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Zhou Y, Liu G, Huang H, Wu J. Advances and impact of arginine-based materials in wound healing. J Mater Chem B 2021; 9:6738-6750. [PMID: 34346479 DOI: 10.1039/d1tb00958c] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
In studies on wound-dressing materials, bioactive materials have been developed rapidly to accelerate wound healing. In recent years, scientists have studied arginine as a bioactive component due to its excellent biosafety, antimicrobial properties and therapeutic effects on wound healing. Surprisingly, arginine therapy is also used under specific pathological conditions, such as diabetes and trauma/hemorrhagic shock. Due to the broad utilization of arginine-assisted therapy, we present the unique properties of arginine for healing lesions of damaged tissue and examined multiple arginine-based systems for the application of wound healing. This review shows that arginine-based therapy can be separated in two categories: direct supplemental approaches of free arginine, and indirect approaches based on arginine derivatives in which modified arginine can be released after biodegradation. Using these two pathways, arginine-based therapy may prove to be a promising strategy in the development of wound curative treatments.
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Affiliation(s)
- Yang Zhou
- The State Key Laboratory of Polymer Materials Engineering, Polymer Research Institute of Sichuan University, Chengdu 610065, China
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Cheshmeh S, Hojati N, Mohammadi A, Rahmani N, Moradi S, Pasdar Y, Elahi N. The use of oral and enteral tube-fed arginine supplementation in pressure injury care: A systematic review and meta-analysis. Nurs Open 2021; 9:2552-2561. [PMID: 34170617 PMCID: PMC9584468 DOI: 10.1002/nop2.974] [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: 02/16/2021] [Revised: 05/01/2021] [Accepted: 06/02/2021] [Indexed: 02/02/2023] Open
Abstract
AIM Pressure injuries (PIs) are one of the most common complications related to immobility, especially in hospitalized patients, which lead to increased morbidity, infection and overall decreased quality of life. Arginine supplementation may prevent the development of PIs. This study has summarized the findings of studies on the effect of arginine supplementation on PI healing. DESIGN Systematic review and meta-analysis. METHODS This study was conducted on online electronic databases including PubMed, Scopus, Web of Science, Google Scholar and Embase to identify relevant clinical trial studies up to September 2020. The pooled effect size of arginine supplement effects on PI was evaluated with standard mean difference (SMD) with 95% confidence interval (CI). RESULTS Eight studies met the inclusion criteria for this meta-analysis with 196 patients. PIs were significantly improved with Arginine supplementation (SMD: -0.6; CI 95%: -0.9 to -0.3, I2 : 72.5%, p = .001). Subgroup analysis showed that administering Arginine supplement more than 15 g/day had more beneficial effects on the healing of PIs (SMD: -2.8; CI 95%: -4.08 to -1.52, I2 : 54.7%, p = .138). CONCLUSIONS Our findings suggest that the administration of Arginine supplement in patients with PIs can accelerate the healing of this type of ulcer. Arginine is a supplement, and primary treatment is still needed to optimize PI healing. Therefore, arginine supplementation in addition to primary treatment seems to be an appropriate approach for the healing of PIs. Further well-designed studies are necessary to prevent the development of PIs compared to their primary treatment.
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Affiliation(s)
- Sahar Cheshmeh
- School of Nutritional Sciences and Food TechnologyKermanshah University of Medical SciencesKermanshahIran
| | - Niloofar Hojati
- School of Nutritional Sciences and Food TechnologyKermanshah University of Medical SciencesKermanshahIran
| | - Arman Mohammadi
- Department of PediatricSchool of Nursing and MidwiferyShahid Beheshti University of Medical SciencesTehranIran
| | - Negin Rahmani
- Julius Maximillian University of WuerzburgWuerzburgGermany
| | - Shima Moradi
- Department of Nutritional SciencesResearch Center for Environmental Determinants of Health (RCEDH)Health InstituteKermanshah University of Medical SciencesKermanshahIran
| | - Yahya Pasdar
- Department of Nutritional SciencesResearch Center for Environmental Determinants of Health (RCEDH)Health InstituteKermanshah University of Medical SciencesKermanshahIran
| | - Negin Elahi
- School of Nutritional Sciences and Food TechnologyKermanshah University of Medical SciencesKermanshahIran
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Figueroa-Gutiérrez L, Martínez-Cano J, Giraldo-Ossa B, López-González LA, Echeverry-Rendón S, Rodríguez-Suárez E, Galvis-Acevedo S, Flórez-López JA. Terapia de presión negativa en pediatría. REVISTA COLOMBIANA DE CIRUGÍA 2020. [DOI: 10.30944/20117582.483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introducción. La terapia de presión negativa es un recurso utilizado cada vez con mayor frecuencia en el manejo de heridas complejas en pediatría. El objetivo de este estudio fue describir la experiencia con esta terapia en diferentes situaciones clínicas.
Métodos. Se llevó a cabo un estudio descriptivo retrospectivo en un grupo de pacientes pediátricos en quienes se utilizó la terapia de presión negativa entre el año 2010 y el 2015. Se analizaron las variables sociodemográficas, los diagnósticos que indicaron la terapia, el tiempo de uso, sus complicaciones y la mortalidad.
Resultados. Se incluyeron 41 pacientes. La terapia se indicó en 39 casos con heridas localizadas en el abdomen, en uno con infección de los tejidos blandos perianales y en otro con una herida de esternotomía infectada. De las heridas abdominales, 14 fueron por complicaciones relacionadas con apendicitis aguda, 6 por enfermedades relacionadas con megacolon, 5 por obstrucción intestinal, 4 para el manejo de fístulas, 4 por enterocolitis necrosante del recién nacido, 3 por pancreatitis aguda y 3 por otras causas. El tiempo promedio de uso de la terapia fue de 7 días. Se presentaron fallas en el sistema de vacío en dos pacientes, pero no hubo complicaciones por el uso de la terapia. Dos pacientes fallecieron por complicaciones relacionadas con su enfermedad de base.
Conclusión. La terapia de presión negativa es un recurso efectivo en el manejo de heridas complejas en la población pediátrica.
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Palmieri B, Vadalà M, Laurino C. Nutrition in wound healing: investigation of the molecular mechanisms, a narrative review. J Wound Care 2019; 28:683-693. [DOI: 10.12968/jowc.2019.28.10.683] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Nutrition can be outlined in terms of epigenetic signals influencing each of the wound healing steps (haemostasis, inflammatory, proliferative and remodelling phase). Specific nutrients, such as amino acids, minerals, vitamins, natural compounds and herbal extracts, target DNA-regulating transcription factors, cytokines, extracellular matrix proteins and glycosaminoglycan, and are specifically involved in the wound healing process. This review focuses on experimental in vivo and clinical evidence of dietary supplements administration in pressure ulcers. A good nutritional status is, for example, fundamental to the haemostasis phase of skin wounds. In the inflammatory phase, vitamin A enhances cytokine release, bromelain and amino acids prevent prolonged inflammatory events, while vitamin C enhances neutrophil migration and lymphocyte activation. In the proliferative phase, vitamin C and Centella asiatica are required for collagen synthesis. Glucosamine enhances hyaluronic acid production, vitamin A promotes epithelial cell differentiation, zinc is required for DNA and protein synthesis and cell division, and Aloe vera supports granulation tissue generation. Finally, in the remodelling phase, amino acids and proteins play a key role in wound scar stabilisation.
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Affiliation(s)
- Beniamino Palmieri
- Dipartimento Chirurgico, Medico, Odontoiatrico e di Scienze Morfologiche con Interesse Trapiantologico, Oncologico e di Medicina Rigenerativa, Università degli Studi di Modena e Reggio Emilia, Modena, Italy. Second Opinion Medical Network
| | - Maria Vadalà
- Dipartimento Chirurgico, Medico, Odontoiatrico e di Scienze Morfologiche con Interesse Trapiantologico, Oncologico e di Medicina Rigenerativa, Università degli Studi di Modena e Reggio Emilia, Modena, Italy. Second Opinion Medical Network
| | - Carmen Laurino
- Dipartimento Chirurgico, Medico, Odontoiatrico e di Scienze Morfologiche con Interesse Trapiantologico, Oncologico e di Medicina Rigenerativa, Università degli Studi di Modena e Reggio Emilia, Modena, Italy. Second Opinion Medical Network
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Santosa KB, Keller M, Olsen M, Keane AM, Sears ED, Snyder-Warwick AK. Negative-Pressure Wound Therapy in Infants and Children: A Population-Based Study. J Surg Res 2019; 235:560-568. [PMID: 30691843 PMCID: PMC6364568 DOI: 10.1016/j.jss.2018.10.043] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 09/27/2018] [Accepted: 10/25/2018] [Indexed: 01/18/2023]
Abstract
BACKGROUND Although the safety and benefits of negative-pressure wound therapy (NPWT) have been clearly demonstrated in the adult population, studies evaluating the safety and describing the use of NPWT in the pediatric population have been limited. Given this paucity, the goals of this study were to (1) evaluate the literature dedicated to NPWT use in infants and children and (2) leverage a population-level analysis to describe the experience of NPWT use in the pediatric population. MATERIALS AND METHODS We performed a literature review and analyzed the Truven Health Analytics MarketScan Commercial Claims Databases from 2006 to 2014 to identify infants and children treated with NPWT. We evaluated patient characteristics, indications, complications before and after NPWT placement, and health care utilization within 30 d of NPWT placement. RESULTS We identified 457 articles, 11 of which fit our inclusion criteria. Most studies (65.2%) were case reports or series with less than 10 patients. In addition, we identified 3184 patients aged younger than of 18 y who were treated with NPWT between 2006 and 2014. Serious incident complications within 30 d after NPWT placement were rare (bleeding 0.6%, septicemia 0.5%, and sepsis 0.5%). CONCLUSIONS Despite the lack of robust studies, NPWT is widely used for many indications and across different ages and providers. Given the low incidence of serious complications, we conclude that NPWT use in infants and children is safe and can be effectively used by different providers spanning surgical and nonsurgical disciplines.
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Affiliation(s)
- Katherine B. Santosa
- Postdoctoral Research Fellow, Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine, 660 S. Euclid Avenue Campus Box 8238 St. Louis, MO 63110;
| | - Matt Keller
- Senior Statistical Data Analyst, Division of Infectious Diseases, Department of Internal Medicine, Washington University, 660 S. Euclid Avenue Campus Box 8238 St. Louis, MO 63110
| | - Margaret Olsen
- Professor, Division of Infectious Diseases, Department of Internal Medicine, Washington University, 660 S. Euclid Avenue Campus Box 8238 St. Louis, MO 63110
| | - Alexandra M. Keane
- Medical Student, Washington University School of Medicine, 660 S. Euclid Avenue Campus Box 8238 St. Louis, MO 63110
| | - Erika D. Sears
- Assistant Professor, Section of Plastic Surgery, Department of Surgery, University of Michigan, 1500 E. Medical Center Drive Ann Arbor, MI 48109
| | - Alison K. Snyder-Warwick
- Assistant Professor, Division of Plastic Surgery, Department of Surgery, Washington University, 660 S. Euclid Avenue Campus Box 8238 St. Louis, MO 63110 St. Louis, MO
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Esumi G, Matsuura T, Hayashida M, Takahashi Y, Yoshimaru K, Yanagi Y, Wada M, Taguchi T. Efficacy of Prophylactic Negative Pressure Wound Therapy After Pediatric Liver Transplant. EXP CLIN TRANSPLANT 2019; 17:381-386. [PMID: 30696394 DOI: 10.6002/ect.2018.0076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES Wound dehiscence is a common surgical complication, especially among pediatric liver transplant recipients in our center. In 2013, we introduced negative pressure wound therapy as a preventive treatment. We herein report the clinical outcomes of this intervention. MATERIALS AND METHODS We conducted a retrospective review of the 26 pediatric liver transplant recipients in our center since 2011. We excluded 1 girl whose wound could not be closed due to bowel edema. The first 13 of the 25 remaining patients were treated with conventional wound management (conventional group). The latter 12 were treated with prophylactic negative pressure wound therapy (prophylactic group). Incidences of surgical complications and patient characteristics were compared between groups. RESULTS Wound dehiscence occurred in 7 of the 13 patients in the conventional group and 3 of the 12 patients in the prophylactic group. When restricted to dehiscence that required surgical debridement, there were 6 cases in the conventional group and no cases in the prophylactic group. Although background data showed that liver insufficiency in the prophylactic group was more severe, this group had a lower incidence of wound dehiscence (P = .015). CONCLUSIONS Prophylactic negative pressure wound therapy is thought to be effective for preventing wound dehiscence among pediatric liver transplant recipients.
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Affiliation(s)
- Genshiro Esumi
- From the Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Abstract
OBJECT The aim of this paper is to review the current knowledge on the management of local infections in posterior cranial fossa (PCF) and spinal surgery; the center of our paper will be the diagnosis and management of infections of the wound, the subcutaneous tissue, and muscle strata. RESULTS AND CONCLUSIONS Very few papers address the problem of local infections in posterior cranial fossa and spinal surgery. The largest amount of the literature data is indeed centered on how to deal with deep infections, CSF leak, and secondary meningitis or hardware infection. Concerning PCF surgery, a higher rate of local infections has been reported, compared with supratentorial surgery. To prevent such complications, prophylaxis remains the most important tool in dealing with local infections; a careful surgical planning and patient selection are also important. On the other hand, in dealing with local infection in spinal setting, there are several evidences that local vancomycin might help reducing them in adults as well as in children. The treatment protocol consists in antibiotic therapy and, whenever needed, wound revision to remove infectious material or to obtain a microbiological diagnosis. Prognosis has overall to be considered favorable both in the short term as well as in the long term.
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Visser R, Milbrandt K, Lum Min S, Wiseman N, Hancock BJ, Morris M, Keijzer R. Applying vacuum to accomplish reduced wound infections in laparoscopic pediatric surgery. J Pediatr Surg 2017; 52:849-852. [PMID: 28245914 DOI: 10.1016/j.jpedsurg.2017.01.035] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Accepted: 01/23/2017] [Indexed: 10/20/2022]
Abstract
INTRODUCTION The prevention of surgical site infections has received little attention in pediatric surgery. Negative pressure wound therapy is used to treat complex wounds. We hypothesized that this principle could reduce wound infection rates following laparoscopic surgery. We tested this in a randomized controlled trial. MATERIALS AND METHODS We randomized pediatric patients with an umbilical port site to a standard dressing or a vacuum dressing. The dressings were removed 48h after surgery. A nurse blinded for the treatment inspected the umbilical wound between post-operative days 7-10 for infection. Data comparison was performed using a Fisher exact test with p<0.05 defined as significant. RESULTS We recruited 90 patients over 2 years and randomized 44 to the vacuum dressing arm and 42 to the control arm. We observed a 2.8% (n=1/35) infection rate in the vacuum dressing group and 3.3% (n=1/30) in the control group (p=1.0). DISCUSSION We ended our study early when an interim analysis showed an impractical number of patients would be required to achieve sufficient power. We did not find a significant difference between the control and vacuum dressings in reducing post-operative wound infections. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- Robin Visser
- Department of General Surgery, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kris Milbrandt
- Department of Surgery, Division of Pediatric Surgery, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Pediatrics & Child Health and Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Suyin Lum Min
- Department of Surgery, Division of Pediatric Surgery, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Pediatrics & Child Health and Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Nathan Wiseman
- Department of Surgery, Division of Pediatric Surgery, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Pediatrics & Child Health and Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Betty-Jean Hancock
- Department of Surgery, Division of Pediatric Surgery, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Pediatrics & Child Health and Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Melanie Morris
- Department of Surgery, Division of Pediatric Surgery, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Pediatrics & Child Health and Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Richard Keijzer
- Department of Surgery, Division of Pediatric Surgery, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Pediatrics & Child Health and Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada.
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Panayi AC, Leavitt T, Orgill DP. Evidence based review of negative pressure wound therapy. World J Dermatol 2017; 6:1-16. [DOI: 10.5314/wjd.v6.i1.1] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 10/15/2016] [Accepted: 01/14/2017] [Indexed: 02/06/2023] Open
Abstract
Vacuum-assisted closure, sometimes referred to as microdeformational wound therapy or most commonly negative pressure wound therapy (NPWT), has significantly improved wound care over the past two decades. NPWT is known to affect wound healing through four primary mechanisms (macrodeformation, microdeformation, fluid removal, and alteration of the wound environment) and various secondary mechanisms (including neurogenesis, angiogenesis, modulation of inflammation, and alterations in bioburden) which are described in this review. In addition, the technique has many established uses, for example in wound healing of diabetic and pressure ulcers, as well as burn and blast wounds. This therapy also has many uses whose efficacy has yet to be confirmed, for example the use in digestive surgery. Modifications of the traditional NPWT have also been established and are described in detail. This therapy has various considerations and contraindications which are summarized in this review. Finally, future perspectives, such as the optimal cycling of the treatment and the most appropriate interface material, are touched upon in the final segment. Overall, despite the fact that questions remain to be answered about NPWT, this technology is a major breakthrough in wound healing with significant potential use both in the hospital but also in the community.
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Huang C, Leavitt T, Bayer LR, Orgill DP. Effect of negative pressure wound therapy on wound healing. Curr Probl Surg 2014; 51:301-31. [PMID: 24935079 DOI: 10.1067/j.cpsurg.2014.04.001] [Citation(s) in RCA: 262] [Impact Index Per Article: 26.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Accepted: 04/15/2014] [Indexed: 12/13/2022]
Abstract
The efficacy of NPWT in promoting wound healing has been largely accepted by clinicians, yet the number of high-level clinical studies demonstrating its effectiveness is small and much more can be learned about the mechanisms of action. In the future, hopefully we will have the data to assist clinicians in selecting optimal parameters for specific wounds including interface material, waveform of suction application, and the amount of suction to be applied. Further investigation into specific interface coatings and instillation therapy are also needed. We believe that advances in mechanobiology, the science of wound healing, the understanding of biofilms, and advances in cell therapy will lead to better care for our patients.
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Obuchi T, Imakiire T, Yoneda S, Iwasaki A. Efficacy of arginine supplementation for the treatment of air leakage. Asian Cardiovasc Thorac Ann 2014; 22:172-5. [PMID: 24585788 DOI: 10.1177/0218492313484025] [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: 11/16/2022]
Abstract
BACKGROUND Recently, the role of the amino acid arginine in wound healing has been emphasized. We studied whether postoperative enteral arginine supplementation can contribute to the resolution of prolonged air leakage after lung resections. METHODS 42 patients undergoing lung resection at our institutions from 2009 to 2012 were enrolled in this study. In these patients, continuous air leakage in the expiratory phase was identified on the day of surgery and on the following day. The patients were divided into 2 groups; the first group included 21 patients consuming 3 packs of an arginine supplement beverage daily postoperatively, and the second group (control) included 21 patients who did not consume any additional supplements. The durations of air leakage and chest tube drainage were compared between the two groups. RESULTS The mean durations of air leakage and chest tube drainage were shorter in the arginine supplementation group (4.4 vs. 6.7 days, p = 0.010; 6.5 vs. 8.3 days, p = 0.042, respectively). CONCLUSION Postoperative enteral arginine supplementation may contribute to stopping air leaks after lung surgery.
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Affiliation(s)
- Toshiro Obuchi
- Department of Thoracic Surgery, St. Mary's Hospital, Kurume, Japan
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Kuck M, Strese H, Alawi SA, Meinke MC, Fluhr JW, Burbach GJ, Krah M, Sterry W, Lademann J. Evaluation of optical coherence tomography as a non-invasive diagnostic tool in cutaneous wound healing. Skin Res Technol 2013; 20:1-7. [PMID: 23782399 DOI: 10.1111/srt.12077] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND The monitoring of wound-healing processes is indispensable for the therapeutic effectiveness and improved care of chronic wounds. Histological sections provide the best morphological assessment of wound recovery, but cause further tissue destruction and increase the risk of infection. Therefore, it is reasonable to apply a diagnostic tool that allows a non-invasive and reliable observation of morphological changes in wound healing. METHODS Optical coherence tomography (OCT) is an imaging technique for in vivo evaluation of skin diseases with a resolution close to histopathology. The aim of this study was to investigate whether OCT is suited to display the phases of wound healing. For this purpose, six patients with chronic wounds were objectively characterized by OCT during a period of 2 weeks. RESULTS Comparable results between histological findings and OCT were achieved. OCT allowed the detection of partial loss of the epidermis, vasoconstriction, vasodilatation and epithelialization. CONCLUSION Consequently, OCT could be a potential non-invasive diagnostic tool for the characterization and monitoring of cutaneous wound-healing processes over time.
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Affiliation(s)
- Monika Kuck
- Department of Dermatology, Venerology and Allergology, Center of Experimental and Applied Cutaneous Physiology (CCP), Charité - Universitätsmedizin Berlin, Berlin, Germany
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