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Pan Y, Yang D, Zhou M, Liu Y, Pan J, Wu Y, Huang L, Li H. Advance in topical biomaterials and mechanisms for the intervention of pressure injury. iScience 2023; 26:106956. [PMID: 37378311 PMCID: PMC10291478 DOI: 10.1016/j.isci.2023.106956] [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] [Indexed: 06/29/2023] Open
Abstract
Pressure injuries (PIs) are localized tissue damage resulting from prolonged compression or shear forces on the skin or underlying tissue, or both. Different stages of PIs share common features include intense oxidative stress, abnormal inflammatory response, cell death, and subdued tissue remodeling. Despite various clinical interventions, stage 1 or stage 2 PIs are hard to monitor for the changes of skin or identify from other disease, whereas stage 3 or stage 4 PIs are challenging to heal, painful, expensive to manage, and have a negative impact on quality of life. Here, we review the underlying pathogenesis and the current advances of biochemicals in PIs. We first discuss the crucial events involved in the pathogenesis of PIs and key biochemical pathways lead to wound delay. Then, we examine the recent progress of biomaterials-assisted wound prevention and healing and their prospects.
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Affiliation(s)
- Yingying Pan
- School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang 325035, China
| | - Dejun Yang
- Engineering Research Center of Clinical Functional Materials and Diagnosis & Treatment Devices of Zhejiang Province, Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou, Zhejiang 325011, China
| | - Min Zhou
- School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang 325035, China
| | - Yong Liu
- Engineering Research Center of Clinical Functional Materials and Diagnosis & Treatment Devices of Zhejiang Province, Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou, Zhejiang 325011, China
- Joint Research Centre on Medicine, The Affiliated Xiangshan Hospital of Wenzhou Medical University, Ningbo, Zhejiang 315700, China
| | - Jiandan Pan
- The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325035, China
| | - Yunlong Wu
- Engineering Research Center of Clinical Functional Materials and Diagnosis & Treatment Devices of Zhejiang Province, Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou, Zhejiang 325011, China
- School of Pharmaceutical Sciences, Xiamen University, Xiamen, Fujian 361102, China
| | - Lijiang Huang
- Joint Research Centre on Medicine, The Affiliated Xiangshan Hospital of Wenzhou Medical University, Ningbo, Zhejiang 315700, China
| | - Huaqiong Li
- Joint Research Centre on Medicine, The Affiliated Xiangshan Hospital of Wenzhou Medical University, Ningbo, Zhejiang 315700, China
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Russell D, Atkin L, Betts A, Dowsett C, Fatoye F, Gardner S, Green J, Manu C, McKenzie T, Meally H, Mitchell L, Mullings J, Odeyemi I, Sharpe A, Yeowell G, Devlin N. Using a modified Delphi methodology to gain consensus on the use of dressings in chronic wounds management. J Wound Care 2019; 27:156-165. [PMID: 29509111 DOI: 10.12968/jowc.2018.27.3.156] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Managing chronic wounds is associated with a burden to patients, caregivers, health services and society and there is a lack of clarity regarding the role of dressings in improving outcomes. This study aimed to provide understanding on a range of topics, including: the definition of chronicity in wounds, the burden of illness, clinical outcomes of reducing healing time and the impact of early interventions on clinical and economic outcomes and the role of matrix metalloproteinases (MMPs) in wound healing. METHOD A systematic review of the literature was carried out on the role of dressings in diabetic foot ulcer (DFU), and venous leg ulcer (VLU) management strategies, their effectiveness, associated resource use/cost, and quality of life (QoL) impact on patients. From this evidence-base statements were written regarding chronicity in wounds, burden of illness, healing time, and the role of MMPs, early interventions and dressings. A modified Delphi methodology involving two iterations of email questionnaires followed by a face-to-face meeting was used to validate the statements, in order to arrive at a consensus for each. Clinical experts were selected, representing nurses, surgeons, podiatrists, academics, and policy experts. RESULTS In the first round, 38/47 statements reached or exceeded the consensus threshold of 80% and none were rejected. According to the protocol, any statement not confirmed or rejected had to be modified using the comments from participants and resubmitted. In the second round, 5/9 remaining statements were confirmed and none rejected, leaving 4 to discuss at the meeting. All final statements were confirmed with at least 80% consensus. CONCLUSION This modified Delphi panel sought to gain clarity from clinical experts surrounding the use of dressings in the management of chronic wounds. A full consensus statement was developed to help clinicians and policy makers improve the management of patients with these conditions.
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Affiliation(s)
- David Russell
- Consultant Vascular Surgeon and Honorary Clinical Associate Professor, Leeds Teaching Hospitals NHS Trust
| | - Leanne Atkin
- Vascular Nurse Specialist, Mid Yorkshire Hospitals NHS Trust
| | - April Betts
- Health Technology Assessment Project Manager, Manchester Metropolitan University
| | - Caroline Dowsett
- Nurse Consultant Tissue Viability, East London NHS Foundation Trust, London
| | - Francis Fatoye
- Professor of Health Economics and Outcomes, Manchester Metropolitan University
| | - Sarah Gardner
- Clinical Lead, Tissue Viability, Oxford Health NHS Foundation Trust
| | - Julie Green
- Senior Lecturer in Nursing, Director of Postgraduate Programmes, Keele University, School of Nursing and Midwifery
| | - Chris Manu
- Consultant Diabetologist and Clinical Researcher in Diabetic Foot, King's College Hospital, London
| | - Tracey McKenzie
- Head of Tissue Viability Services, Torbay and Southern Devon NHS Foundation Trust
| | - Helena Meally
- Hospital Podiatrist, Leeds Teaching Hospitals NHS Trust
| | | | - Julie Mullings
- Lead Tissue Viability Nurse, University Hospital of South Manchester, NHS Foundation Trust
| | - Isaac Odeyemi
- Visiting Professor of Health Technology Assessment and Health Policy, Manchester Metropolitan University
| | - Andrew Sharpe
- Advanced Podiatrist and Lecturer Practitioner, West Lancashire Community Service, Virgin Care and University of Huddersfield
| | - Gillian Yeowell
- MSc Advanced Physiotherapy Programme Leader, Manchester Metropolitan University
| | - Nancy Devlin
- Director of Research, Professor, Office of Health Economics, Victoria Street, London
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Radulescu M, Andronescu E, Dolete G, Popescu RC, Fufă O, Chifiriuc MC, Mogoantă L, Bălşeanu TA, Mogoşanu GD, Grumezescu AM, Holban AM. Silver Nanocoatings for Reducing the Exogenous Microbial Colonization of Wound Dressings. MATERIALS 2016; 9:ma9050345. [PMID: 28773468 PMCID: PMC5503056 DOI: 10.3390/ma9050345] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 04/05/2016] [Accepted: 05/04/2016] [Indexed: 01/08/2023]
Abstract
The aim of this work was to obtain an antimicrobial coating (NanoAg) for polyester-nylon wound dressings (WDs) for reducing the risk of exogenous wound related infections. The as-prepared NanoAg-WDs were characterized by XRD (X-ray Diffraction), SEM (Scanning Electron Microscopy), TEM (Transmission Electron Microscopy), SAED (Selected Area Electron Diffraction) and IRM (InfraRed Microscopy). Biological characterization consisted of in vitro evaluation of the interaction with fibroblast cell cultures and in vivo biodistribution studies of AgNPs on mice models. Then, specimens of commercial WDs were immersed in a glucose and NaOH solution of silver nanoparticles, followed by the subsequent dropwise addition of AgNO₃ solution. The antimicrobial efficiency of the NanoAg-WDs was assessed by in vitro qualitative and quantitative analyses on Staphylococcus aureus and Pseudomonas aeruginosa strains. The in vitro and in vivo studies demonstrated that the tested nanoparticles utilized to coat WDs have a good biocompatibility, allowing the normal development of cultured human cells and revealing a normal biodistribution within a mouse model, without toxic effects. The modified and viable cells count analyses proved that the modified WDs exhibit an improved inhibitory activity of microbial colonization, attachment and biofilm growth. The reported data recommend this type of coatings to obtain modified WDs with antibacterial properties, able to prevent the exogenous microbial contamination of the wound tissue, colonization and further biofilm development.
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Affiliation(s)
- Marius Radulescu
- Department of Inorganic Chemistry, Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest, 1-7 Polizu Street, Bucharest 011061, Romania.
| | - Ecaterina Andronescu
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest, 1-7 Polizu Street, Bucharest 011061, Romania.
| | - Georgiana Dolete
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest, 1-7 Polizu Street, Bucharest 011061, Romania.
| | - Roxana Cristina Popescu
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest, 1-7 Polizu Street, Bucharest 011061, Romania.
- Department of Life and Environmental Physics, "Horia Hulubei" National Institute of Physics and Nuclear Engineering, Magurele 077125, Romania.
| | - Oana Fufă
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest, 1-7 Polizu Street, Bucharest 011061, Romania.
- Lasers Department, National Institute for Laser, Plasma and Radiation Physics, Magurele 077125, Romania.
| | - Mariana Carmen Chifiriuc
- Microbiology Immunology Department, Faculty of Biology, Research Institute of the University of Bucharest (ICUB), University of Bucharest, 1-3 Portocalelor Lane, Sector 5, Bucharest 77206, Romania.
| | - Laurenţiu Mogoantă
- Research Center for Microscopic Morphology and Immunology, University of Medicine and Pharmacy of Craiova 2 Petru Rareş Street, Craiova 200349, Romania.
| | - Tudor-Adrian Bălşeanu
- Research Center for Clinical and Experimental Medicine, University of Medicine and Pharmacy of Craiova 2 Petru Rareş Street, Craiova 200349, Romania.
| | - George Dan Mogoşanu
- Department of Pharmacognosy & Phytotherapy, Faculty of Pharmacy, University of Medicine and Pharmacy of Craiova 2 Petru Rareş Street, Craiova 200349, Romania.
| | - Alexandru Mihai Grumezescu
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest, 1-7 Polizu Street, Bucharest 011061, Romania.
| | - Alina Maria Holban
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest, 1-7 Polizu Street, Bucharest 011061, Romania.
- Microbiology Immunology Department, Faculty of Biology, Research Institute of the University of Bucharest (ICUB), University of Bucharest, 1-3 Portocalelor Lane, Sector 5, Bucharest 77206, Romania.
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