror K, Dulphy N, des Courtils C, Duciel L, Boccara D, Mimoun M, Samardzic M, Bagot M, Bensussan A, Michel L. Modulation of NK cell activation by exogenous calcium from alginate dressings in vitro. Front Immunol 2023; 14:1141047. [PMID: 37090742 PMCID: PMC10117844 DOI: 10.3389/fimmu.2023.1141047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 03/16/2023] [Indexed: 04/08/2023] Open
Abstract
Natural Killer (NK) cells participate in the defense against infection by killing pathogens and infected cells and secreting immuno-modulatory cytokines. Defects in NK cell activity have been reported in obese, diabetic, and elderly patients that are at high risk of developing infected chronic wounds. Calcium alginate dressings are indicated for the debridement during the inflammatory phase of healing. Since calcium ions are major activators of NK cells, we hypothesized that these dressings could enhance NK functions, as investigated in vitro herein. Primary human blood NK cells were freshly-isolated from healthy volunteers and exposed to conditioned media (CM) from two alginate dressings, Algosteril® (ALG, pure Ca2+ alginate) and Biatain® Alginate (BIA, Ca2+ alginate with CMC), in comparison with an exogenous 3mM calcium solution. Our results demonstrated that exogenous calcium and ALG-CM, but not BIA-CM, induced NK cell activation and enhanced their capacity to kill their targets as a result of increased degranulation. NK cell stimulation by ALG depended on the influx of extracellular Ca2+via the SOCE Ca2+ permeable plasma membrane channels. ALG-CM also activated NK cell cytokine production of IFN-γ and TNF-α through a partly Ca2+-independent mechanism. This work highlights the non-equivalence between alginate dressings for NK cell stimulation and shows that the pure calcium alginate dressing Algosteril® enhances NK cell cytotoxic and immuno-modulatory activities. Altogether, these results underline a specific property of this medical device in innate defense that is key for the cutaneous wound healing process.
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Affiliation(s)
- Yara Adib
- Skin Research Center, Institut National de la Santé et de la Recherche Médicale (INSERM) Unités Mixtes de Recherche (UMRS)_976, Hôpital Saint-Louis, Paris, France
- Université Paris Cité, Paris, France
- Laboratoires Brothier, Nanterre, France
| | - Maxime Boy
- Université Paris Cité, Paris, France
- Department of Immunology, Institut National de la Santé et de la Recherche Médicale (INSERM) Unités Mixtes de Recherche (UMRS)_1160, Hôpital Saint-Louis, Paris, France
| | - Kevin Serror
- Skin Research Center, Institut National de la Santé et de la Recherche Médicale (INSERM) Unités Mixtes de Recherche (UMRS)_976, Hôpital Saint-Louis, Paris, France
- Université Paris Cité, Paris, France
- Service de Chirurgie plastique, reconstructive et esthétique, Hôpital Saint-Louis, Paris, France
| | - Nicolas Dulphy
- Université Paris Cité, Paris, France
- Department of Immunology, Institut National de la Santé et de la Recherche Médicale (INSERM) Unités Mixtes de Recherche (UMRS)_1160, Hôpital Saint-Louis, Paris, France
- Service d’Immunologie et Histocompatibilité, Assistance publique-Hôpitaux de Paris (APHP), Hôpital Saint Louis, Paris, France
| | | | | | - David Boccara
- Service de Chirurgie plastique, reconstructive et esthétique, Hôpital Saint-Louis, Paris, France
| | - Maurice Mimoun
- Service de Chirurgie plastique, reconstructive et esthétique, Hôpital Saint-Louis, Paris, France
| | | | - Martine Bagot
- Université Paris Cité, Paris, France
- Service de Dermatologie, Assistance publique-Hôpitaux de Paris, Hôpital Saint Louis, Paris, France
| | - Armand Bensussan
- Skin Research Center, Institut National de la Santé et de la Recherche Médicale (INSERM) Unités Mixtes de Recherche (UMRS)_976, Hôpital Saint-Louis, Paris, France
- Université Paris Cité, Paris, France
| | - Laurence Michel
- Skin Research Center, Institut National de la Santé et de la Recherche Médicale (INSERM) Unités Mixtes de Recherche (UMRS)_976, Hôpital Saint-Louis, Paris, France
- Université Paris Cité, Paris, France
- *Correspondence: Laurence Michel,
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26
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Kropp M, De Clerck E, Vo TTKS, Thumann G, Costigliola V, Golubnitschaja O. Short communication: unique metabolic signature of proliferative retinopathy in the tear fluid of diabetic patients with comorbidities - preliminary data for PPPM validation. EPMA J 2023; 14:43-51. [PMID: 36845280 PMCID: PMC9944425 DOI: 10.1007/s13167-023-00318-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 02/08/2023] [Indexed: 02/24/2023]
Abstract
Type 2 diabetes (T2DM) defined as the adult-onset type that is primarily not insulin-dependent, comprises over 95% of all diabetes mellitus (DM) cases. According to global records, 537 million adults aged 20-79 years are affected by DM that means at least 1 out of 15 persons. This number is projected to grow by 51% by the year 2045. One of the most common complications of T2DM is diabetic retinopathy (DR) with an overall prevalence over 30%. The total number of the DR-related visual impairments is on the rise, due to the growing T2DM population. Proliferative diabetic retinopathy (PDR) is the progressing DR and leading cause of preventable blindness in working-age adults. Moreover, PDR with characteristic systemic attributes including mitochondrial impairment, increased cell death and chronic inflammation, is an independent predictor of the cascading DM-complications such as ischemic stroke. Therefore, early DR is a reliable predictor appearing upstream of this "domino effect". Global screening, leading to timely identification of DM-related complications, is insufficiently implemented by currently applied reactive medicine. A personalised predictive approach and cost-effective targeted prevention shortly - predictive, preventive and personalised medicine (PPPM / 3PM) could make a good use of the accumulated knowledge, preventing blindness and other severe DM complications. In order to reach this goal, reliable stage- and disease-specific biomarker panels are needed characterised by an easy way of the sample collection, high sensitivity and specificity of analyses. In the current study, we tested the hypothesis that non-invasively collected tear fluid is a robust source for the analysis of ocular and systemic (DM-related complications) biomarker patterns suitable for differential diagnosis of stable DR versus PDR. Here, we report the first results of the comprehensive ongoing study, in which we correlate individualised patient profiles (healthy controls versus patients with stable D as well as patients with PDR with and without co-morbidities) with their metabolic profiles in the tear fluid. Comparative mass spectrometric analysis performed has identified following metabolic clusters which are differentially expressed in the groups of comparison: acylcarnitines, amino acid & related compounds, bile acids, ceramides, lysophosphatidyl-choline, nucleobases & related compounds, phosphatidyl-cholines, triglycerides, cholesterol esters, and fatty acids. Our preliminary data strongly support potential clinical utility of metabolic patterns in the tear fluid indicating a unique metabolic signature characteristic for the DR stages and PDR progression. This pilot study creates a platform for validating the tear fluid biomarker patterns to stratify T2DM-patients predisposed to the PDR. Moreover, since PDR is an independent predictor of severe T2DM-related complications such as ischemic stroke, our international project aims to create an analytical prototype for the "diagnostic tree" (yes/no) applicable to healthrisk assessment in diabetes care.
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Affiliation(s)
- Martina Kropp
- Experimental Ophthalmology, University of Geneva, 1205 Geneva, Switzerland
- Ophthalmology Department, University Hospitals of Geneva, 1205 Geneva, Switzerland
| | - Eline De Clerck
- Experimental Ophthalmology, University of Geneva, 1205 Geneva, Switzerland
- Ophthalmology Department, University Hospitals of Geneva, 1205 Geneva, Switzerland
| | - Trong-Tin Kevin Steve Vo
- Experimental Ophthalmology, University of Geneva, 1205 Geneva, Switzerland
- Ophthalmology Department, University Hospitals of Geneva, 1205 Geneva, Switzerland
| | - Gabriele Thumann
- Experimental Ophthalmology, University of Geneva, 1205 Geneva, Switzerland
- Ophthalmology Department, University Hospitals of Geneva, 1205 Geneva, Switzerland
| | | | - Olga Golubnitschaja
- Predictive, Preventive and Personalised (3P) Medicine, Department of Radiation Oncology, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, 53127 Bonn, Germany
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27
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Seena S, Ferrão R, Pala M, Roelants SLKW, Soetaert W, Stevens CV, Ferreira L, Rai A. Acidic sophorolipid and antimicrobial peptide based formulation as antimicrobial and antibiofilm agents. BIOMATERIALS ADVANCES 2023; 146:213299. [PMID: 36706607 DOI: 10.1016/j.bioadv.2023.213299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 12/26/2022] [Accepted: 01/13/2023] [Indexed: 01/19/2023]
Abstract
Antimicrobial peptides (AMPs) are considered promising candidates to treat various infections in soft tissues and skin. However, no effective treatment based on AMPs has been reached to clinics due to their instability in serum and wounds. Biosurfactants such as acidic sophorolipids (ASLs) of very high concentrations (equal or above 5 mg/mL) have been demonstrated to be antimicrobial agents, however these concentrations might induce cytotoxic effects to human cells. Here, we have demonstrated the synergistic antimicrobial effect of ASL nanoparticles (NPs) and LL37 peptides (below their minimum inhibitory concentrations; MICs) to eradicate Gram-positive and Gram-negative bacteria in human serum (HS) and in the presence of trypsin. The formulations containing ASL NPs (500 μg/mL) and LL37 peptides (15-25 μg/mL) effectively kill wide strains of bacteria in 5 % HS and the presence of trypsin. Moreover, the combination of ASL NPs (500 μg/mL) and LL37 peptides (15 μg/mL) prevents the formation of S. aureus biofilm and eradicates the one-day old biofilm. Importantly, the combination of ASL NPs and LL37 peptides severely damages the cell membrane of Escherichia coli (E. coli) as shown by atomic force microscopy (AFM). The combination of ASL NPs and LL37 peptides rapidly damages the outer (OM) and inner membrane (IM) of E. coli, while ASL NPs (1000 μg/mL) alone slowly compromise the integrity of the bacterial membrane. Importantly, the combination of ASL NPs and LL37 peptides is biocompatible to human keratinocyte cells (HaCaTs) and human umbilical vein endothelial cells (HUVECs), and induces the expression of anti-inflammatory cytokine in macrophages. Overall, ASL NPs in combination with LL37 peptides might be developed as an effective topical formulation to prevent bacterial infections in the skin.
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Affiliation(s)
- Sahadevan Seena
- MARE - Marine and Environmental Sciences Centre, Department of Life Sciences, University of Coimbra, Coimbra, Portugal; ARNET-Aquatic Research Network, Department of Life Sciences, University of Coimbra, Coimbra, Portugal
| | - Rafaela Ferrão
- CNC - Centro de Neurociências e Biologia Celular, CIBB - Centro de Inovação em Biomedicina e Biotecnologia, Universidade de Coimbra, Coimbra, Portugal
| | - Melike Pala
- SynBioC, Department of Green Chemistry and Technology, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - S L K W Roelants
- InBio, Department of Biotechnology, Faculty of Bioscience Engineering, Ghent University and Bio Base Europe Pilot Plant, Ghent, Belgium
| | - Wim Soetaert
- InBio, Department of Biotechnology, Faculty of Bioscience Engineering, Ghent University and Bio Base Europe Pilot Plant, Ghent, Belgium
| | - Christian V Stevens
- SynBioC, Department of Green Chemistry and Technology, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Lino Ferreira
- CNC - Centro de Neurociências e Biologia Celular, CIBB - Centro de Inovação em Biomedicina e Biotecnologia, Universidade de Coimbra, Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Portugal
| | - Akhilesh Rai
- CNC - Centro de Neurociências e Biologia Celular, CIBB - Centro de Inovação em Biomedicina e Biotecnologia, Universidade de Coimbra, Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Portugal.
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Wang C, Li H, Dong Y, Wang H, Li D, Zhao C, Cao L, Sun K, Geng J, Yang B. Risk factors for wound healing complications after revascularization for MMD with complete Y-shaped incision. Sci Rep 2023; 13:3251. [PMID: 36828875 PMCID: PMC9958019 DOI: 10.1038/s41598-022-18709-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 08/18/2022] [Indexed: 02/26/2023] Open
Abstract
Moyamoya disease (MMD) is a chronic occlusive cerebrovascular disease that can be treated with revascularization. Surgery increases the risk of poor wound healing (PWH) due to the impact on the blood supply to the flap. We aimed to analyze risk factors for PWH in MMD with a complete Y-shaped incision. A total of 125 patients with MMD were enrolled in this prospective observational study. The wounds were assessed and measured on the third and seventh days after surgery. The mean age of these patients was 43.3 ± 10.0 years. The ratio of male to female was 1:1.3. 15 (12.0%) patients had incision complications. 5 patients (4.0%) had redness; 2 patients (1.6%) had swelling; 2 patients (1.6%) had fat necrosis; 3 patients (2.4%) had incision infection; and 3 patients (2.4%) had flap necrosis. Student's t test showed significant differences in BMI (P = 0.040) and fever time (P = 0.050). The standard chi-squared test showed significant differences in incision infection (P = 0.010), suture mode (P = 0.047), and cutting off large branch vessels in the flap (P < 0.001). Multivariate logistic regression analysis suggested that incision infection (P = 0.026, OR 12.958), using a skin stapler (P = 0.030, OR 4.335), cutting off large branch vessels in the flap (P = 0.009, OR 5.227), and BMI (P = 0.027, OR 1.204) were risk factors. The area under the curve for risk factors for PWH on a receiver operating characteristic curve was 0.853. Incision infection, using a skin stapler, higher BMI, and cutting off large branch vessels in the flap are risk factors for PWH.
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Affiliation(s)
- Chenchao Wang
- grid.412633.10000 0004 1799 0733Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, No. 1, Jianshe East Road, Erqi District, Zhengzhou, 450053 Henan China
| | - Hongwei Li
- grid.412633.10000 0004 1799 0733Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, No. 1, Jianshe East Road, Erqi District, Zhengzhou, 450053 Henan China
| | - Yang Dong
- grid.412633.10000 0004 1799 0733Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, No. 1, Jianshe East Road, Erqi District, Zhengzhou, 450053 Henan China
| | - Hao Wang
- grid.412633.10000 0004 1799 0733Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, No. 1, Jianshe East Road, Erqi District, Zhengzhou, 450053 Henan China
| | - Dongpeng Li
- grid.412633.10000 0004 1799 0733Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, No. 1, Jianshe East Road, Erqi District, Zhengzhou, 450053 Henan China
| | - Chengbin Zhao
- grid.412633.10000 0004 1799 0733Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, No. 1, Jianshe East Road, Erqi District, Zhengzhou, 450053 Henan China
| | - Lei Cao
- grid.412633.10000 0004 1799 0733Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, No. 1, Jianshe East Road, Erqi District, Zhengzhou, 450053 Henan China
| | - Kaiwen Sun
- grid.412633.10000 0004 1799 0733Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, No. 1, Jianshe East Road, Erqi District, Zhengzhou, 450053 Henan China
| | - Jiefeng Geng
- grid.412633.10000 0004 1799 0733Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, No. 1, Jianshe East Road, Erqi District, Zhengzhou, 450053 Henan China
| | - Bo Yang
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, No. 1, Jianshe East Road, Erqi District, Zhengzhou, 450053, Henan, China.
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Edet UO, Mbim EN, Ezeani E, Henshaw OU, Ibor OR, Bassey IU, Asanga EE, Antai EE, Nwaokorie FO, Edet BO, Bebia GP, Tega C, Mboto CI, Nkang A, Nneoyi-Egbe AF. Antimicrobial analysis of honey against Staphylococcus aureus isolates from wound, ADMET properties of its bioactive compounds and in-silico evaluation against dihydropteroate synthase. BMC Complement Med Ther 2023; 23:39. [PMID: 36747234 PMCID: PMC9901111 DOI: 10.1186/s12906-023-03841-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 01/11/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND One of the main challenges of wound healing is infection with multi-drug resistant (MDR) bacteria such as Staphylococcus aureus. The spectrum of antibiotics used to treat them is declining; thus, there is a need for alternatives. Our study was designed to evaluate the antimicrobial properties of honey, its pharmacokinetics (ADMET) properties and in-silico analysis of its bioactive compounds against dihydropteroate synthase of S. aureus using trimethoprim as control. METHODS Standard protocols were employed in collection and preparation of samples, generation of canonical strings, and conduction of microbiological analyses. Bioactive compounds' ADMET properties were evaluated using the SWISSADME and the MCULE toxicity checker tools. The MCULE one-click docking tool was used in carrying out the dockings. RESULTS The gas chromatography-mass spectrophotometry revealed twenty (20) bioactive compounds and was dominated by sugars (> 60%). We isolated a total of 47 S. aureus isolates from the wound samples. At lower concentrations, resistance to trimethoprim (95.74 to 100.00%) was higher than honey (70.21 to 96.36%). Only seven (7) isolates meet Lipinski's rule of five and ADMET properties. The docking scores of the bioactive compounds ranged from -3.3 to -4.6 while that of trimethoprim was -6.1, indicating better binding or interaction with the dihydropteroate synthase. The bioactive compounds were not substrates to P450 cytochrome enzymes (CYP1A2, CYP2CI9 and CYP2D6) and p-glycoprotein, indicating better gastrointestinal tract (GIT) absorption. CONCLUSION The favourable docking properties shown by the bioactive compounds suggest they could be lead compounds for newer antimetabolites for management of MDR S. aureus.
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Affiliation(s)
- Uwem Okon Edet
- Department of Biological Science, Faculty of Natural and Applied Sciences, Arthur Jarvis University, Cross River State, Akpabuyo, Nigeria
| | - Elizabeth Nkagafel Mbim
- Department of Public Health, Faculty of Basic Medical Sciences, Arthur Jarvis University, Cross River State, Akpabuyo, Nigeria
| | - Esu Ezeani
- grid.8991.90000 0004 0425 469XThe Medical Research Council Unit The Gambia at The London, School of Hygiene and Tropical Medicine, London, UK
| | - Okoroiwu Uchechi Henshaw
- Department of Medical Laboratory Science, Faculty of Basic Medical Sciences, Arthur Jarvis University, Cross River State, Akpabuyo, Nigeria
| | - Oju R. Ibor
- grid.413097.80000 0001 0291 6387Department of Zoology and Environmental Biology, Faculty of Biological Sciences, University of Calabar, Cross River State, Calabar, Nigeria
| | - Ini Ubi Bassey
- grid.413097.80000 0001 0291 6387Department of Microbiology, Faculty of Biological Sciences, University of Calabar, Cross River State, Calabar, Nigeria
| | - Edet Effiong Asanga
- Department of Chemical Sciences (Biochemistry Unit), Faculty of Natural and Applied Sciences, Arthur Jarvis University, Cross River State, Akpabuyo, Nigeria
| | - Ekpo Eyo Antai
- grid.413097.80000 0001 0291 6387Department of Biological (Microbiology) Oceanography, Faculty of Oceanography, University of Calabar, Nigeria. (Antai), Calabar, Nigeria
| | - Francisca O. Nwaokorie
- grid.411782.90000 0004 1803 1817Department of Medical Laboratory Science, College of Medicine, University of Lagos, Nigeria, Lagos State, Nigeria
| | - Bassey Okon Edet
- Department of Biological Science, Faculty of Natural and Applied Sciences, Arthur Jarvis University, Cross River State, Akpabuyo, Nigeria
| | - Glory P. Bebia
- grid.413097.80000 0001 0291 6387Department of Medical Microbiology/Parasitology, Faculty of Medical Laboratory Science, University of Calabar (Glory), Calabar, Nigeria
| | - Curtis Tega
- grid.413097.80000 0001 0291 6387Department of Microbiology, Faculty of Biological Sciences, University of Calabar, Cross River State, Calabar, Nigeria
| | - Clement I. Mboto
- grid.413097.80000 0001 0291 6387Microbiology Department, Faculty of Biological Sciences, University of Calabar, Calabar, Nigeria
| | - Ani Nkang
- Department of Biological Science, Faculty of Natural and Applied Sciences, Arthur Jarvis University, Cross River State, Akpabuyo, Nigeria
| | - Ada Francesca Nneoyi-Egbe
- grid.413097.80000 0001 0291 6387Department of Biochemistry, Faculty of Basic Medical Sciences, University of Calabar, Calabar, Nigeria
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Mainprize M, Spencer Netto FAC, Degani C, Szasz P. The Shouldice Method: an expert's consensus. Hernia 2023; 27:147-156. [PMID: 35939246 DOI: 10.1007/s10029-022-02658-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 07/20/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Hernia repairs are a commonly performed surgical procedure and the Shouldice Repair of inguinal hernias has been well described before in terms of its outcomes. However, the purpose of this paper was to understand what experts from Shouldice Hospital consider to be the essential steps to the Shouldice Method. METHODS Utilizing a Delphi Methodology, surgeons at Shouldice Hospital who are considered content experts, provided their answers on what is essential to the Shouldice Method. The median, interquartile range, and percent agreement from the responses as well as the Delphi's overall Cronbach's Alpha were determined. All Delphi items were ranked on a five-point Likert scale and consensus was reached when Cronbach's Alpha was ≥ 0.8. The items from the survey that ranked as 5-completely agree or 4-partially agree by ≥ 80% of participants on the five-point Likert scale were included in the final framework. RESULTS The final consensus for the Shouldice Method included 39 items with 7 overarching steps: preoperative preparation of the patient, anesthetic component, incision and nerve identification, treatment of the cremasteric muscles, hernia identification and treatment, reconstruction of the posterior wall, and post-operative management of patients. CONCLUSION The results of this consensus provide a step-by-step approach to the Shouldice Method, as well as information that is timely and can be utilized by surgeons incorporating non-mesh hernia repairs into their practice.
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Affiliation(s)
- Marguerite Mainprize
- Department of Surgery, Shouldice Hospital, 7750 Bayview Avenue, Thornhill, ON, L3T 7N2, Canada.
| | | | - Cassim Degani
- Department of Surgery, Shouldice Hospital, 7750 Bayview Avenue, Thornhill, ON, L3T 7N2, Canada
| | - Peter Szasz
- Department of Surgery, Kingston Health Sciences Center, Queen's University, Kingston, ON, Canada
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Zhang WQ, Tang W, Hu SQ, Fu XL, Wu H, Shen WQ, Chen HL. Effect of matrix metalloproteinases on the healing of diabetic foot ulcer: A systematic review. J Tissue Viability 2023; 32:51-58. [PMID: 36513539 DOI: 10.1016/j.jtv.2022.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 10/24/2022] [Accepted: 12/06/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND This study aims to discuss the expression of matrix metalloproteinase in wound healing of diabetic foot ulcers and further summarize the strategies of targeted matrix metalloproteinase and its inhibitors in the treatment of diabetic foot ulcers. METHODS Following PRISMA-SCR guidelines, databases (PubMed, Home-PMC-NCBI, CINAHL, Web of Science) were systematically searched from inception to 19 June 2022. Newcastle-Ottawa Scale (NOS) was used to evaluate the bias risk of the included studies. RESULTS Eight studies are finally eligible for our systematic review. The combined data analysis of 8 studies showed that there were no significant difference in age(p = 0.110), duration of diabetes(p = 0.197), glycosylated hemoglobin content(p = 0.489), size(p = 0.133) and depth(p>0.05) of initial ulcer between the ulcer wound healing group and the non-healing group. MMP-1, 2, 8, 9, and TIMP-1, 2 affected the healing of DFUs. In the DFUs healing group, the concentrations of MMP (MMP-1, 2, 8, 9) decreased, and the concentration of TIMP-1 increased. CONCLUSION Our study showed that high levels of MMP-1, 2, 9 delayed the healing of diabetic foot ulcers, and high expression of MMP-8 in tissues improved wound healing. This study also summarized the effective intervention strategies for the treatment of diabetic foot ulcers.
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Affiliation(s)
| | - Wen Tang
- School of Medicine, Nantong University, Nantong, China
| | - Shi-Qi Hu
- School of Medicine, Nantong University, Nantong, China
| | - Xue-Lei Fu
- School of Medicine, Nantong University, Nantong, China
| | - Hua Wu
- School of Medicine, Nantong University, Nantong, China
| | - Wang-Qin Shen
- School of Medicine, Nantong University, Nantong, China.
| | - Hong-Lin Chen
- School of Public Health, Nantong University, Nantong, China.
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Rowley MA, Thawanyarat K, Shah JK, Yesantharao PS, Nazerali R. A recent national analysis of breast reconstruction outcomes in patients with underlying autoimmune connective tissue diseases. EUROPEAN JOURNAL OF PLASTIC SURGERY 2023. [DOI: 10.1007/s00238-023-02043-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Temelci A, Yılmaz HG, Ünsal G, Uyanik LO, Yazman D, Ayali A, Minervini G. Investigation of the Wetting Properties of Thalassemia Patients' Blood Samples on Grade 5 Titanium Implant Surfaces: A Pilot Study. Biomimetics (Basel) 2023; 8:biomimetics8010025. [PMID: 36648811 PMCID: PMC9844454 DOI: 10.3390/biomimetics8010025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/20/2022] [Accepted: 01/04/2023] [Indexed: 01/11/2023] Open
Abstract
Background and Objectives: Beta-thalassemia (BT) has a high prevalence in Mediterranean, Southeast Asian, and African countries. Studies stated that thalassemia is an endemic disease that causes significant health problems in Cyprus. This study aimed to measure the contact angle between the implant and blood samples from BT major patients and healthy individuals to compare the contact angles and wettability of Grade 5 titanium implant surfaces. Materials and Methods: Grade 5 titanium discs that were 10 mm in diameter were used since they mimic the surface of dental implants. Following receiving informed consent, blood samples were taken from the patients’ index fingers in each group with lancet needles and a photo of the contact angle between the blood samples and the titanium surface was taken; the collected blood was transferred to a titanium disc with a medical pipette. ImageJ software with a specific contact angle plugin was used for the contact angle measurements. Results: Theta-mean, theta-circular, and theta-ellipse values were compared between all groups, and no significant difference was found (p > 0.05). Conclusions: In this study, it was hypothesized that the patients’ rheological property of decreased deformability would affect the wettability of implant surfaces in vitro; however, no such finding was reached in this study. Since in-depth studies associated with dental implant success in BTM patients are absent in the literature and Cyprus is one of the Mediterranean countries with a high prevalence of BTM, this study was conducted to enrich the literature. While some systemic diseases may affect the contact angle between the implant surface and blood, it can be concluded that this condition was not present for BTM patients in our study. Last but not least, we emphasize that this experiment was done on a single surface type and the results can be totally different when using other surface types.
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Affiliation(s)
- Ali Temelci
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Near East University, Nicosia 99138, Cyprus
- Correspondence: (A.T.); (G.M.)
| | - Hasan Güney Yılmaz
- Department of Periodontology, Faculty of Dentistry, Near East University, Nicosia 99138, Cyprus
| | - Gürkan Ünsal
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Near East University, Nicosia 99138, Cyprus
| | - Lokman Onur Uyanik
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Near East University, Nicosia 99138, Cyprus
| | - Dilek Yazman
- Center of Thalassemia, Dr. Burhan Nalbantoğlu State Hospital, Nicosia 99010, Cyprus
| | - Aysa Ayali
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, European University of Lefke, Nicosia 99728, Cyprus
| | - Giuseppe Minervini
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, 81100 Caserta, Italy
- Correspondence: (A.T.); (G.M.)
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Nardini C, Candelise L, Turrini M, Addimanda O. Semi-automated socio-anthropologic analysis of the medical discourse on rheumatoid arthritis: Potential impact on public health. PLoS One 2022; 17:e0279632. [PMID: 36580470 PMCID: PMC9799325 DOI: 10.1371/journal.pone.0279632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 12/12/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The debilitating effects of noncommunicable diseases (NCDs) and the accompanying chronic inflammation represent a significant obstacle for the sustainability of our development, with efforts spreading worldwide to counteract the diffusion of NCDs, as per the United Nations Sustainable Development Goals (SDG 3). In fact, despite efforts of varied intensity in numerous directions (from innovations in biotechnology to lifestyle modifications), the incidence of NCDs remains pandemic. The present work wants to contribute to addressing this major concern, with a specific focus on the fragmentation of medical approaches, via an interdisciplinary analysis of the medical discourse, i.e. the heterogenous reporting that biomedical scientific literature uses to describe the anti-inflammatory therapeutic landscape in NCDs. The aim is to better capture the roots of this compartmentalization and the power relations existing among three segregated pharmacological, experimental and unstandardized biomedical approaches to ultimately empower collaboration beyond medical specialties and possibly tap into a more ample and effective reservoir of integrated therapeutic opportunities. METHOD Using rheumatoid arthritis (RA) as an exemplar disease, twenty-eight articles were manually translated into a nine-dimensional categorical variable of medical socio-anthropological relevance, relating in particular (but not only) to legitimacy, temporality and spatialization. This digitalized picture (9 x 28 table) of the medical discourse was further analyzed by simple automated learning approaches to identify differences and highlight commonalities among the biomedical categories. RESULTS Interpretation of these results provides original insights, including suggestions to: empower scientific communication between unstandardized approaches and basic biology; promote the repurposing of non-pharmacological therapies to enhance robustness of experimental approaches; and align the spatial representation of diseases and therapies in pharmacology to effectively embrace the systemic approach promoted by modern personalized and preventive medicines. We hope this original work can expand and foster interdisciplinarity among public health stakeholders, ultimately contributing to the achievement of SDG3.
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Affiliation(s)
- Christine Nardini
- Consiglio Nazionale delle Ricerche, Istituto per le Applicazioni del Calcolo "Mauro Picone", Roma, Italy
- * E-mail: (CN); (LC); (MT)
| | - Lucia Candelise
- ISS, Istitut Sciences Sociales, Université de Lausanne, Lausanne, Switzerland
- CEPED, Centre Population et Développement, Université de Paris, Paris, France
- * E-mail: (CN); (LC); (MT)
| | - Mauro Turrini
- Institute of Public Goods and Policies (IPP), Spanish National Research Council (CSIC), Madrid, Spain
- * E-mail: (CN); (LC); (MT)
| | - Olga Addimanda
- UOC Medicina Interna ad Indirizzo Reumatologico, Ospedale Maggiore, AUSL Bologna, Bologna, Italy
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Giannakopoulos E, Katopodi A, Rallis M, Politopoulos K, Alexandratou E. The effects of low power laser light at 661 nm on wound healing in a scratch assay fibroblast model. Lasers Med Sci 2022; 38:27. [PMID: 36574084 PMCID: PMC9794538 DOI: 10.1007/s10103-022-03670-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 10/12/2022] [Indexed: 12/28/2022]
Abstract
Wound treatment, especially for chronic and infected wounds, has been a permanent socio-economical challenge. This study aimed to investigate the ability of red light at 661 nm to accelerate wound healing an in vitro wound model using 3T3 fibroblasts. The purpose is further specified in clarifying the mechanisms of wound closure by means of intracellular ROS production, proliferation and migration of cells, and cellular orientation. Illumination effects of red light from a diode laser (661 nm) at different doses on 3T3 cell viability was assessed via MTT assay and tested in a scratch wound model. Wound closure rates were calculated by image analysis at 0, 24, and 48 h after laser treatment. ROS production was monitored and quantified immediately and 24 h after the treatment by fluorescence microscopy. Cellular orientation was quantified by image analysis. No phototoxic energy doses used and increased cell viability in most of the groups. Scratch assay revealed an energy interval of 3 - 4.5 J/cm2 that promote higher wound healing rate 24 h post treatment. An increase in ROS production was also observed 24 h post irradiation higher in the group with the highest wound healing rate. Also, cellular orientation toward the margin of the wound was observed and quantified after irradiation. Low power laser light at 661 nm activated both the migration and proliferation in the in vitro model used, providing evidence that it could also accelerate wound healing in vivo. Also, ROS production and cellular orientation seem to play an important role in wound healing process.
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Affiliation(s)
- Efstathios Giannakopoulos
- Laboratory of Biomedical Optics and Applied Biophysics, School of Electrical and Computer Engineering, National Technical University of Athens, Zografou Campus, 15780, Athens, Greece.
- Division of Pharmaceutical Technology, School of Pharmacy, National and Kapodistrian University of Athens, Panepistimioupoli, Zografou Campus, 15771, Athens, Greece.
| | - Annita Katopodi
- Laboratory of Organic Chemistry, School of Chemical Engineering, National Technical University of Athens, Zografou Campus, 15780, Athens, Greece
| | - Michail Rallis
- Division of Pharmaceutical Technology, School of Pharmacy, National and Kapodistrian University of Athens, Panepistimioupoli, Zografou Campus, 15771, Athens, Greece
| | - Konstantinos Politopoulos
- Laboratory of Biomedical Optics and Applied Biophysics, School of Electrical and Computer Engineering, National Technical University of Athens, Zografou Campus, 15780, Athens, Greece
| | - Eleni Alexandratou
- Laboratory of Biomedical Optics and Applied Biophysics, School of Electrical and Computer Engineering, National Technical University of Athens, Zografou Campus, 15780, Athens, Greece
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Leal EC, Carvalho E. Heme Oxygenase-1 as Therapeutic Target for Diabetic Foot Ulcers. Int J Mol Sci 2022; 23:ijms231912043. [PMID: 36233341 PMCID: PMC9569859 DOI: 10.3390/ijms231912043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 10/04/2022] [Accepted: 10/09/2022] [Indexed: 11/22/2022] Open
Abstract
A diabetic foot ulcer (DFU) is one of the major complications of diabetes. Wound healing under diabetic conditions is often impaired. This is in part due to the excessive oxidative stress, prolonged inflammation, immune cell dysfunction, delayed re-epithelialization, and decreased angiogenesis present at the wound site. As a result of these multifactorial impaired healing pathways, it has been difficult to develop effective therapeutic strategies for DFU. Heme oxygenase-1 (HO-1) is the rate-limiting enzyme in heme degradation generating carbon monoxide (CO), biliverdin (BV) which is converted into bilirubin (BR), and iron. HO-1 is a potent antioxidant. It can act as an anti-inflammatory, proliferative, angiogenic and cytoprotective enzyme. Due to its biological functions, HO-1 plays a very important role in wound healing, in part mediated through the biologically active end products generated by its enzymatic activity, particularly CO, BV, and BR. Therapeutic strategies involving the activation of HO-1, or the topical application of its biologically active end products are important in diabetic wound healing. Therefore, HO-1 is an attractive therapeutic target for DFU treatment. This review will provide an overview and discussion of the importance of HO-1 as a therapeutic target for diabetic wound healing.
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Affiliation(s)
- Ermelindo Carreira Leal
- Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504 Coimbra, Portugal
- Institute of Interdisciplinary Research, University of Coimbra, 3004-504 Coimbra, Portugal
- Correspondence: (E.C.L.); (E.C.); Tel.: +351-239-820-190 (E.C.L. & E.C.)
| | - Eugenia Carvalho
- Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504 Coimbra, Portugal
- Institute of Interdisciplinary Research, University of Coimbra, 3004-504 Coimbra, Portugal
- Correspondence: (E.C.L.); (E.C.); Tel.: +351-239-820-190 (E.C.L. & E.C.)
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Mendes AI, Peixoto MJ, Marques AP, Pedrosa J, Fraga AG. An optimized mouse model of Staphylococcus aureus infected diabetic ulcers. BMC Res Notes 2022; 15:293. [PMID: 36071445 PMCID: PMC9450231 DOI: 10.1186/s13104-022-06170-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 08/10/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Diabetic foot infection (DFI) represents a major healthcare burden, for which treatment is challenging owing to the pathophysiological alterations intrinsic to diabetes and the alarming increase of antimicrobial resistance. Novel therapies targeting DFI are therefore a pressing research need for which proper models of disease are required. RESULTS Here, we present an optimized diabetic mouse model of methicillin-resistant Staphylococcus aureus (MRSA)-infected wounds, that resemble key features of DFI, such as pathogen invasion through wound bed and surrounding tissue, necrosis, persistent inflammation and impaired wound healing. Thus, in a time-efficient manner and using simple techniques, this model represents a suitable approach for studying emerging therapies targeting DFI caused by MRSA.
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Affiliation(s)
- Ana Isabel Mendes
- School of Medicine, Life and Health Sciences Research Institute (ICVS), University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal.,ICVS/3B's-PT Government Associate Laboratory, Braga, Guimarães, Portugal
| | - Maria João Peixoto
- School of Medicine, Life and Health Sciences Research Institute (ICVS), University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal.,ICVS/3B's-PT Government Associate Laboratory, Braga, Guimarães, Portugal
| | - Alexandra Pinto Marques
- ICVS/3B's-PT Government Associate Laboratory, Braga, Guimarães, Portugal.,3B's Research Group, I3Bs - Research Institute on Biomaterials, Biodegradables and Biomimetics, Headquarters of the European Institute of Excellence On Tissue Engineering and Regenerative Medicine, University of Minho, AvePark, Zona Industrial da Gandra, 4805-017, Barco, Guimarães, Portugal
| | - Jorge Pedrosa
- School of Medicine, Life and Health Sciences Research Institute (ICVS), University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal.,ICVS/3B's-PT Government Associate Laboratory, Braga, Guimarães, Portugal
| | - Alexandra Gabriel Fraga
- School of Medicine, Life and Health Sciences Research Institute (ICVS), University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal. .,ICVS/3B's-PT Government Associate Laboratory, Braga, Guimarães, Portugal.
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Flavonoids exert potential in the management of hypertensive disorders in pregnancy. Pregnancy Hypertens 2022; 29:72-85. [DOI: 10.1016/j.preghy.2022.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 06/29/2022] [Indexed: 11/19/2022]
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Pressure Injuries and Management after Spinal Cord Injury. J Pers Med 2022; 12:jpm12071130. [PMID: 35887627 PMCID: PMC9325194 DOI: 10.3390/jpm12071130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/30/2022] [Accepted: 07/08/2022] [Indexed: 11/17/2022] Open
Abstract
Spinal cord injury (SCI) results in motor paralysis and sensory loss that places individuals at particularly high risk of pressure injuries. Multiple comorbidities associated with autonomic, cardiovascular, pulmonary, endocrine, gastrointestinal, genitourinary, neurological, and musculoskeletal dysfunction makes it even more likely that pressure injuries will occur. This manuscript will review the structure and function of the integumentary system, and address the multidisciplinary approach required to prevent and manage pressure injuries in this vulnerable population.
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Andersen JW, Dashnaw B, Hoegh A. Autologous blood patch treatment of patients with hard-to-heal wounds: a prospective cohort study. J Wound Care 2022; 31:572-578. [PMID: 35797258 DOI: 10.12968/jowc.2022.31.7.572] [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: 11/11/2022]
Abstract
OBJECTIVE To describe the effect of autologous blood patch (3CP, Reapplix, Denmark) treatments as a supplement to standard care among patients with hard-to-heal wounds in an outpatient multidisciplinary wound centre (MWC). METHOD The 3CP is an autologous leukocyte- and platelet-rich fibrin patch, which is applied directly into the wound bed. Patients with a wound duration >6 weeks and an unsatisfactory outcome following standard care were considered. Weekly administration of the autologous blood patch was carried out and the wound size was measured using a picture-based area calculation program at three timepoints (first contact with the MWC, initiation of the autologous blood patch treatment and at the end of the autologous blood patch treatment). The effect was followed for one year or until healing. RESULTS From June 2016 to September 2019, 36 patients were included. The median age was 63.5 years (interquartile range (IQR): 58-70), and 14 patients were female (38.9%) and 22 were male (61.1%). Median wound duration pre-autologous blood patch was 21.5 weeks (IQR: 11.1-50.0) and median treatment time was 3.4 weeks (IQR: 1.6-5.3). Half of the patients (50%, 18/36) healed in <20 weeks, 30.6% (11/36) healed in 20-52 weeks and 19.4% (7/36) did not heal within a year. There was a significant difference between the mean wound area (±standard deviation) at the start of autologous blood patch treatment and the area at the end: 2.85±3.71cm2 versus 1.65±2.37cm2, respectively (p=0.0017). Treatment was stopped prematurely for 5/36 patients (reasons included wound infection, major amputation, procedure discomfort or withdrawal without reason). CONCLUSION Among MWC patients with hard-to-heal wounds not responding to standard care, autologous blood patch treatment as a supplement to standard wound care expedited wound healing.
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Affiliation(s)
- Jesper Winkler Andersen
- Wound Center Viborg, Department of Vascular Surgery, Viborg Regional Hospital, Denmark.,Department of Internal Medicine, Horsens Regional Hospital, Denmark
| | - Birgit Dashnaw
- Wound Center Viborg, Department of Vascular Surgery, Viborg Regional Hospital, Denmark
| | - Annette Hoegh
- Wound Center Viborg, Department of Vascular Surgery, Viborg Regional Hospital, Denmark
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Evaluation of Wound Healing Activity (Excision Wound Model) of Ointment Prepared from Infusion Extract of Polyherbal Tea Bag Formulation in Diabetes-Induced Rats. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:1372199. [PMID: 35707477 PMCID: PMC9192309 DOI: 10.1155/2022/1372199] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 04/22/2022] [Indexed: 02/07/2023]
Abstract
In the present investigation, Ichnocarpus frutescens, Ficus dalhousiae, Crateva magna, Alpinia galanga, and Swertia chirata plants were selected to formulate polyherbal tea bag. The infusion obtained from these polyherbal tea bags was used to formulate 5% and 10% ointment formulation to perform its wound healing activity. The excision wound model was used to assess the wound healing activity in diabetic as well nondiabetic rats. The mean percentage closure of wound area was calculated on the 3rd, 6th, 9th, 12th, 15th, 18th, and finally 21st day. The wound healing activity of formulation was found to be significantly compared with that of the reference standard and untreated groups. The percentages of closure of excision wound area on the 21st day in diabetic animals treated with ointment formulations (F1 and F2) were found to be 93.91 ± 1.65% and 99.12 ± 5.21% respectively, whereas the chloramphenicol sodium drug solution was found to be 99.81 ± 3.16%. The percentages of closure of excision wound area in nondiabetic animals treated with ointment formulations (F1 and F2) were found to be 96.81 ± 2.04% and 98.13 ± 1.14%, respectively, whereas the chloramphenicol sodium drug solution was found to be 99.15 ± 1.41% at 21st day. Therefore, from the above results, we have concluded that this polyherbal ointment can be used clinically for the treatment of diabetic and nondiabetic wounds.
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Mu R, Campos de Souza S, Liao Z, Dong L, Wang C. Reprograming the immune niche for skin tissue regeneration - From cellular mechanisms to biomaterials applications. Adv Drug Deliv Rev 2022; 185:114298. [PMID: 35439569 DOI: 10.1016/j.addr.2022.114298] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 04/07/2022] [Accepted: 04/12/2022] [Indexed: 02/07/2023]
Abstract
Despite the rapid development of therapeutic approaches for skin repair, chronic wounds such as diabetic foot ulcers remain an unaddressed problem that affects millions of people worldwide. Increasing evidence has revealed the crucial and diverse roles of the immune cells in the development and repair of the skin tissue, prompting new research to focus on further understanding and modulating the local immune niche for comprehensive, 'perfect' regeneration. In this review, we first introduce how different immunocytes and certain stromal cells involved in innate and adaptive immunity coordinate to maintain the immune niche and tissue homeostasis, with emphasis on their specific roles in normal and pathological wound healing. We then discuss novel engineering approaches - particularly biomaterials systems and cellular therapies - to target different players of the immune niche, with three major aims to i) overcome 'under-healing', ii) avoid 'over-healing', and iii) promote functional restoration, including appendage development. Finally, we highlight how these strategies strive to manage chronic wounds and achieve full structural and functional skin recovery by creating desirable 'soil' through modulating the immune microenvironment.
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Deng X, Gould M, Ali MA. A review of current advancements for wound healing: Biomaterial applications and medical devices. J Biomed Mater Res B Appl Biomater 2022; 110:2542-2573. [PMID: 35579269 PMCID: PMC9544096 DOI: 10.1002/jbm.b.35086] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 04/28/2022] [Accepted: 04/30/2022] [Indexed: 12/12/2022]
Abstract
Wound healing is a complex process that is critical in restoring the skin's barrier function. This process can be interrupted by numerous diseases resulting in chronic wounds that represent a major medical burden. Such wounds fail to follow the stages of healing and are often complicated by a pro‐inflammatory milieu attributed to increased proteinases, hypoxia, and bacterial accumulation. The comprehensive treatment of chronic wounds is still regarded as a significant unmet medical need due to the complex symptoms caused by the metabolic disorder of the wound microenvironment. As a result, several advanced medical devices, such as wound dressings, wearable wound monitors, negative pressure wound therapy devices, and surgical sutures, have been developed to correct the chronic wound environment and achieve skin tissue regeneration. Most medical devices encompass a wide range of products containing natural (e.g., chitosan, keratin, casein, collagen, hyaluronic acid, alginate, and silk fibroin) and synthetic (e.g., polyvinyl alcohol, polyethylene glycol, poly[lactic‐co‐glycolic acid], polycaprolactone, polylactic acid) polymers, as well as bioactive molecules (e.g., chemical drugs, silver, growth factors, stem cells, and plant compounds). This review addresses these medical devices with a focus on biomaterials and applications, aiming to deliver a critical theoretical reference for further research on chronic wound healing.
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Affiliation(s)
- Xiaoxuan Deng
- Centre for Bioengineering & Nanomedicine (Dunedin), Department of Oral Rehabilitation, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Maree Gould
- Centre for Bioengineering & Nanomedicine (Dunedin), Department of Oral Rehabilitation, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - M Azam Ali
- Centre for Bioengineering & Nanomedicine (Dunedin), Department of Oral Rehabilitation, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
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Massada KE, Baltodano PA, Webster TK, Elmer NA, Zhao H, Lu X, Kaplunov BS, Araya S, Brebion R, Coronado M, Patel SA. Optimizing Abdominoplasty Surgical Site Morbidity Profiling Through an Effective and Nationally Validated Risk Scoring System. Ann Plast Surg 2022; 88:S274-S278. [PMID: 35513330 DOI: 10.1097/sap.0000000000003115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Abdominoplasty complication rates are among the highest for cosmetic surgery. We sought to create a validated scoring system to predict the likelihood of wound complications after abdominoplasty using a national multi-institutional database. METHODS Patients who underwent abdominoplasty in the American College of Surgeons National Surgical Quality Improvement Program 2007-2019 database were analyzed for surgical site complications, a composite outcome of wound disruption, and surgical site infections. The cohort was randomly divided into a 60% testing and a 40% validation sample. Multivariable logistic regression analysis was performed to identify independent predictors of complications using the testing sample (n = 11,294). The predictors were weighted according to β coefficients to develop an integer-based clinical risk score. This system was validated using receiver operating characteristic analysis of the validation sample (n = 7528). RESULTS A total of 18,822 abdominoplasty procedures were identified. The proportion of patients who developed a composite surgical site complication was 6.8%. Independent risk factors for composite surgical site complication included inpatient procedure (P < 0.01), smoking (P < 0.01), American Society of Anesthesiologists class ≥3 (P < 0.01), and body mass index ≥25.0 and ≤18.0 kg/m2 (P < 0.01). African American race was a protective factor against surgical site complications (P < 0.01). The factors were integrated into a scoring system, ranging from -5 to 42, and the receiver operating characteristic analysis revealed an area under the curve of 0.71. CONCLUSIONS We present a validated scoring system for postoperative 30-day surgical site morbidity after abdominoplasty. This system will enable surgeons to optimize patient selection to decrease morbidity and unnecessary healthcare expenditure.
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Affiliation(s)
- Karen E Massada
- From the Department of General Surgery, Mercy Catholic Medical Center
| | - Pablo A Baltodano
- Fox Chase Cancer Center/Division of Plastic and Reconstructive Surgery, Temple University
| | - Theresa K Webster
- Fox Chase Cancer Center/Division of Plastic and Reconstructive Surgery, Temple University
| | | | - Huaqing Zhao
- Biostatistics and Bioinformatics Facility, Temple University Health System, Philadelphia, PA
| | - Xiaoning Lu
- Biostatistics and Bioinformatics Facility, Temple University Health System, Philadelphia, PA
| | - Briana S Kaplunov
- Fox Chase Cancer Center/Division of Plastic and Reconstructive Surgery, Temple University
| | - Sthefano Araya
- Fox Chase Cancer Center/Division of Plastic and Reconstructive Surgery, Temple University
| | - Rohan Brebion
- Fox Chase Cancer Center/Division of Plastic and Reconstructive Surgery, Temple University
| | - Michael Coronado
- Fox Chase Cancer Center/Division of Plastic and Reconstructive Surgery, Temple University
| | - Sameer A Patel
- Fox Chase Cancer Center/Division of Plastic and Reconstructive Surgery, Temple University
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Murphy C, Atkin L, Vega de Ceniga M, Weir D, Swanson T, Walker A, Mrozikiewicz-Rakowska B, Ciprandi G, Martínez JLL, Černohorská J. Embedding Wound Hygiene into a proactive wound healing strategy. J Wound Care 2022; 31:S1-S19. [DOI: 10.12968/jowc.2022.31.sup4a.s1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Foreword. Wound Hygiene: the next stage Since a panel published the first consensus document on Wound Hygiene in March 2020, there has been a flurry of activity in support of this newly established concept in proactive wound healing. 1 The document concluded that all wounds, particularly hard-to-heal ones, will benefit from Wound Hygiene, which should be initiated at the first referral, following a full holistic assessment to identify the wound aetiology and comorbidities, and then implemented at every dressing change until full healing occurs. 1 The consensus has since been bolstered by educational webinars; competency-based skills training and support; development of international Wound Hygiene ambassadors; a survey of 1478 respondents, published in July 2021; 2 and a case study supplement, published in January 2022, featuring a range of wound types, anatomies and underlying conditions on the improvements in wound-healing progress that can be achieved. 3 Wound Hygiene has gained its own identity and is now a term in and of itself, that encompasses a 4-step protocol of care. It is an antibiofilm approach that is increasingly being used across wound care. The results of the survey 2 were particularly encouraging for seeing how far Wound Hygiene has come, and how quickly: More than half (57.4%) had heard of the concept of Wound Hygiene Of those, 75.3% have implemented Wound Hygiene Overall, following implementation of Wound Hygiene, 80.3% of respondents reported improved healing rates. 2 However, the top three barriers identified by the survey—lack of confidence, competence and research data—show that there is more to be done to support Wound Hygiene in practice. 2 As a result, a consensus panel of international key opinion leaders convened virtually in the summer of 2021 to discuss what has been done so far, the outputs of the survey, and ideas for addressing the unmet needs identified by the results. The result is this publication, which represents an addendum to the initial consensus document, broadening support for implementation of Wound Hygiene. This document will reflect on the reasons Wound Hygiene has been successful in its first two years of implementation, reiterating its DNA: Do not wait to treat hard-to-heal wounds Use a simple 4-step approach Enable all healthcare professionals to implement and use Wound Hygiene. The document will also discuss the evolution of the Wound Hygiene concept, focusing on how and when to implement Wound Hygiene on all tissue types of hard-to-heal wounds, and proposing what these are. The panel has expanded the framework in which Wound Hygiene is used, with the ultimate objective of introducing the concept of ‘embedding Wound Hygiene intro a proactive wound healing strategy.’ Key inefficiencies are often observed along the journeys of people living with hard-to-heal wounds. The limited number of specialised healthcare professionals and the resulting delays in reaching them may increase the likelihood of a hard-to-heal wound developing. In a world where so much is happening so quickly that we may, at times, feel powerless to drive change, the panel wants to provide further guidance to propel the use of Wound Hygiene. The concept of Wound Hygiene is resonating, and the panel wants you to know that in whatever region you work, in whatever area of clinical practice, you are enabled to make this change. Wielding the 4-step Wound Hygiene protocol consistently is a key action every healthcare professional in every care setting can take to tackle the global wound care crisis. Wound Hygiene has taken off—now, where do we want to land? In a place where Wound Hygiene is practised on all wounds, at every stage, until healing. The panel once again recognises that the community of global healthcare providers should consider their local standards and guidelines when applying the recommendations of this document. To this end, the panel has created a flexible 3-phase framework that situates Wound Hygiene as integral to proactive wound healing. The panel hopes you will continue to implement Wound Hygiene and see the benefits it can bring to people living with wounds, as well as those who care for them.
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Affiliation(s)
- Chris Murphy
- Vascular Nurse Specialist, The Ottawa Hospital Limb Preservation Centre, Ottawa, Canada
| | - Leanne Atkin
- Vascular Nurse Consultant, Mid Yorkshire Hospitals NHS Trust and University of Huddersfield, UK
| | - Melina Vega de Ceniga
- Consultant Angiologist, Vascular and Endovascular Surgeon, Galdakao-Usansolo Hospital, Bizkaia, Spain
| | - Dot Weir
- Wound Clinician, Consultant at Saratoga Hospital Center for Wound Healing and Hyperbaric Medicine, US
| | - Terry Swanson
- Nurse Practitioner, Warrnambool, Victoria, Australia
| | - Angela Walker
- Podiatry Lead Clinical Specialist, Birmingham Community Healthcare NHS Foundation Trust, UK
| | - Beata Mrozikiewicz-Rakowska
- Associate Professor, Diabetology and Metabolic Diseases Department, Medical University of Warsaw, Warsaw, Poland
| | - Guido Ciprandi
- Chief Wound Care Surgical Unit, Division of Plastic and Maxillofacial Surgery, Bambino Gesù Children's Hospital, Research Institute, Rome, Italy
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Fischer A, Wannemacher J, Christ S, Koopmans T, Kadri S, Zhao J, Gouda M, Ye H, Mück-Häusl M, Krenn PW, Machens HG, Fässler R, Neumann PA, Hauck SM, Rinkevich Y. Neutrophils direct preexisting matrix to initiate repair in damaged tissues. Nat Immunol 2022; 23:518-531. [PMID: 35354953 PMCID: PMC8986538 DOI: 10.1038/s41590-022-01166-6] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 02/18/2022] [Indexed: 11/09/2022]
Abstract
Internal organs heal injuries with new connective tissue, but the cellular and molecular events of this process remain obscure. By tagging extracellular matrix around the mesothelium lining in mouse peritoneum, liver and cecum, here we show that preexisting matrix was transferred across organs into wounds in various injury models. Using proteomics, genetic lineage-tracing and selective injury in juxtaposed organs, we found that the tissue of origin for the transferred matrix likely dictated the scarring or regeneration of the healing tissue. Single-cell RNA sequencing and genetic and chemical screens indicated that the preexisting matrix was transferred by neutrophils dependent on the HSF-integrin AM/B2-kindlin3 cascade. Pharmacologic inhibition of this axis prevented matrix transfer and the formation of peritoneal adhesions. Matrix transfer was thus an early event of wound repair and provides a therapeutic window to dampen scaring across a range of conditions.
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Affiliation(s)
- Adrian Fischer
- Institute of Regenerative Biology and Medicine, Helmholtz Zentrum München Deutsches Forschungszentrum für Gesundheit und Umwelt (GmbH), München, Germany
| | - Juliane Wannemacher
- Institute of Regenerative Biology and Medicine, Helmholtz Zentrum München Deutsches Forschungszentrum für Gesundheit und Umwelt (GmbH), München, Germany
| | - Simon Christ
- Institute of Regenerative Biology and Medicine, Helmholtz Zentrum München Deutsches Forschungszentrum für Gesundheit und Umwelt (GmbH), München, Germany
| | - Tim Koopmans
- Hubrecht Institute,, Developmental Biology and Stem Cell Research, Utrecht, the Netherlands
| | - Safwen Kadri
- Institute of Regenerative Biology and Medicine, Helmholtz Zentrum München Deutsches Forschungszentrum für Gesundheit und Umwelt (GmbH), München, Germany
| | - Jiakuan Zhao
- Institute of Regenerative Biology and Medicine, Helmholtz Zentrum München Deutsches Forschungszentrum für Gesundheit und Umwelt (GmbH), München, Germany
| | - Mahesh Gouda
- Institute of Regenerative Biology and Medicine, Helmholtz Zentrum München Deutsches Forschungszentrum für Gesundheit und Umwelt (GmbH), München, Germany
| | - Haifeng Ye
- Institute of Regenerative Biology and Medicine, Helmholtz Zentrum München Deutsches Forschungszentrum für Gesundheit und Umwelt (GmbH), München, Germany
| | - Martin Mück-Häusl
- Institute of Regenerative Biology and Medicine, Helmholtz Zentrum München Deutsches Forschungszentrum für Gesundheit und Umwelt (GmbH), München, Germany
| | - Peter W Krenn
- Department of Molecular Medicine, Max Planck Institute of Biochemistry, Martinsried, Germany
- Department of Biosciences and Medical Biology, Paris-Lodron University Salzburg, Salzburg, Austria
| | - Hans-Günther Machens
- Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Department of Plastic and Hand Surgery, Munich, Germany
| | - Reinhard Fässler
- Department of Molecular Medicine, Max Planck Institute of Biochemistry, Martinsried, Germany
| | - Philipp-Alexander Neumann
- Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Department of Surgery, Munich, Germany
| | - Stefanie M Hauck
- Metabolomics and Proteomics Core and Research Unit Protein Science, Helmholtz Zentrum München Deutsches Forschungszentrum für Gesundheit und Umwelt (GmbH), München, Germany
| | - Yuval Rinkevich
- Institute of Regenerative Biology and Medicine, Helmholtz Zentrum München Deutsches Forschungszentrum für Gesundheit und Umwelt (GmbH), München, Germany.
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Hong JS, Yoo SJ, Shin HK. A new technique of suturing using adhesive skin closure for uncooperative patients. Int Wound J 2022; 19:1821-1828. [PMID: 35293122 PMCID: PMC9615285 DOI: 10.1111/iwj.13787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/25/2022] [Accepted: 03/05/2022] [Indexed: 11/26/2022] Open
Abstract
Open wounds are usually closed with suture. However, young patients often do not cooperate and prevent proper suture placement. Young patients are often terrified of mild pain and wholly uncooperative, which is why we introduce this timesaving, less painful, more aesthetic technique of placing and removing stitches. 104 patients with facial lacerations aged 5 to 15 years were treated at a single center from May 2019 to March 2021. Patients were randomly assigned equally to a simple interrupted suture group (the SI group) or a continuous locking with Steri‐Strip group (the CS group). Suture times, times for stitch removal, pain scores at stitch removal and mature scar scores were evaluated. Suture and stitch removal times were significantly shorter, and pain scores at stitch removal and observer scar assessment scale scores were lower in the CS group. Patient scar assessment scale score was non‐significantly lower in the SI group. This study shows that the novel continuous locking with the Steri‐Strip technique is easier and quicker to perform, causes less pain when removing stitches, provides better aesthetic results than the simple interrupted suture technique and suggests the continuous locking with Steri‐Strip technique would be very useful for uncooperative young patients.
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Affiliation(s)
- Joon-Shik Hong
- Department of Plastic and Reconstructive Surgery, College of Medicine, Dongguk University, Gyeongju, Republic of Korea
| | - Seok-Ju Yoo
- Department of Preventive Medicine, College of Medicine, Dongguk University, Gyeongju, Republic of Korea
| | - Hea-Kyeong Shin
- Department of Plastic and Reconstructive Surgery, College of Medicine, Dongguk University, Gyeongju, Republic of Korea
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Song Y, Jo Y, Sohn J, Kim R. A Pilot Study to Explore a Correlation between Inflammatory Markers and the Wound Healing Rate in Diabetic Patients. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58030390. [PMID: 35334566 PMCID: PMC8951608 DOI: 10.3390/medicina58030390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 02/28/2022] [Accepted: 03/03/2022] [Indexed: 01/08/2023]
Abstract
Background and objectives: We examined whether there is a significant correlation between inflammatory markers and the wound healing rate (WHR) in diabetic patients. Materials and Methods: A total of 60 patients were divided into two groups depending on the completion of wound healing (WH) at 5 weeks: the early WH group (period of WH < 5 weeks; n = 27) and the late WH group (period of WH > 5 weeks; n = 33). The baseline characteristics and wound measurements were compared between the two groups. To identify the correlation between inflammatory markers (e.g., white blood cell counts (WBCs), serum C-reactive protein (CRP) levels and erythrocyte sedimentation rate (ESR)) and WHR, we performed a Pearson correlation analysis. Results: The WHR was 8.06 ± 4.02 mm2/day in the early WH group and 2.71 ± 0.88 mm2/day in the late group. This difference reached statistical significance (p < 0.001). Moreover, WBC counts were significantly higher and serum levels of CRP and ESR were significantly lower in the early WH group than in the late group (p = 0.027, 0.036 and 0.043, respectively). Conclusions: Our results indicate that WBC as well as serum CRP and ESR levels have a significant correlation with WHR in diabetic patients.
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Affiliation(s)
- Yukwan Song
- Department of Plastic and Reconstructive Surgery, Soonsoo Hospital, Hwaseong-si 18617, Gyeonggi, Korea
- Correspondence: (Y.S.); (J.S.); Tel.: +82-31-319-0119 (Y.S.); +82-64-740-5476 (J.S.); Fax: +82-31-8059-1181 (Y.S.)
| | - Yongkyu Jo
- Department of Anesthesiology and Pain Medicine, Cheju Halla General Hospital, Jeju 63127, Korea;
| | - Jeongeun Sohn
- Department of Anesthesiology and Pain Medicine, Cheju Halla General Hospital, Jeju 63127, Korea;
- Correspondence: (Y.S.); (J.S.); Tel.: +82-31-319-0119 (Y.S.); +82-64-740-5476 (J.S.); Fax: +82-31-8059-1181 (Y.S.)
| | - Robert Kim
- Department of Medical and Pharmaceutical Affairs, Doctor CONSULT, Seoul 06296, Korea;
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Lauwers P, Dirinck E, Van Bouwel S, Verrijken A, Van Dessel K, Van Gils C, Sels M, Peiffer F, Van Schil P, De Block C, Hendriks J. Malnutrition and its relation with diabetic foot ulcer severity and outcome: a review. Acta Clin Belg 2022; 77:79-85. [PMID: 32727304 DOI: 10.1080/17843286.2020.1800315] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Malnutrition has a detrimental effect on wound healing; hence, it might influence the outcome in people with a diabetic foot ulcer (DFU).The aim of this manuscript is to overview studies that describe the prevalence of malnutrition in DFU patients and assess the relation between malnutrition, DFU severity, and outcome. METHODS A literature review was performed. Malnutrition had to be defined by anthropometry and/or validated screening and assessment tools. RESULTS Five papers were included: one RCT, three prospective cohort studies and one retrospective observational study. A substantial number of patients were at risk for malnutrition (49%-70%) or were malnourished (15%-62%). In one study, nutritional status was related to DFU severity. Three authors demonstrated a negative influence of malnutrition on outcome. Two studies examined the prevalence of malnutrition after six months, but did not detect a decline in malnutrition rates. CONCLUSIONS Despite a large heterogeneity, all papers indicated that malnutrition is highly prevalent among DFU patients. Notwithstanding the lack of unequivocal evidence, malnutrition might have a negative influence on DFU outcome. Therefore, clinicians should pay attention to the nutritional status of people with a DFU.Abbreviations: BMI: Body Mass Index; DFU: Diabetic Foot Ulcer; DM: Diabetes Mellitus; GNRI: Geriatric Nutritional Risk Index; HbA1c: Glycated Hemoglobin; IWGDF: International Working Group on the Diabetic Foot; LEA: Lower Extremity Amputation; MNA: Mini Nutritional Assessment; MNA-SF: Mini Nutritional Assessment-Short Form; MUST: Malnutrition Universal Screening Tool; NRS-2002: Nutritional Risk Screening-2002; PAD: Peripheral Arterial Disease; RCT: randomized controlled trial; SGA: Subjective Global Assessment.
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Affiliation(s)
- Patrick Lauwers
- Department of Thoracic and Vascular Surgery, Antwerp University Hospital (UZA), Edegem, Belgium
| | - Eveline Dirinck
- Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital (UZA), Edegem, Belgium
- Laboratory of Experimental Medicine and Pediatrics (LEMP), Division of Endocrinology, University of Antwerp, Antwerp, Belgium
| | - Saskia Van Bouwel
- Department of Orthopedic Surgery, Antwerp University Hospital (UZA), Edegem, Belgium
| | - An Verrijken
- Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital (UZA), Edegem, Belgium
- Laboratory of Experimental Medicine and Pediatrics (LEMP), Division of Endocrinology, University of Antwerp, Antwerp, Belgium
| | - Kristof Van Dessel
- Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital (UZA), Edegem, Belgium
- Laboratory of Experimental Medicine and Pediatrics (LEMP), Division of Endocrinology, University of Antwerp, Antwerp, Belgium
| | - Carolien Van Gils
- Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital (UZA), Edegem, Belgium
| | - Michaël Sels
- Department of Clinical Nutrition and Dietetics, Antwerp University Hospital (UZA), Edegem, Belgium
| | - Frida Peiffer
- Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital (UZA), Edegem, Belgium
| | - Paul Van Schil
- Department of Thoracic and Vascular Surgery, Antwerp University Hospital (UZA), Edegem, Belgium
- Antwerp Surgical Training, Anatomy and Research Centre (ASTARC), University of Antwerp, Antwerp, Belgium
| | - Christophe De Block
- Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital (UZA), Edegem, Belgium
- Laboratory of Experimental Medicine and Pediatrics (LEMP), Division of Endocrinology, University of Antwerp, Antwerp, Belgium
| | - Jeroen Hendriks
- Department of Thoracic and Vascular Surgery, Antwerp University Hospital (UZA), Edegem, Belgium
- Antwerp Surgical Training, Anatomy and Research Centre (ASTARC), University of Antwerp, Antwerp, Belgium
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Grigoryan AY, Terekhov AG. [Modern concept about trophic venous ulcers]. Khirurgiia (Mosk) 2022:73-80. [PMID: 35080830 DOI: 10.17116/hirurgia202201173] [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: 11/17/2022]
Abstract
Venous trophic ulcer is a common complication of chronic venous diseases that have a negative impact on the quality of life and result negative socio-economic consequences. There are three main theories of development of venous trophic ulcers. The criterion is visible trophic changes of skin (CEAP class C4). If correction of etiological factor of ulcer is impossible, local management is preferred. There are various wound coverings which can be used for the treatment of trophic ulcers. However, data on their effectiveness are sometimes unavailable. Therefore, it is necessary to systematize knowledge about modern measures and methods of exposure to trophic ulcers. The authors also discuss current understanding of pathophysiology, symptoms and diagnosis of venous trophic ulcers.
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