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Wang F, Zhang X, Zhang J, Xu Q, Yu X, Xu A, Yi C, Bian X, Shao S. Recent advances in the adjunctive management of diabetic foot ulcer: Focus on noninvasive technologies. Med Res Rev 2024; 44:1501-1544. [PMID: 38279968 DOI: 10.1002/med.22020] [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: 08/13/2022] [Revised: 12/15/2023] [Accepted: 01/10/2024] [Indexed: 01/29/2024]
Abstract
Diabetic foot ulcer (DFU) is one of the most costly and serious complications of diabetes. Treatment of DFU is usually challenging and new approaches are required to improve the therapeutic efficiencies. This review aims to update new and upcoming adjunctive therapies with noninvasive characterization for DFU, focusing on bioactive dressings, bioengineered tissues, mesenchymal stem cell (MSC) based therapy, platelet and cytokine-based therapy, topical oxygen therapy, and some repurposed drugs such as hypoglycemic agents, blood pressure medications, phenytoin, vitamins, and magnesium. Although the mentioned therapies may contribute to the improvement of DFU to a certain extent, most of the evidence come from clinical trials with small sample size and inconsistent selections of DFU patients. Further studies with high design quality and adequate sample sizes are necessitated. In addition, no single approach would completely correct the complex pathogenesis of DFU. Reasonable selection and combination of these techniques should be considered.
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Affiliation(s)
- Fen Wang
- Division of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Branch of National Clinical Research Center for Metabolic Diseases, Hubei, China
| | - Xiaoling Zhang
- Division of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Branch of National Clinical Research Center for Metabolic Diseases, Hubei, China
| | - Jing Zhang
- Division of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Branch of National Clinical Research Center for Metabolic Diseases, Hubei, China
| | - Qinqin Xu
- Division of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Branch of National Clinical Research Center for Metabolic Diseases, Hubei, China
| | - Xuefeng Yu
- Division of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Branch of National Clinical Research Center for Metabolic Diseases, Hubei, China
| | - Anhui Xu
- Division of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chengla Yi
- Division of Trauma Surgery, Tongji Hospital, Tongji Medical College, Wuhan, China
| | - Xuna Bian
- Division of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Branch of National Clinical Research Center for Metabolic Diseases, Hubei, China
| | - Shiying Shao
- Division of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Branch of National Clinical Research Center for Metabolic Diseases, Hubei, China
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2
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Kulatunge DR, Jayawardana KH, Abeysekera AM, Wijeyaratne SC, Gunaherath GMKB. In-vitro cell migration enhancing constituents from Decalepis hamiltonii, a plant used in the preparation of 'Pinda oil', a medicinal oil used in Ayurveda for wound management. Nat Prod Res 2024:1-7. [PMID: 38235612 DOI: 10.1080/14786419.2024.2305220] [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: 09/07/2023] [Accepted: 01/05/2024] [Indexed: 01/19/2024]
Abstract
Decalepis hamiltonii, Wight & Arn. (Apocyanaceae) is a one of the raw materials used in the preparation of 'Pinda oil', a medicinal oil which is used for treatment of wounds in Ayurveda. Of the hexanes, dichloromethane, and ethyl acetate extracts derived from the plant raw materials used to prepare 'Pinda oil', the hexanes extract of D. hamiltonii exhibited the highest mean percentage wound closure (75.1 ± 2.9) compared to the negative controls (1% DMSO in DMEM, 4.2 ± 1.2 and 100% DMEM, 4.1 ± 0.9) in the scratch wound assay (SWA). Fractionation of the hexanes extract of stem of D. hamiltonii led to the isolation of 2-hydroxy-4-methoxybenzaldehyde (1) and a mixture of long chain esters of lupeol (2), which showed enhanced cell migration in SWA. It was observed that the esters of lupeol bind to the cell membrane and/or enter the cells during the SWA. It was found that these constituents are also present in 'Pinda oil' which may contribute to the enhancement of wound healing activity of 'Pinda oil'.
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Affiliation(s)
- D R Kulatunge
- Department of Chemistry, The Open University of Sri Lanka, Nugegoda, Sri Lanka
| | | | - Ajita M Abeysekera
- Department of Chemistry, Sri Jayewardenepura University, Nugegoda, Sri Lanka
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Fadilah NIM, Riha SM, Mazlan Z, Wen APY, Hao LQ, Joseph B, Maarof M, Thomas S, Motta A, Fauzi MB. Functionalised-biomatrix for wound healing and cutaneous regeneration: future impactful medical products in clinical translation and precision medicine. Front Bioeng Biotechnol 2023; 11:1160577. [PMID: 37292094 PMCID: PMC10245056 DOI: 10.3389/fbioe.2023.1160577] [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: 02/07/2023] [Accepted: 05/08/2023] [Indexed: 06/10/2023] Open
Abstract
Skin tissue engineering possesses great promise in providing successful wound injury and tissue loss treatments that current methods cannot treat or achieve a satisfactory clinical outcome. A major field direction is exploring bioscaffolds with multifunctional properties to enhance biological performance and expedite complex skin tissue regeneration. Multifunctional bioscaffolds are three-dimensional (3D) constructs manufactured from natural and synthetic biomaterials using cutting-edge tissue fabrication techniques incorporated with cells, growth factors, secretomes, antibacterial compounds, and bioactive molecules. It offers a physical, chemical, and biological environment with a biomimetic framework to direct cells toward higher-order tissue regeneration during wound healing. Multifunctional bioscaffolds are a promising possibility for skin regeneration because of the variety of structures they provide and the capacity to customise the chemistry of their surfaces, which allows for the regulated distribution of bioactive chemicals or cells. Meanwhile, the current gap is through advanced fabrication techniques such as computational designing, electrospinning, and 3D bioprinting to fabricate multifunctional scaffolds with long-term safety. This review stipulates the wound healing processes used by commercially available engineered skin replacements (ESS), highlighting the demand for a multifunctional, and next-generation ESS replacement as the goals and significance study in tissue engineering and regenerative medicine (TERM). This work also scrutinise the use of multifunctional bioscaffolds in wound healing applications, demonstrating successful biological performance in the in vitro and in vivo animal models. Further, we also provided a comprehensive review in requiring new viewpoints and technological innovations for the clinical application of multifunctional bioscaffolds for wound healing that have been found in the literature in the last 5 years.
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Affiliation(s)
- Nur Izzah Md Fadilah
- Centre for Tissue Engineering and Regenerative Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Shaima Maliha Riha
- Centre for Tissue Engineering and Regenerative Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Zawani Mazlan
- Centre for Tissue Engineering and Regenerative Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Adzim Poh Yuen Wen
- Department of Surgery, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Looi Qi Hao
- My Cytohealth Sdn Bhd Kuala Lumpur, Kuala Lumpur, Malaysia
| | - Blessy Joseph
- Business Innovation and Incubation Centre, Mahatma Gandhi University, Kottayam, Kerala, India
| | - Manira Maarof
- Centre for Tissue Engineering and Regenerative Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Sabu Thomas
- International and Inter University Centre for Nanosciences and Nanotechnology, Mahatma Gandhi University, Kottayam, Kerala, India
| | - Antonella Motta
- Department of Industrial Engineering, University of Trento, Trento, Italy
| | - Mh Busra Fauzi
- Centre for Tissue Engineering and Regenerative Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Chen Y, Du P, Lv G. A meta‐analysis examined the effect of oxidised regenerated cellulose/collagen dressing on the management of chronic skin wounds. Int Wound J 2022; 20:1544-1551. [PMID: 36480562 PMCID: PMC10088825 DOI: 10.1111/iwj.14009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 10/21/2022] [Accepted: 10/22/2022] [Indexed: 12/13/2022] Open
Abstract
To assess the impact of oxidised regenerated cellulose/collagen dressing on the management of chronic skin wounds, we conducted a meta-analysis. A thorough review of the literature up to September 2022 revealed that 1521 participants had chronic skin wounds at the start of the investigations; 763 of them used oxidised regenerated cellulose/collagen dressing, while 758 received control. Using dichotomous or contentious methods and a random or fixed-effect model, odds ratios (OR) and mean difference (MD) with 95% confidence intervals (CIs) were estimated to evaluate the impact of oxidised regenerated cellulose/collagen dressing on the management of chronic skin wounds. The oxidised regenerated cellulose/collagen dressing had significantly higher complete wound healing (OR, 1.74; 95% CI, 1.06-2.85; P = .03), higher wound relative reduction percent (MD, 13.50; 95% CI, 2.39-24.61; P = .02), and lower adverse events in wound healing (OR, 0.63; 95% CI, 0.41-0.98; P = .04) compared with control in chronic skin wounds. The oxidised regenerated cellulose/collagen dressing had significantly higher complete wound healing, higher wound relative reduction percent and lower adverse events in wound healing compared with control in chronic skin wounds. The low sample size of 8 out of 10 researches in the meta-analysis and the small number of studies in several comparisons calls for care when analysing the results.
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Affiliation(s)
- Yang Chen
- Nanjing University of Traditional Chinese Medicine Nanjing Jiangsu China
| | - Pan Du
- Department of Wuxi School of Medicine Jiangnan University Wuxi China
| | - Guozhong Lv
- Nanjing University of Traditional Chinese Medicine Nanjing Jiangsu China
- Department of Burn and Plastic Surgery the Affiliated Hospital of Jiangnan University Wuxi China
- Engineering Research Center of the Ministry of Education for Wound repair Technology Jiangnan University Wuxi China
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Iqbal MW, Riaz T, Mahmood S, Bilal M, Manzoor MF, Qamar SA, Qi X. Fucoidan-based nanomaterial and its multifunctional role for pharmaceutical and biomedical applications. Crit Rev Food Sci Nutr 2022; 64:354-380. [PMID: 35930305 DOI: 10.1080/10408398.2022.2106182] [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: 11/03/2022]
Abstract
Fucoidans are promising sulfated polysaccharides isolated from marine sources that have piqued the interest of scientists in recent years due to their widespread use as a bioactive substance. Bioactive coatings and films, unsurprisingly, have seized these substances to create novel, culinary, therapeutic, and diagnostic bioactive nanomaterials. The applications of fucoidan and its composite nanomaterials have a wide variety of food as well as pharmacological properties, including anti-oxidative, anti-inflammatory, anti-cancer, anti-thrombic, anti-coagulant, immunoregulatory, and anti-viral properties. Blends of fucoidan with other biopolymers such as chitosan, alginate, curdlan, starch, etc., have shown promising coating and film-forming capabilities. A blending of biopolymers is a recommended approach to improve their anticipated properties. This review focuses on the fundamental knowledge and current development of fucoidan, fucoidan-based composite material for bioactive coatings and films, and their biological properties. In this article, fucoidan-based edible bioactive coatings and films expressed excellent mechanical strength that can prolong the shelf-life of food products and maintain their biodegradability. Additionally, these coatings and films showed numerous applications in the biomedical field and contribute to the economy. We hope this review can deliver the theoretical basis for the development of fucoidan-based bioactive material and films.
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Affiliation(s)
| | - Tahreem Riaz
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang, China
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu, China
| | - Shahid Mahmood
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang, China
| | - Muhammad Bilal
- School of Life Science and Food Engineering, Huaiyin Institute of Technology, Huaian, China
| | | | - Sarmad Ahmad Qamar
- Institute of Organic and Polymeric Materials, National Taipei University of Technology, Taipei, Taiwan
| | - Xianghui Qi
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang, China
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Issa R, Thompson KL, Price BL. CONTROL OF STAPHYLOCOCCAL-MEDIATED ENDOGENOUS PROTEASE ACTIVITY ALTERS WOUND CLOSURE TIME IN A COMPLEX WOUND MODEL. J Dermatol Sci 2022; 105:105-112. [DOI: 10.1016/j.jdermsci.2022.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 01/13/2022] [Accepted: 01/18/2022] [Indexed: 10/19/2022]
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Hawthorne B, Simmons JK, Stuart B, Tung R, Zamierowski DS, Mellott AJ. Enhancing wound healing dressing development through interdisciplinary collaboration. J Biomed Mater Res B Appl Biomater 2021; 109:1967-1985. [PMID: 34002476 PMCID: PMC8519107 DOI: 10.1002/jbm.b.34861] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 04/03/2021] [Accepted: 04/30/2021] [Indexed: 12/31/2022]
Abstract
The process of wound healing includes four phases: Hemostasis, inflammation, proliferation, and remodeling. Many wound dressings and technologies have been developed to enhance the body's ability to close wounds and restore the function of damaged tissues. Several advancements in wound healing technology have resulted from innovative experiments by individual scientists or physicians working independently. The interplay between the medical and scientific research fields is vital to translating new discoveries in the lab to treatments at the bedside. Tracing the history of wound dressing development reveals that there is an opportunity for deeper collaboration between multiple disciplines to accelerate the advancement of novel wound healing technologies. In this review, we explore the different types of wound dressings and biomaterials used to treat wounds, and we investigate the role of multidisciplinary collaboration in the development of various wound management technologies to illustrate the benefit of direct collaboration between physicians and scientists.
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Affiliation(s)
- Briauna Hawthorne
- Department of Plastic SurgeryUniversity of Kansas Medical CenterKansas CityKansasUSA
| | - J. Kai Simmons
- Department of Plastic SurgeryUniversity of Kansas Medical CenterKansas CityKansasUSA
| | - Braden Stuart
- Department of Plastic SurgeryUniversity of Kansas Medical CenterKansas CityKansasUSA
| | - Robert Tung
- Department of Plastic SurgeryUniversity of Kansas Medical CenterKansas CityKansasUSA
| | - David S. Zamierowski
- Department of Plastic SurgeryUniversity of Kansas Medical CenterKansas CityKansasUSA
| | - Adam J. Mellott
- Department of Plastic SurgeryUniversity of Kansas Medical CenterKansas CityKansasUSA
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Taha O, Saied S, Shoeib M, Abdelaal M, Abozeid M, Talaat M. Staple Line Complications without Reinforcement, with Oversewing and with Buttressing Using Oxidized Regenerated Cellulose in Laparoscopic Sleeve Gastrectomy, Randomized Comparative Study. Bariatr Surg Pract Patient Care 2021. [DOI: 10.1089/bari.2021.0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Osama Taha
- Department of Plastic, Bariatric and Metabolic Surgery, Assiut University, Assiut, Egypt
| | - Samia Saied
- Department of Plastic and Reconstructive Surgery, Sohag University, Sohag, Egypt
| | - Mohamed Shoeib
- Department of Plastic and Reconstructive Surgery, Sohag University, Sohag, Egypt
| | - Mahmoud Abdelaal
- Department of Plastic, Bariatric and Metabolic Surgery, Assiut University, Assiut, Egypt
| | - Mohamed Abozeid
- Department of General, Bariatric and Metabolic Surgery, Ain Shams University, Cairo, Egypt
| | - Mohamed Talaat
- Department of Plastic and Reconstructive Surgery, Sohag University, Sohag, Egypt
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Zhang L, Wang S, Tan M, Zhou H, Tang Y, Zou Y. Efficacy of Oxidized Regenerated Cellulose/Collagen Dressing for Management of Skin Wounds: A Systematic Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2021; 2021:1058671. [PMID: 34394376 PMCID: PMC8357491 DOI: 10.1155/2021/1058671] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 07/22/2021] [Indexed: 01/19/2023]
Abstract
OBJECTIVE The purpose of this study was to evaluate the wound healing efficacy of oxidized regenerated cellulose (ORC)/collagen dressing and ORC/collagen/silver-ORC dressings compared to standard of care or control in treatment of chronic skin wounds such as diabetic foot ulcers (DFUs), venous leg ulcers (VLUs), and pressure injuries sore ulcers (PISUs). METHODS An electronic search was carried out in four popular databases PubMed, Scopus, Embase, and CENTRAL to identify thirteen included studies, comparing the clinical efficacy of ORC/collagen dressings when compared to control in management of chronic skin wounds, especially DFUs, VLUs, and PISUs, and skin graft donor site wounds. RESULTS Consolidated data from thirteen comparative clinical studies undertaken for management of DFUs, VLUs, and PISUs showed favorable outcomes towards use of ORC/collagen compared to other traditional and hydrocolloid foam dressings in terms of wound healing rate (P=0.02) and percentage wound relative reduction (P=0.003). The time taken to achieve complete wound healing in the included studies did not show any statistical significant difference (P=0.24). There was no significant difference in adverse events between ORC/collagen-treated group and comparative group (P=0.19). CONCLUSION ORC/collagen wound dressings are beneficial in terms of improved wound healing rate and percentage wound relative reduction compared to already existing traditional standard of care with non-MMP, inhibiting biomaterials such as moistened gauze, autologous growth factors, hydrocolloid foam dressings, or ovine extracellular matrix.
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Affiliation(s)
- Li Zhang
- Department of Orthopedics and Trauma, The Affifiliated Nanhua Hospital, University of South China, Hengyang, Hunan, China
| | - Simei Wang
- Department of Wound Stoma Care, The Affifiliated Nanhua Hospital, University of South China, Hengyang, Hunan, China
| | - Meihua Tan
- Department of Wound Stoma Care, The Affifiliated Nanhua Hospital, University of South China, Hengyang, Hunan, China
| | - Hongwei Zhou
- Department of Wound Stoma Care, The Affifiliated Nanhua Hospital, University of South China, Hengyang, Hunan, China
| | - Ying Tang
- Department of Wound Stoma Care, The Affifiliated Nanhua Hospital, University of South China, Hengyang, Hunan, China
| | - Yan Zou
- Department of Hand and Foot Surgery, The Affifiliated Nanhua Hospital, University of South China, Hengyang, Hunan, China
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10
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Wound dressings: curbing inflammation in chronic wound healing. Emerg Top Life Sci 2021; 5:523-537. [PMID: 34196717 PMCID: PMC8589427 DOI: 10.1042/etls20200346] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 05/07/2021] [Accepted: 06/10/2021] [Indexed: 12/15/2022]
Abstract
Chronic wounds represent an economic burden to healthcare systems worldwide and a societal burden to patients, deeply impacting their quality of life. The incidence of recalcitrant wounds has been steadily increasing since the population more susceptible, the elderly and diabetic, are rapidly growing. Chronic wounds are characterised by a delayed wound healing process that takes longer to heal under standard of care than acute (i.e. healthy) wounds. Two of the most common problems associated with chronic wounds are inflammation and infection, with the latter usually exacerbating the former. With this in mind, researchers and wound care companies have developed and marketed a wide variety of wound dressings presenting different compositions but all aimed at promoting healing. This makes it harder for physicians to choose the correct therapy, especially given a lack of public quantitative data to support the manufacturers’ claims. This review aims at giving a brief introduction to the clinical need for chronic wound dressings, focusing on inflammation and evaluating how bio-derived and synthetic dressings may control excess inflammation and promote healing.
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11
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Dissemond J, Augustin M, Dietlein M, Faust U, Keuthage W, Lobmann R, Münter KC, Strohal R, Stücker M, Traber J, Vanscheidt W, Läuchli S. Efficacy of MMP-inhibiting wound dressings in the treatment of chronic wounds: a systematic review. J Wound Care 2020; 29:102-118. [PMID: 32058850 DOI: 10.12968/jowc.2020.29.2.102] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Matrix metalloproteinases (MMPs) substantially contribute to the development of chronicity in wounds. Thus, MMP-inhibiting dressings may support healing. A systematic review was performed to determine the existing evidence base for the treatment of hard-to-heal wounds with these dressings. METHODS A systematic literature search in databases and clinical trial registers was conducted to identify randomised controlled trials (RCTs) investigating the efficacy of MMP-inhibiting dressings. Studies were analysed regarding their quality and clinical evidence. RESULTS Of 721 hits, 16 relevant studies were assessed. There were 13 studies performed with collagen and three with technology lipido-colloid nano oligosaccharide factor (TLC-NOSF) dressings. Indications included diabetic foot ulcers, venous leg ulcers, pressure ulcers or wounds of mixed origin. Patient-relevant endpoints comprised wound size reduction, complete wound closure, healing time and rate. Considerable differences in the quality and subsequent clinical evidence exist between the studies identified. Substantial evidence for significant improvement in healing was identified only for some dressings. CONCLUSION Evidence for the superiority of some MMP-inhibiting wound dressings exists regarding wound closure, wound size reduction, healing time and healing rate. More research is required to substantiate the existing evidence for different types of hard-to-heal wounds and to generate evidence for some of the different types of MMP-inhibiting wound dressings.
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Affiliation(s)
- Joachim Dissemond
- Department of Dermatology, Venerology and Allergology, University of Essen, Essen, Germany
| | | | | | - Uta Faust
- MEDAHCON GmbH, HealthCare Communication, Bonn, Germany
| | - Winfried Keuthage
- Specialist Practice for Diabetology and Nutritional Medicine, Münster, Germany
| | - Ralf Lobmann
- Department of Endocrinology, Diabetology and Geriatrics, Stuttgart General Hospital, Bad Cannstatt, Stuttgart, Germany
| | | | - Robert Strohal
- Department of Dermatology and Venerology, State Hospital and Academic Teaching Hospital Feldkirch, Feldkirch, Austria
| | - Markus Stücker
- Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - Jürg Traber
- Department of Surgery, Venenklinik Bellevue, Kreuzlingen, Switzerland
| | | | - Severin Läuchli
- University Hospital Zurich, Department of Dermatology, Zurich, Switzerland
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12
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Robbins ER, Pins GD, Laflamme MA, Gaudette GR. Creation of a contractile biomaterial from a decellularized spinach leaf without ECM protein coating: An in vitro study. J Biomed Mater Res A 2020; 108:2123-2132. [PMID: 32323417 PMCID: PMC7725356 DOI: 10.1002/jbm.a.36971] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 03/24/2020] [Accepted: 03/28/2020] [Indexed: 01/08/2023]
Abstract
Myocardial infarction (MI) results in the death of cardiac tissue, decreases regional contraction, and can lead to heart failure. Tissue engineered cardiac patches containing human induced pluripotent stem cell-derived cardiomyocytes (hiPS-CMs) can restore contractile function. However, cells within thick patches require vasculature for blood flow. Recently, we demonstrated fibronectin coated decellularized leaves provide a suitable scaffold for hiPS-CMs. Yet, the necessity of this additional coating step is unclear. Therefore, we compared hiPS-CM behavior on decellularized leaves coated with collagen IV or fibronectin extracellular matrix (ECM) proteins to noncoated leaves for up to 21 days. Successful coating was verified by immunofluorescence. Similar numbers of hiPS-CMs adhered to coated and noncoated decellularized leaves for 21 days. At Day 14, collagen IV coated leaves contracted more than noncoated leaves (3.25 ± 0.39% vs. 1.54 ± 0.60%; p < .05). However, no differences in contraction were found between coated leaves, coated tissue culture plastic (TCP), noncoated leaves, or noncoated TCP at other time points. No significant differences were observed in hiPS-CM spreading or sarcomere lengths on leaves with or without coating. This study demonstrates that cardiac scaffolds can be created from decellularized leaves without ECM coatings. Noncoated decellularized leaf surfaces facilitate robust cell attachment for an engineered tissue patch.
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Affiliation(s)
- Emily R. Robbins
- Biomedical Engineering, Worcester Polytechnic Institute, Worcester, Massachusetts
| | - George D. Pins
- Biomedical Engineering, Worcester Polytechnic Institute, Worcester, Massachusetts
| | - Michael A. Laflamme
- McEwen Stem Cell Institute, University Health Network, Toronto, Ontario, Canada
| | - Glenn R. Gaudette
- Biomedical Engineering, Worcester Polytechnic Institute, Worcester, Massachusetts
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13
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Loh ML, Goh BKL, Kong Y, Varughese G, Ng JL, Lo ZJ, Pek CH. Combination therapy of oxidised regenerated cellulose/collagen/silver dressings with negative pressure wound therapy for coverage of exposed critical structures in complex lower-extremity wounds. Int Wound J 2020; 17:1356-1365. [PMID: 32447838 DOI: 10.1111/iwj.13406] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 05/05/2020] [Indexed: 01/17/2023] Open
Abstract
Complex wounds with exposed critical structures such as tendon and bone are a conundrum in wound management, especially in the setting where the patient is not a suitable candidate for flap surgery. While the individual use of negative pressure wound therapy (NPWT) and oxidised regenerated cellulose (ORC)/collagen/silver (PROMOGRAN PRISMA) dressing has been described in the literature, there are little data on the efficacy of their combined use. In this study, we describe a novel technique of combining the use of NPWT and ORC/collagen/silver dressings to manage complex wound beds as an alternative management option for patients not suitable for reconstructive flap surgery. This technique was performed in a series of 37 patients with complex lower-extremity wounds that were not healing with conventional NPWT alone. All patients had open wounds with exposed critical structures that were difficult to manage, such as exposed tendon, bone, deep crevices, and joint. Successful coverage of exposed critical structures was achieved in 89% of patients, and coverage was achieved within 28 days of combination therapy in 82% of these patients, without any complications. The novel technique of combining ORC/collagen/silver dressing and NPWT provides a useful option in the armamentarium of a reconstructive surgeon dealing with difficult complex lower-extremity wounds.
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Affiliation(s)
- Mei Ling Loh
- Department of General Surgery, Plastic, Reconstructive and Aesthetic Surgery Service, Khoo Teck Puat Hospital, Singapore, Singapore
| | - Benjamin K L Goh
- Department of General Surgery, Plastic, Reconstructive and Aesthetic Surgery Service, Khoo Teck Puat Hospital, Singapore, Singapore
| | - Yuan Kong
- Department of General Surgery, Plastic, Reconstructive and Aesthetic Surgery Service, Khoo Teck Puat Hospital, Singapore, Singapore
| | - George Varughese
- Department of General Surgery, Plastic, Reconstructive and Aesthetic Surgery Service, Khoo Teck Puat Hospital, Singapore, Singapore
| | - Jia Lin Ng
- Department of Podiatry, Khoo Teck Puat Hospital, Singapore, Singapore
| | - Zhiwen J Lo
- Vascular Surgery Service, Department of General Surgery, Tan Tock Seng Hospital, Singapore, Singapore
| | - Chong Han Pek
- Department of General Surgery, Plastic, Reconstructive and Aesthetic Surgery Service, Khoo Teck Puat Hospital, Singapore, Singapore
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Huynh P, Phie J, Krishna SM, Golledge J. Systematic review and meta-analysis of mouse models of diabetes-associated ulcers. BMJ Open Diabetes Res Care 2020; 8:8/1/e000982. [PMID: 32467222 PMCID: PMC7259859 DOI: 10.1136/bmjdrc-2019-000982] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 02/29/2020] [Accepted: 04/18/2020] [Indexed: 12/14/2022] Open
Abstract
Mouse models are frequently used to study diabetes-associated ulcers, however, whether these models accurately simulate impaired wound healing has not been thoroughly investigated. This systematic review aimed to determine whether wound healing is impaired in mouse models of diabetes and assess the quality of the past research. A systematic literature search was performed of publicly available databases to identify original articles examining wound healing in mouse models of diabetes. A meta-analysis was performed to examine the effect of diabetes on wound healing rate using random effect models. A meta-regression was performed to examine the effect of diabetes duration on wound healing impairment. The quality of the included studies was also assessed using two newly developed tools. 77 studies using eight different models of diabetes within 678 non-diabetic and 720 diabetic mice were included. Meta-analysis showed that wound healing was impaired in all eight models. Meta-regression suggested that longer duration of diabetes prior to wound induction was correlated with greater degree of wound healing impairment. Pairwise comparisons suggested that non-obese diabetic mice exhibited more severe wound healing impairment compared with db/db mice, streptozotocin-induced diabetic mice or high-fat fed mice at an intermediate stage of wound healing (p<0.01). Quality assessment suggested that the prior research frequently lacked incorporation of key clinically relevant characteristics. This systematic review suggested that impaired wound healing can be simulated in many different mouse models of diabetes but these require further refinement to become more clinically relevant.
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Affiliation(s)
- Pacific Huynh
- Queensland Research Centre for Peripheral Vascular Disease, James Cook University, Townsville, Queensland, Australia
| | - James Phie
- Queensland Research Centre for Peripheral Vascular Disease, James Cook University, Townsville, Queensland, Australia
| | - Smriti Murali Krishna
- Queensland Research Centre for Peripheral Vascular Disease, James Cook University, Townsville, Queensland, Australia
| | - Jonathan Golledge
- Queensland Research Centre for Peripheral Vascular Disease, James Cook University, Townsville, Queensland, Australia
- Department of Vascular and Endovascular Surgery, Townsville University Hospital, Townsville, Queensland, Australia
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15
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Shimizu N, Tanaka Y, Kuroda S, Nakamura H, Matsumoto G, Mitsui S, Sakai S, Minami K, Doi T, Hokka D, Maniwa Y. Oxidized regenerated cellulose for a clear thoracoscopic view: a single-centre randomized trial. Interact Cardiovasc Thorac Surg 2020; 30:346-352. [PMID: 31747012 DOI: 10.1093/icvts/ivz271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 10/12/2019] [Accepted: 10/18/2019] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES During video-assisted thoracoscopic surgery (VATS), blood oozing from the surface of the access port wound can hamper the surgical view. Although this oozing is difficult to prevent, it can be decreased by placing a wound edge protector with oxidized regenerated cellulose (ORC) on the surface of the access port wound, thereby improving the surgical outcomes and safety of VATS. METHODS We conducted a prospective, single-centre, open-label, randomized clinical trial to evaluate the operative outcomes of VATS when using the ORC (ORC group) compared with operative outcomes without using the ORC (non-ORC group). The primary end point was interruption of the operation as a result of blood oozing from the surface of the access port wound. The secondary end points were the other intraoperative and postoperative outcomes. RESULTS A total of 108 patients were divided into the ORC group (n = 54) and the non-ORC group (n = 54). Compared with the non-ORC group, the ORC group had fewer patients with an interruption in the operation (11.1% vs 51.8%; P < 0.001), less need for wound haemostasis of the access ports during wound closure (44.4% vs 72.2%; P = 0.003), similar rates of postoperative deaths and complications and a tendency for shorter operation times (149.3 vs 168.8 min, respectively; P = 0.083). CONCLUSION The use of an ORC sheet around a wound edge protector for haemostasis can ensure a clear view during VATS. CLINICAL TRIAL REGISTRATION NUMBER UMIN000031112.
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Affiliation(s)
- Nahoko Shimizu
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yugo Tanaka
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Sanae Kuroda
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hayate Nakamura
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Gaku Matsumoto
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Suguru Mitsui
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shuto Sakai
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kazuhiro Minami
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takefumi Doi
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Daisuke Hokka
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yoshimasa Maniwa
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
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Pinho AMDMR, Kencis CCS, Miranda DRP, Sousa Neto OMD. Traumatic perforations of the tympanic membrane: immediate clinical recovery with the use of bacterial cellulose film. Braz J Otorhinolaryngol 2019; 86:727-733. [PMID: 31526712 PMCID: PMC9422489 DOI: 10.1016/j.bjorl.2019.05.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 02/06/2019] [Accepted: 05/11/2019] [Indexed: 11/26/2022] Open
Abstract
Introduction Perforation of the tympanic membrane is a reasonably frequent diagnosis in otorhinolaryngologists’ offices. The expectant management is to wait for spontaneous healing, which usually occurs in almost all cases in a few weeks. However, while waiting for healing to be completed, the patients may experience uncomfortable symptoms. Although some research suggests the use of various materials to aid in the recovery of the tympanic membrane, none presented robust evidence of improvement in the cicatricial process. Nevertheless, the occlusion of the perforation with some material of specific texture and resistance can alleviate the patients’ symptoms and accelerate the healing process. Objective To evaluate the clinical (symptomatic and functional) improvement after the placement of bacterial cellulose film (Bionext®) on tympanic membrane perforations (traumatic). Methods We evaluated 24 patients, victims of traumatic perforations of the tympanic membrane, who were evaluated in the Otorhinolaryngology Emergency Room. Following otoscopy and audiometric examination was performed, before and after the use of cellulose film occluding the tympanic membrane perforation. Results Twenty-four patients were included, whose degree of overall discomfort caused by the tympanic membrane perforation and the presence of symptoms of autophonia, ear fullness and tinnitus were investigated. The mean score attributed to the overall annoyance caused by tympanic membrane perforation was 7.79, decreasing to a mean value of 2.25 after the film application. Symptom evaluation also showed improvement after using the film: autophonia decreased from a mean value of 6.25 to 2.08, tinnitus from 7 to 1.92 and ear fullness from 7.29 to 1.96. The auditory analysis showed mean threshold values still within the normal range at low and medium frequencies, with slight hearing loss at acute frequencies, but with significant improvement at all frequencies, with the exception of 8000 Hz, after film use. Conclusion The use of bacterial cellulose film fragment on traumatic perforations of the tympanic membrane promoted immediate functional and symptomatic recovery in the assessed patients.
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Freedman BR, Mooney DJ. Biomaterials to Mimic and Heal Connective Tissues. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2019; 31:e1806695. [PMID: 30908806 PMCID: PMC6504615 DOI: 10.1002/adma.201806695] [Citation(s) in RCA: 107] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 01/27/2019] [Indexed: 05/11/2023]
Abstract
Connective tissue is one of the four major types of animal tissue and plays essential roles throughout the human body. Genetic factors, aging, and trauma all contribute to connective tissue dysfunction and motivate the need for strategies to promote healing and regeneration. The goal here is to link a fundamental understanding of connective tissues and their multiscale properties to better inform the design and translation of novel biomaterials to promote their regeneration. Major clinical problems in adipose tissue, cartilage, dermis, and tendon are discussed that inspire the need to replace native connective tissue with biomaterials. Then, multiscale structure-function relationships in native soft connective tissues that may be used to guide material design are detailed. Several biomaterials strategies to improve healing of these tissues that incorporate biologics and are biologic-free are reviewed. Finally, important guidance documents and standards (ASTM, FDA, and EMA) that are important to consider for translating new biomaterials into clinical practice are highligted.
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Affiliation(s)
- Benjamin R Freedman
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, 02138, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, 02115, USA
| | - David J Mooney
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, 02138, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, 02115, USA
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18
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Westby MJ, Dumville JC, Stubbs N, Norman G, Wong JKF, Cullum N, Riley RD. Protease activity as a prognostic factor for wound healing in venous leg ulcers. Cochrane Database Syst Rev 2018; 9:CD012841. [PMID: 30171767 PMCID: PMC6513613 DOI: 10.1002/14651858.cd012841.pub2] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Venous leg ulcers (VLUs) are a common type of complex wound that have a negative impact on people's lives and incur high costs for health services and society. It has been suggested that prolonged high levels of protease activity in the later stages of the healing of chronic wounds may be associated with delayed healing. Protease modulating treatments have been developed which seek to modulate protease activity and thereby promote healing in chronic wounds. OBJECTIVES To determine whether protease activity is an independent prognostic factor for the healing of venous leg ulcers. SEARCH METHODS In February 2018, we searched the following databases: Cochrane Central Register of Controlled Trials (CENTRAL), Ovid MEDLINE, Ovid Embase and CINAHL. SELECTION CRITERIA We included prospective and retrospective longitudinal studies with any follow-up period that recruited people with VLUs and investigated whether protease activity in wound fluid was associated with future healing of VLUs. We included randomised controlled trials (RCTs) analysed as cohort studies, provided interventions were taken into account in the analysis, and case-control studies if there were no available cohort studies. We also included prediction model studies provided they reported separately associations of individual prognostic factors (protease activity) with healing. Studies of any type of protease or combination of proteases were eligible, including proteases from bacteria, and the prognostic factor could be examined as a continuous or categorical variable; any cut-off point was permitted. The primary outcomes were time to healing (survival analysis) and the proportion of people with ulcers completely healed; the secondary outcome was change in ulcer size/rate of wound closure. We extracted unadjusted (simple) and adjusted (multivariable) associations between the prognostic factor and healing. DATA COLLECTION AND ANALYSIS Two review authors independently assessed studies for inclusion at each stage, and undertook data extraction, assessment of risk of bias and GRADE assessment. We collected association statistics where available. No study reported adjusted analyses: instead we collected unadjusted results or calculated association measures from raw data. We calculated risk ratios when both outcome and prognostic factor were dichotomous variables. When the prognostic factor was reported as continuous data and healing outcomes were dichotomous, we either performed regression analysis or analysed the impact of healing on protease levels, analysing as the standardised mean difference. When both prognostic factor and outcome were continuous data, we reported correlation coefficients or calculated them from individual participant data.We displayed all results on forest plots to give an overall visual representation. We planned to conduct meta-analyses where this was appropriate, otherwise we summarised narratively. MAIN RESULTS We included 19 studies comprising 21 cohorts involving 646 participants. Only 11 studies (13 cohorts, 522 participants) had data available for analysis. Of these, five were prospective cohort studies, four were RCTs and two had a type of case-control design. Follow-up time ranged from four to 36 weeks. Studies covered 10 different matrix metalloproteases (MMPs) and two serine proteases (human neutrophil elastase and urokinase-type plasminogen activators). Two studies recorded complete healing as an outcome; other studies recorded partial healing measures. There was clinical and methodological heterogeneity across studies; for example, in the definition of healing, the type of protease and its measurement, the distribution of active and bound protease species, the types of treatment and the reporting of results. Therefore, meta-analysis was not performed. No study had conducted multivariable analyses and all included evidence was of very low certainty because of the lack of adjustment for confounders, the high risk of bias for all studies except one, imprecision around the measures of association and inconsistency in the direction of association. Collectively the research indicated complete uncertainty as to the association between protease activity and VLU healing. AUTHORS' CONCLUSIONS This review identified very low validity evidence regarding any association between protease activity and VLU healing and there is complete uncertainty regarding the relationship. The review offers information for both future research and systematic review methodology.
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Affiliation(s)
- Maggie J Westby
- University of Manchester, Manchester Academic Health Science CentreDivision of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and HealthJean McFarlane BuildingOxford RoadManchesterUKM13 9PL
| | - Jo C Dumville
- University of Manchester, Manchester Academic Health Science CentreDivision of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and HealthJean McFarlane BuildingOxford RoadManchesterUKM13 9PL
| | - Nikki Stubbs
- St Mary's HospitalLeeds Community Healthcare NHS Trust3 Greenhill RoadLeedsUKLS12 3QE
| | - Gill Norman
- University of Manchester, Manchester Academic Health Science CentreDivision of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and HealthJean McFarlane BuildingOxford RoadManchesterUKM13 9PL
| | - Jason KF Wong
- Manchester University NHS Foundation TrustManchester Centre for Plastic Surgery and Burns, Wythenshawe HospitalSouthmoor Road, WythenshaweManchesterUKM23 9LT
| | - Nicky Cullum
- University of Manchester, Manchester Academic Health Science CentreDivision of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and HealthJean McFarlane BuildingOxford RoadManchesterUKM13 9PL
| | - Richard D Riley
- Keele UniversityResearch Institute for Primary Care and Health SciencesDavid Weatherall Building, Keele University CampusKeeleStaffordshireUKST5 5BG
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Biopolymers: Applications in wound healing and skin tissue engineering. Mol Biol Rep 2018; 45:2857-2867. [PMID: 30094529 DOI: 10.1007/s11033-018-4296-3] [Citation(s) in RCA: 164] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 08/01/2018] [Indexed: 12/13/2022]
Abstract
Wound is a growing healthcare challenge affecting several million worldwide. Lifestyle disorders such as diabetes increases the risk of wound complications. Effective management of wound is often difficult due to the complexity in the healing process. Addition to the conventional wound care practices, the bioactive polymers are gaining increased importance in wound care. Biopolymers are naturally occurring biomolecules synthesized by microbes, plants and animals with highest degree of biocompatibility. The bioactive properties such as antimicrobial, immune-modulatory, cell proliferative and angiogenic of the polymers create a microenvironment favorable for the healing process. The versatile properties of the biopolymers such as cellulose, alginate, hyaluronic acid, collagen, chitosan etc have been exploited in the current wound care market. With the technological advances in material science, regenerative medicine, nanotechnology, and bioengineering; the functional and structural characteristics of biopolymers can be improved to suit the current wound care demands such as tissue repair, restoration of lost tissue integrity and scarless healing. In this review we highlight on the sources, mechanism of action and bioengineering approaches adapted for commercial exploitation.
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20
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Tati R, Nordin S, Abdillahi SM, Mörgelin M. Biological wound matrices with native dermis-like collagen efficiently modulate protease activity. J Wound Care 2018; 27:199-209. [DOI: 10.12968/jowc.2018.27.4.199] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- Ramesh Tati
- Postdoctoral Researcher, Department of Clinical Sciences, Division of Infection Medicine, Lund University, SE-221 84 Lund, Sweden
| | - Sara Nordin
- Postdoctoral Researcher, Department of Clinical Sciences, Division of Infection Medicine, Lund University, SE-221 84 Lund, Sweden
| | - Suado M Abdillahi
- Postdoctoral Researcher, Department of Clinical Sciences, Division of Infection Medicine, Lund University, SE-221 84 Lund, Sweden
| | - Matthias Mörgelin
- Department of Clinical Sciences, Division of Infection Medicine, Lund University, SE-221 84 Lund, Sweden, Colzyx ltd, Medicon Village, Scheelevägen 2, SE-223 81 Lund, Sweden
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21
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Instructive microenvironments in skin wound healing: Biomaterials as signal releasing platforms. Adv Drug Deliv Rev 2018; 129:95-117. [PMID: 29627369 DOI: 10.1016/j.addr.2018.03.012] [Citation(s) in RCA: 97] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 03/16/2018] [Accepted: 03/27/2018] [Indexed: 12/16/2022]
Abstract
Skin wound healing aims to repair and restore tissue through a multistage process that involves different cells and signalling molecules that regulate the cellular response and the dynamic remodelling of the extracellular matrix. Nowadays, several therapies that combine biomolecule signals (growth factors and cytokines) and cells are being proposed. However, a lack of reliable evidence of their efficacy, together with associated issues such as high costs, a lack of standardization, no scalable processes, and storage and regulatory issues, are hampering their application. In situ tissue regeneration appears to be a feasible strategy that uses the body's own capacity for regeneration by mobilizing host endogenous stem cells or tissue-specific progenitor cells to the wound site to promote repair and regeneration. The aim is to engineer instructive systems to regulate the spatio-temporal delivery of proper signalling based on the biological mechanisms of the different events that occur in the host microenvironment. This review describes the current state of the different signal cues used in wound healing and skin regeneration, and their combination with biomaterial supports to create instructive microenvironments for wound healing.
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Bopage NS, Kamal Bandara Gunaherath GM, Jayawardena KH, Wijeyaratne SC, Abeysekera AM, Somaratne S. Dual function of active constituents from bark of Ficus racemosa L in wound healing. Altern Ther Health Med 2018; 18:29. [PMID: 29370854 PMCID: PMC5785810 DOI: 10.1186/s12906-018-2089-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 01/14/2018] [Indexed: 11/10/2022]
Abstract
Background Different parts including the latex of Ficus racemosa L. has been used as a medicine for wound healing in the Ayurveda and in the indigenous system of medicine in Sri Lanka. This plant has been evaluated for its wound healing potential using animal models. The aim of this study was to obtain an insight into the wound healing process and identify the potential wound healing active substance/s present in F. racemosa L. bark using scratch wound assay (SWA) as the in-vitro assay method. Method Stem bark extracts of F. racemosa were evaluated using scratch wound assay (SWA) on Baby Hamster Kidney (BHK 21) and Madin-Darby Canine Kidney (MDCK) cell lines and Kirby Bauer disc diffusion assay on common bacteria and fungi for cell migration enhancing ability and antimicrobial activity respectively. Dichloromethane and hexanes extracts which showed cell migration enhancement activity on SWA were subjected to bioactivity directed fractionation using column chromatography followed by preparative thin layer chromatography to identify the compounds responsible for the cell migration enhancement activity. Results Dichloromethane and hexanes extracts showed cell migration enhancement activity on both cell lines, while EtOAc and MeOH extracts showed antibacterial activity against Staphylococcus and Bacillus species and antifungal activity against Saccharomyces spp. and Candida albicans. Lupeol (1) and β-sitosterol (2) were isolated as the potential wound healing active compounds which exhibited significant cell migration enhancement activity on BHK 21 and MDCK cell lines (> 80%) in par with the positive control, asiaticoside at a concentration of 25 μM. The optimum concentration of each compound required for the maximum wound healing has been determined as 30 μM and 35 μM for 1 and 2 respectively on both cell lines. It is also established that lupeol acetate (3) isolated from the hexanes extract act as a pro-drug by undergoing hydrolysis into lupeol in the vicinity of cells. Conclusion Different chemical constituents present in stem bark of Ficus racemosa L show enhancement of cell migration (which corresponds to the cell proliferation) as well as antimicrobial activity. This dual action of F. racemosa stem bark provides scientific support for its traditional use in wound healing.
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Wu Y, Wang F, Huang Y. Comparative Evaluation of Biological Performance, Biosecurity, and Availability of Cellulose-Based Absorbable Hemostats. Clin Appl Thromb Hemost 2018; 24:566-574. [PMID: 29363998 PMCID: PMC6714697 DOI: 10.1177/1076029617751177] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Hemorrhage remains a leading cause of death after trauma, and developing a hemostat with excellent performance and good biosecurity is an extremely active area of research and commercial product development. Although oxidized regenerated cellulose (ORC) has been developed to address these problems, it is not always efficient and its biosecurity is not perfect. We aimed to refine ORC via a simple and mild neutralization method. The prepared neutralized oxidized regenerated cellulose (NORC) showed a superior gel property due to its chemical structure. The biological performance of both ORC and NORC was systematically evaluated; the results showed that ORC would induce erythema and edema in the irritation test, whereas NORC did not cause any adverse inflammation, indicating NORC had desirable biocompatibility. We further demonstrated that NORC confirmed to the toxicity requirements of International Organization for Standardization (ISO) standards; however, ORC showed an unacceptable cytotoxicity. The rabbit hepatic defect model stated that NORC exhibited better ability of hemostasis, which was attributed to its significant gel performance in physiological environment.
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Affiliation(s)
- Yadong Wu
- 1 MIIT Key Laboratory of Critical Materials Technology for New Energy Conversion and Storage, School of Chemistry and Chemical Engineering, Harbin Institute of Technology, Harbin, China
| | - Fang Wang
- 1 MIIT Key Laboratory of Critical Materials Technology for New Energy Conversion and Storage, School of Chemistry and Chemical Engineering, Harbin Institute of Technology, Harbin, China
| | - Yudong Huang
- 1 MIIT Key Laboratory of Critical Materials Technology for New Energy Conversion and Storage, School of Chemistry and Chemical Engineering, Harbin Institute of Technology, Harbin, China
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Collagen-fucoidan blend film with the potential to induce fibroblast proliferation for regenerative applications. Int J Biol Macromol 2018; 106:1032-1040. [DOI: 10.1016/j.ijbiomac.2017.08.111] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 08/17/2017] [Accepted: 08/17/2017] [Indexed: 11/20/2022]
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Liang H, Russell SJ, Wood DJ, Tronci G. A hydroxamic acid–methacrylated collagen conjugate for the modulation of inflammation-related MMP upregulation. J Mater Chem B 2018; 6:3703-3715. [DOI: 10.1039/c7tb03035e] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The selective covalent coupling of hydroxamic acid functions on to methacrylated type I collagen led to UV-cured networks with inherent MMP-modulating capability and enhanced proteolytic stability.
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Affiliation(s)
- He Liang
- Clothworkers’ Centre for Textile Materials Innovation for Healthcare
- School of Design
- University of Leeds
- UK
- Biomaterials and Tissue Engineering Research Group
| | - Stephen J. Russell
- Clothworkers’ Centre for Textile Materials Innovation for Healthcare
- School of Design
- University of Leeds
- UK
| | - David J. Wood
- Biomaterials and Tissue Engineering Research Group
- School of Dentistry
- St. James's University Hospital
- University of Leeds
- UK
| | - Giuseppe Tronci
- Clothworkers’ Centre for Textile Materials Innovation for Healthcare
- School of Design
- University of Leeds
- UK
- Biomaterials and Tissue Engineering Research Group
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Wu S, Applewhite AJ, Niezgoda J, Snyder R, Shah J, Cullen B, Schultz G, Harrison J, Hill R, Howell M, Speyrer M, Utra H, de Leon J, Lee W, Treadwell T. Oxidized Regenerated Cellulose/Collagen Dressings: Review of Evidence and Recommendations. Adv Skin Wound Care 2017; 30:S1-S18. [PMID: 29049055 PMCID: PMC5704727 DOI: 10.1097/01.asw.0000525951.20270.6c] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 09/06/2017] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Healthcare systems are being challenged to manage increasing numbers of nonhealing wounds. Wound dressings are one of the first lines of defense in wound management, and numerous options exist. The oxidized regenerated cellulose (ORC)/collagen dressing may offer healthcare providers a robust and cost-effective tool for use in a variety of wounds. DESIGN A multidisciplinary panel meeting was convened to discuss the use of ORC/collagen dressings in wound care and provide practice recommendations. A literature search was conducted to provide a brief review of the peer-reviewed studies published between January 2000 and March 2016 to inform the meeting. SETTING A 2-day panel meeting convened in February 2017. PARTICIPANTS Healthcare providers with experience using ORC/collagen dressings. This multidisciplinary panel of 15 experts in wound healing included podiatrists, wound care specialists (doctors, certified wound care nurses, and research scientists), and an orthopedist. RESULTS The literature search identified 58 articles, a majority of which were low levels of evidence (69.3% were level 3 or lower). Panel members identified wound types, such as abrasions, burns, stalled wounds, diabetic foot ulcers, and pressure injuries, where ORC/collagen dressing use could be beneficial. Panel members then provided recommendations and technical pearls for the use of ORC/collagen dressings in practice. Barriers to ORC/collagen dressing use were discussed, and potential resolutions were offered. CONCLUSIONS An ORC/collagen dressing can be a critical tool for clinicians to help manage a variety of wounds. Clinical and economic studies comparing standard-of-care dressings and plain collagen dressings to ORC/collagen dressings are needed.
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Affiliation(s)
- Stephanie Wu
- Stephanie Wu, DPM, MS, is Professor of Surgery, Dr William M. School College of Podiatric Medicine, Rosalind Franklin University of Medicine and Science, Center for Lower Extremity Ambulatory Research (CLEAR), North Chicago, Illinois. Andrew J. Applewhite, MD, CSWP, is Medical Director and Physician, Comprehensive Wound Care and Hyperbaric Center at Baylor University Medical Center, Dallas, Texas. Jeffrey Niezgoda, MD, FACHM, MAPWCA, CHWS, is President and Chief Medical Officer of Advancing the Zenith of Healthcare, Milwaukee, Wisconsin. Robert Snyder, DPM, MSc, is Professor and Director of Clinical Research, Barry University School of Podiatric Medicine, North Miami Beach, Florida. Jayesh Shah, MD, is President, South Texas Wound Associated PA, San Antonio, Texas. Breda Cullen, PhD, is R&D Program Director, Systagenix, Gargrave, United Kingdom. Gregory Schultz, PhD, is Professor, University of Florida College of Medicine, Gainesville, Florida. Janis Harrison, BSN, RN, CWOCN, CFCN, is Partner and Chief Clinical Consultant to Harrison WOC Services LLC, Thurston, Nebraska. Rosemary Hill, RN, CWOCN, CETN(C), is Enterostomal Therapist, Lions Gate Hospital, North Vancouver, British Columbia, Canada. Melania Howell, RN, CWOCN, is Wound Care Consultant, Dynamic Wound Care Solutions LLC, Turlock, California. Marcus Speyrer, RN, CWS, is Chief Operating Officer, The Wound Treatment Center LLC, Opelousas General Health System, Opelousas, Louisiana. Howard Utra, BSN, RN, CWCN, is Registered Nurse, Innovated Healing Systems, Tampa, Florida. Jean de Leon, MD, FAPWCA, is Professor, University of Texas Southwestern Medical Center, Dallas, Texas. Wayne Lee, MD, is in private practice, Hill Country Orthopaedic Surgery & Sports Medicine, San Antonio, Texas. Terry Treadwell, MD, is Medical Director, Institute for Advanced Wound Care at Baptist Medical Center, Montgomery, Alabama. ACKNOWLEDGMENTS: The authors thank Ricardo Martinez and Julie M. Robertson (ACELITY) for manuscript preparation and editing. Drs Wu, Applewhite, Niezgoda, Snyder, Shah, Schultz, de Leon, Lee, and Treadwell; Ms Harrison, Hill, and Howell; and Mr Speyrer and Mr Utra are consultants for ACELITY. Dr Cullen is an employee of Systagenix, an ACELITY Company. The panel meeting was sponsored by ACELITY
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Westby MJ, Dumville JC, Stubbs N, Norman G, Wong JKF, Cullum N, Riley R. Protease activity as a prognostic factor for wound healing in venous leg ulcers. Hippokratia 2017. [DOI: 10.1002/14651858.cd012841] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Maggie J Westby
- University of Manchester, Manchester Academic Health Science Centre; Division of Nursing, Midwifery & Social Work, School of Health Sciences, Faculty of Biology, Medicine & Health; Jean McFarlane Building Oxford Road Manchester UK M13 9PL
| | - Jo C Dumville
- University of Manchester, Manchester Academic Health Science Centre; Division of Nursing, Midwifery & Social Work, School of Health Sciences, Faculty of Biology, Medicine & Health; Jean McFarlane Building Oxford Road Manchester UK M13 9PL
| | - Nikki Stubbs
- Leeds Community Healthcare NHS Trust, St Mary's Hospital; Wound Prevention and Management Service; 3 Greenhill Road Leeds UK LS12 3QE
| | - Gill Norman
- University of Manchester, Manchester Academic Health Science Centre; Division of Nursing, Midwifery & Social Work, School of Health Sciences, Faculty of Biology, Medicine & Health; Jean McFarlane Building Oxford Road Manchester UK M13 9PL
| | - Jason KF Wong
- University Hospital South Manchester; Plastic and Reconstructive Surgery; Southmoor Road, Wythenshawe Manchester UK M23 9LT
| | - Nicky Cullum
- University of Manchester, Manchester Academic Health Science Centre; Division of Nursing, Midwifery & Social Work, School of Health Sciences, Faculty of Biology, Medicine & Health; Jean McFarlane Building Oxford Road Manchester UK M13 9PL
| | - Richard Riley
- Keele University; Research Institute for Primary Care and Health Sciences; David Weatherall Building, Keele University Campus Keele Staffordshire UK ST5 5BG
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Meaume S, Dompmartin A, Lok C, Lazareth I, Sigal M, Truchetet F, Sauvadet A, Bohbot S. Quality of life in patients with leg ulcers: results from CHALLENGE, a double-blind randomised controlled trial. J Wound Care 2017; 26:368-379. [PMID: 28704156 DOI: 10.12968/jowc.2017.26.7.368] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE We recently showed the superiority of a matrix metalloproteinase (MMP) modulating dressing (foam impregnated with NOSF, nano-oligosaccharide factor) compared with a lipidocolloid matrix (TLC) control dressing in median wound area reduction (WAR). Here we report the results from the same study assessing the performance and safety of TLC-NOSF in the local management of venous leg ulcers (VLUs) or mixed leg ulcers and determining its impact on the patient's health-related quality of life (HRQoL). METHOD A superiority randomised double-blind controlled trial was conducted on patients presenting with a non-infected leg ulcer (VLUs or mixed leg ulcers) of predominantly venous origin (ABPI >0.8), with a surface area ranging from 5 to 50cm2 and a duration of 6 to 36 months. Patients were randomly allocated to either the TLC-NOSF matrix foam (UrgoStart) dressing group or to the neutral TLC foam dressing group (UrgoTul Absorb). All received appropriate compression therapy and the wounds were assessed blindly (clinical examination, wound area tracing and photographic record) every 2 weeks for a period of 8 weeks, or until complete closure. A secondary endpoint, described here, was the patient's HRQoL, documented by the patient, through the EuroQol 5D tool (EQ-5D) questionnaire and visual analogue scale (VAS). RESULTS In total, 187 patients were randomised to either the TLC-NOSF group (n=94) or the control dressing group (n=93). The two groups were well balanced at baseline with regard to wound and patient characteristics. In the HRQoL questionnaire (EQ-5D), the pain/discomfort and anxiety/depression dimensions were significantly improved in the TLC-NOSF group versus the control one (pain/discomfort: 1.53±0.53 versus 1.74±0.65; p=0.022, and anxiety/depression: 1.35±0.53 versus 1.54±0.60, p=0.037). The VAS score was better in the test group compared with the control group (72.1±17.5 versus 67.3±18.7, respectively), without reaching significance (p=0.072). Acceptability and tolerance of the two products were similar in both groups. CONCLUSION The double-blind clinical trial has demonstrated that the TLC-NOSF matrix dressing promotes faster healing of VLUs and mixed leg ulcers and significantly reduces the pain/discomfort and anxiety/depression experienced by the patients. These results suggest that acceleration of VLU healing could improve the HRQoL of the patients and reduced the emotional and social burden of these chronic wounds.
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Affiliation(s)
- S Meaume
- Dermatologist and Geriatrician, Head of Geriatric Department and Wound Care Unit, Rothschild University Hospital, Paris, France
| | - A Dompmartin
- Dermatologist, Dermatology Department, Clemenceau University Hospital, Caen, France
| | - C Lok
- Head of Dermatology Department, South University Hospital, Amiens, France
| | - I Lazareth
- Department of Vascular Medicine, Saint-Joseph Hospital, Paris, France
| | - M Sigal
- Dermatologist, Head of Dermatology Department, Victor Dupouy Hospital, Argenteuil, France
| | - F Truchetet
- Head of Dermatology Department, Beauregard Hospital, Thionville, France
| | - A Sauvadet
- Clinical Research Department, Laboratoires URGO, Chenôve, France
| | - S Bohbot
- Clinical Research Department, Laboratoires URGO, Chenôve, France
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Lohmann N, Schirmer L, Atallah P, Wandel E, Ferrer RA, Werner C, Simon JC, Franz S, Freudenberg U. Glycosaminoglycan-based hydrogels capture inflammatory chemokines and rescue defective wound healing in mice. Sci Transl Med 2017; 9:9/386/eaai9044. [PMID: 28424334 DOI: 10.1126/scitranslmed.aai9044] [Citation(s) in RCA: 202] [Impact Index Per Article: 28.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 01/17/2017] [Accepted: 03/29/2017] [Indexed: 12/31/2022]
Abstract
Excessive production of inflammatory chemokines can cause chronic inflammation and thus impair cutaneous wound healing. Capturing chemokine signals using wound dressing materials may offer powerful new treatment modalities for chronic wounds. Here, a modular hydrogel based on end-functionalized star-shaped polyethylene glycol (starPEG) and derivatives of the glycosaminoglycan (GAG) heparin was customized for maximal chemokine sequestration. The material is shown to effectively scavenge the inflammatory chemokines MCP-1 (monocyte chemoattractant protein-1), IL-8 (interleukin-8), and MIP-1α (macrophage inflammatory protein-1α) and MIP-1β (macrophage inflammatory protein-1β) in wound fluids from patients suffering from chronic venous leg ulcers and to reduce the migratory activity of human monocytes and polymorphonuclear neutrophils. In an in vivo model of delayed wound healing (db/db mice), starPEG-GAG hydrogels outperformed the standard-of-care product Promogran with respect to reduction of inflammation, as well as increased granulation tissue formation, vascularization, and wound closure.
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Affiliation(s)
- Nadine Lohmann
- Department of Dermatology, Venerology, and Allergology, Leipzig University, 04103 Leipzig, Germany.,Collaborative Research Center (SFB-TR67) "Functional Biomaterials for Controlling Healing Processes in Bone and Skin-From Material Science to Clinical Application," Leipzig and Dresden, Germany
| | - Lucas Schirmer
- Collaborative Research Center (SFB-TR67) "Functional Biomaterials for Controlling Healing Processes in Bone and Skin-From Material Science to Clinical Application," Leipzig and Dresden, Germany.,Leibniz Institute of Polymer Research Dresden, Max Bergmann Center of Biomaterials Dresden, Hohe Straße 6, 01069 Dresden, Germany
| | - Passant Atallah
- Collaborative Research Center (SFB-TR67) "Functional Biomaterials for Controlling Healing Processes in Bone and Skin-From Material Science to Clinical Application," Leipzig and Dresden, Germany.,Leibniz Institute of Polymer Research Dresden, Max Bergmann Center of Biomaterials Dresden, Hohe Straße 6, 01069 Dresden, Germany
| | - Elke Wandel
- Department of Dermatology, Venerology, and Allergology, Leipzig University, 04103 Leipzig, Germany.,Collaborative Research Center (SFB-TR67) "Functional Biomaterials for Controlling Healing Processes in Bone and Skin-From Material Science to Clinical Application," Leipzig and Dresden, Germany
| | - Ruben A Ferrer
- Department of Dermatology, Venerology, and Allergology, Leipzig University, 04103 Leipzig, Germany.,Collaborative Research Center (SFB-TR67) "Functional Biomaterials for Controlling Healing Processes in Bone and Skin-From Material Science to Clinical Application," Leipzig and Dresden, Germany
| | - Carsten Werner
- Collaborative Research Center (SFB-TR67) "Functional Biomaterials for Controlling Healing Processes in Bone and Skin-From Material Science to Clinical Application," Leipzig and Dresden, Germany.,Leibniz Institute of Polymer Research Dresden, Max Bergmann Center of Biomaterials Dresden, Hohe Straße 6, 01069 Dresden, Germany.,Technische Universität Dresden, Center for Regenerative Therapies Dresden, Fetscherstraße 105, 01307 Dresden, Germany
| | - Jan C Simon
- Department of Dermatology, Venerology, and Allergology, Leipzig University, 04103 Leipzig, Germany.,Collaborative Research Center (SFB-TR67) "Functional Biomaterials for Controlling Healing Processes in Bone and Skin-From Material Science to Clinical Application," Leipzig and Dresden, Germany
| | - Sandra Franz
- Department of Dermatology, Venerology, and Allergology, Leipzig University, 04103 Leipzig, Germany. .,Collaborative Research Center (SFB-TR67) "Functional Biomaterials for Controlling Healing Processes in Bone and Skin-From Material Science to Clinical Application," Leipzig and Dresden, Germany
| | - Uwe Freudenberg
- Collaborative Research Center (SFB-TR67) "Functional Biomaterials for Controlling Healing Processes in Bone and Skin-From Material Science to Clinical Application," Leipzig and Dresden, Germany. .,Leibniz Institute of Polymer Research Dresden, Max Bergmann Center of Biomaterials Dresden, Hohe Straße 6, 01069 Dresden, Germany
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Fontana G, Gershlak J, Adamski M, Lee JS, Matsumoto S, Le HD, Binder B, Wirth J, Gaudette G, Murphy WL. Biofunctionalized Plants as Diverse Biomaterials for Human Cell Culture. Adv Healthc Mater 2017; 6:10.1002/adhm.201601225. [PMID: 28319334 PMCID: PMC5490445 DOI: 10.1002/adhm.201601225] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 02/04/2017] [Indexed: 01/09/2023]
Abstract
The commercial success of tissue engineering products requires efficacy, cost effectiveness, and the possibility of scaleup. Advances in tissue engineering require increased sophistication in the design of biomaterials, often challenging the current manufacturing techniques. Interestingly, several of the properties that are desirable for biomaterial design are embodied in the structure and function of plants. This study demonstrates that decellularized plant tissues can be used as adaptable scaffolds for culture of human cells. With simple biofunctionalization technique, it is possible to enable adhesion of human cells on a diverse set of plant tissues. The elevated hydrophilicity and excellent water transport abilities of plant tissues allow cell expansion over prolonged periods of culture. Moreover, cells are able to conform to the microstructure of the plant frameworks, resulting in cell alignment and pattern registration. In conclusion, the current study shows that it is feasible to use plant tissues as an alternative feedstock of scaffolds for mammalian cells.
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Affiliation(s)
- Gianluca Fontana
- Department of Orthopedics and Rehabilitation, University of Wisconsin School of Medicine and Public Health, Madison, WI, 53705, USA
| | - Joshua Gershlak
- Biomedical Engineering, Worcester Polytechnic Institute, Worcester, MA, 01609, USA
| | - Michal Adamski
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, 53705, USA
| | - Jae-Sung Lee
- Department of Orthopedics and Rehabilitation, University of Wisconsin School of Medicine and Public Health, Madison, WI, 53705, USA
| | - Shion Matsumoto
- Biomedical Engineering, Worcester Polytechnic Institute, Worcester, MA, 01609, USA
| | - Hau D Le
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, 53705, USA
| | - Bernard Binder
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, 53705, USA
| | - John Wirth
- Olbrich Botanical Gardens, Madison, WI, 53704, USA
| | - Glenn Gaudette
- Biomedical Engineering, Worcester Polytechnic Institute, Worcester, MA, 01609, USA
| | - William L Murphy
- Biomedical Engineering, Material Sciences and Engineering, Department of Orthopedics and Rehabilitation, Department of Surgery, University of Wisconsin-Madison, Madison, WI, 53705, USA
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31
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Song SH, Seong KY, Kim JE, Go J, Koh EK, Sung JE, Son HJ, Jung YJ, Kim HS, Hong JT, Hwang DY. Effects of different cellulose membranes regenerated from Styela clava tunics on wound healing. Int J Mol Med 2017; 39:1173-1187. [PMID: 28339010 PMCID: PMC5403385 DOI: 10.3892/ijmm.2017.2923] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 02/23/2017] [Indexed: 02/02/2023] Open
Abstract
The aim of this study was to investigate the therapeutic effects of three different cellulose membranes (CMs) manufactured from Styela clava tunics (SCTs) on the healing of cutaneous wounds. We examined the physical properties and therapeutic effects of three CMs regenerated from SCTs (referred to as SCT- CMs), including normal CM (SCT-CM), freeze-dried SCT-CM (FSCT-CM) and sodium alginate-supplemented SCT-CM (ASCT-CM) on skin regeneration and angiogenesis using Sprague-Dawley (SD) rats. FSCT-CM exhibited an outstanding interlayered structure, a high tensile strength (1.64 MPa), low elongation (28.59%) and a low water vapor transmission rate (WVTR) compared with the other SCT-CMs, although the fluid uptake rate was maintained at a medium level. In the SD rats with surgically wounded skin, the wound area and score of wound edge were lower in the FSCT-CM-treated group than in the gauze (GZ)-treated group on days 3–6 and 12–14. In addition, a significant attenuation in the histopathological changes was observed in the FSCT-CM-treated group. Furthermore, the expression level of collagen-1 and the signaling pathway of transforming growth factor (TGF)-β1 were significantly stimulated by the topical application of FSCT-CM. However, no signs of toxicity were detected in the livers or kidneys of the three SCT-CM-treated groups. Overall, our data indicate that the FSCT-CM may accelerate the process of wound healing in the surgically wounded skin of SD rats through the regulation of angiogenesis and connective tissue formation without inducing any specific toxicity.
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Affiliation(s)
- Sung Hwa Song
- Department of Biomaterials Science, College of Natural Resources and Life Science/Life and Industry Convergence Research Institute, Pusan National University, Miryang-si, Gyeongsangnam‑do 627‑706, Republic of Korea
| | - Keum Yong Seong
- Department of Biomaterials Science, College of Natural Resources and Life Science/Life and Industry Convergence Research Institute, Pusan National University, Miryang-si, Gyeongsangnam‑do 627‑706, Republic of Korea
| | - Ji Eun Kim
- Department of Biomaterials Science, College of Natural Resources and Life Science/Life and Industry Convergence Research Institute, Pusan National University, Miryang-si, Gyeongsangnam‑do 627‑706, Republic of Korea
| | - Jun Go
- Department of Biomaterials Science, College of Natural Resources and Life Science/Life and Industry Convergence Research Institute, Pusan National University, Miryang-si, Gyeongsangnam‑do 627‑706, Republic of Korea
| | - Eun Kyoung Koh
- Department of Biomaterials Science, College of Natural Resources and Life Science/Life and Industry Convergence Research Institute, Pusan National University, Miryang-si, Gyeongsangnam‑do 627‑706, Republic of Korea
| | - Ji Eun Sung
- Department of Biomaterials Science, College of Natural Resources and Life Science/Life and Industry Convergence Research Institute, Pusan National University, Miryang-si, Gyeongsangnam‑do 627‑706, Republic of Korea
| | - Hong Joo Son
- Department of Biomaterials Science, College of Natural Resources and Life Science/Life and Industry Convergence Research Institute, Pusan National University, Miryang-si, Gyeongsangnam‑do 627‑706, Republic of Korea
| | - Young Jin Jung
- Department of Biomaterials Science, College of Natural Resources and Life Science/Life and Industry Convergence Research Institute, Pusan National University, Miryang-si, Gyeongsangnam‑do 627‑706, Republic of Korea
| | - Hye Sung Kim
- College of Nanoscience and Nanotechnology, Pusan National University, Miryang-si, Gyeongsangnam‑do 627‑706, Republic of Korea
| | - Jin Tae Hong
- College of Pharmacy, Chungbuk National University, Cheongju, Chungbuk 361-763, Republic of Korea
| | - Dae Youn Hwang
- Department of Biomaterials Science, College of Natural Resources and Life Science/Life and Industry Convergence Research Institute, Pusan National University, Miryang-si, Gyeongsangnam‑do 627‑706, Republic of Korea
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Napavichayanun S, Aramwit P. Effect of animal products and extracts on wound healing promotion in topical applications: a review. JOURNAL OF BIOMATERIALS SCIENCE-POLYMER EDITION 2017; 28:703-729. [DOI: 10.1080/09205063.2017.1301772] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Supamas Napavichayanun
- Bioactive Resources for Innovative Clinical Applications Research Unit, Chulalongkorn University, Bangkok, Thailand
- Faculty of Pharmaceutical Sciences, Department of Pharmacy Practice, Chulalongkorn University, Bangkok, Thailand
| | - Pornanong Aramwit
- Bioactive Resources for Innovative Clinical Applications Research Unit, Chulalongkorn University, Bangkok, Thailand
- Faculty of Pharmaceutical Sciences, Department of Pharmacy Practice, Chulalongkorn University, Bangkok, Thailand
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Guillemin Y, Le Broc D, Ségalen C, Kurkdjian E, Gouze JN. Efficacy of a collagen-based dressing in an animal model of delayed wound healing. J Wound Care 2017; 25:406-13. [PMID: 27410395 DOI: 10.12968/jowc.2016.25.7.406] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate in vitro and in vivo the efficacy of GBT013, a collagen-based dressing, for the treatment of chronic wounds, in a db/db mouse model of diabetes. METHOD Macroscopic and histologic analyses of db/db mice wound healing with GBT013 or saline gauze were assessed. The mRNA expression and the proliferation of dermal fibroblast were investigated. Matrix metalloproteinases (MMP)-2 and MMP-9 activities were quantified. RESULTS In db/db mice, GBT013 improves wound epithelialisation when compared with saline gauze. Histological analysis of scar tissue also shows an enhancement of remodelling associated with no sign of acute inflammation. In addition, GBT013 significantly decreases interleukin (IL)-6 and IL-8, significantly increases tissue inhibitors of metalloproteinases (TIMP)-1 and TIMP-2 fibroblast mRNA expression and significantly reduces in vitro MMP-2 and MMP-9 enzymatic activities. Moreover, GBT013 allows cell growth inside the matrix and stimulates proliferation of human dermal fibroblast. CONCLUSION By contributing to restore MMPs/TIMPs balance, GBT013 may function in all key stages of wound healing, such as inflammation, proliferation and tissue remodelling, and ultimately may provide a favourable environment for skin repair. DECLARATION OF INTEREST This work was supported by Genbiotech, the R&D subsidiary of Laboratoires Genévrier, a pharmaceutical company.
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Affiliation(s)
- Y Guillemin
- Department of Research and Development, Genbiotech, 06600 Antibes, France
| | - D Le Broc
- Department of Research and Development, Genbiotech, 06600 Antibes, France
| | - C Ségalen
- Department of Research and Development, Genbiotech, 06600 Antibes, France
| | - E Kurkdjian
- Department of Research and Development, Genbiotech, 06600 Antibes, France
| | - J N Gouze
- Department of Research and Development, Genbiotech, 06600 Antibes, France
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Westby MJ, Norman G, Dumville JC, Stubbs N, Cullum N. Protease-modulating matrix treatments for healing venous leg ulcers. Cochrane Database Syst Rev 2016; 12:CD011918. [PMID: 27977053 PMCID: PMC6463954 DOI: 10.1002/14651858.cd011918.pub2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Venous leg ulcers (VLUs) are open skin wounds on the lower leg that occur because of poor blood flow in the veins of the leg; leg ulcers can last from weeks to years, and are both painful and costly. Prevalence in the UK is about 2.9 cases per 10,000 people. First-line treatment for VLUs is compression therapy, but around 60% of people have unhealed ulcers after 12 weeks' treatment and about 40% after 24 weeks; therefore, there is scope for further improvement. Limited evidence suggests non-healing leg ulcers may have persisting elevated levels of proteases, which is thought to deter the later stages of healing; thus, timely protease-modulating matrix (PMM) treatments may improve healing by physically removing proteases from the wound fluid. OBJECTIVES To determine the effects of protease-modulating matrix (PMM) treatments on the healing of venous leg ulcers, in people managed in any care setting. SEARCH METHODS In September 2016 we searched: the Cochrane Wounds Specialised Register; CENTRAL; Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid Embase and EBSCO CINAHL Plus. We also searched clinical trials registries for ongoing and unpublished studies, and scanned reference lists of relevant included studies as well as reviews, meta-analyses and health technology reports to identify additional studies. There were no restrictions with respect to language, date of publication or study setting. SELECTION CRITERIA We searched for published or unpublished randomised controlled trials (RCTs) that evaluated PMM treatments for VLUs. We defined PMM treatments as those with a purposeful intent of reducing proteases. Wound healing was the primary endpoint. DATA COLLECTION AND ANALYSIS Two review authors independently performed study selection, risk of bias assessment and data extraction. MAIN RESULTS We included 12 studies (784 participants) in this review; sample sizes ranged from 10 to 187 participants (median 56.5). One study had three arms that were all relevant to this review and all the other studies had two arms. One study was a within-participant comparison. All studies were industry funded. Two studies provided unpublished data for healing.Nine of the included studies compared PMM treatments with other treatments and reported results for the primary outcomes. All treatments were dressings. All studies also gave the participants compression bandaging. Seven of these studies were in participants described as having 'non-responsive' or 'hard-to-heal' ulcers. Results, reported at short, medium and long durations and as time-to-event data, are summarised for the comparison of any dressing regimen incorporating PMM versus any other dressing regimen. The majority of the evidence was of low or very low certainty, and was mainly downgraded for risk of bias and imprecision.It is uncertain whether PMM dressing regimens heal VLUs quicker than non-PMM dressing regimens (low-certainty evidence from 1 trial with 100 participants) (HR 1.21, 95% CI 0.74 to 1.97).In the short term (four to eight weeks) it is unclear whether there is a difference between PMM dressing regimens and non-PMM dressing regimens in the probability of healing (very low-certainty evidence, 2 trials involving 207 participants).In the medium term (12 weeks), it is unclear whether PMM dressing regimens increase the probability of healing compared with non-PMM dressing regimens (low-certainty evidence from 4 trials with 192 participants) (RR 1.28, 95% CI 0.95 to 1.71). Over the longer term (6 months), it is also unclear whether there is a difference between PMM dressing regimens and non-PMM dressing regimens in the probability of healing (low certainty evidence, 1 trial, 100 participants) (RR 1.06, 95% CI 0.80 to 1.41).It is uncertain whether there is a difference in adverse events between PMM dressing regimens and non-PMM dressing regimens (low-certainty evidence from 5 trials, 363 participants) (RR 1.03, 95% CI 0.75 to 1.42). It is also unclear whether resource use is lower for PMM dressing regimens (low-certainty evidence, 1 trial involving 73 participants), or whether mean total costs in a German healthcare setting are different (low-certainty evidence, 1 trial in 187 participants). One cost-effectiveness analysis was not included because effectiveness was not based on complete healing. AUTHORS' CONCLUSIONS The evidence is generally of low certainty, particularly because of risk of bias and imprecision of effects. Within these limitations, we are unclear whether PMM dressing regimens influence venous ulcer healing relative to dressing regimens without PMM activity. It is also unclear whether there is a difference in rates of adverse events between PMM and non-PMM treatments. It is uncertain whether either resource use (products and staff time) or total costs associated with PMM dressing regimens are different from those for non-PMM dressing regimens. More research is needed to clarify the impact of PMM treatments on venous ulcer healing.
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Affiliation(s)
- Maggie J Westby
- University of Manchester, Manchester Academic Health Science CentreDivision of Nursing, Midwifery & Social Work, School of Health Sciences, Faculty of Biology, Medicine & HealthJean McFarlane BuildingOxford RoadManchesterUKM13 9PL
| | - Gill Norman
- University of Manchester, Manchester Academic Health Science CentreDivision of Nursing, Midwifery & Social Work, School of Health Sciences, Faculty of Biology, Medicine & HealthJean McFarlane BuildingOxford RoadManchesterUKM13 9PL
| | - Jo C Dumville
- University of Manchester, Manchester Academic Health Science CentreDivision of Nursing, Midwifery & Social Work, School of Health Sciences, Faculty of Biology, Medicine & HealthJean McFarlane BuildingOxford RoadManchesterUKM13 9PL
| | - Nikki Stubbs
- Leeds Community Healthcare NHS Trust, St Mary's HospitalWound Prevention and Management Service3 Greenhill RoadLeedsUKLS12 3QE
| | - Nicky Cullum
- University of Manchester, Manchester Academic Health Science CentreDivision of Nursing, Midwifery & Social Work, School of Health Sciences, Faculty of Biology, Medicine & HealthJean McFarlane BuildingOxford RoadManchesterUKM13 9PL
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35
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Oxidized (non)-regenerated cellulose affects fundamental cellular processes of wound healing. Sci Rep 2016; 6:32238. [PMID: 27557881 PMCID: PMC4997603 DOI: 10.1038/srep32238] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 08/03/2016] [Indexed: 11/16/2022] Open
Abstract
In this study we investigated how hemostats such as oxidized regenerated cellulose (ORC, TABOTAMP) and oxidized non-regenerated cellulose (ONRC, RESORBA CELL) influence local cellular behavior and contraction of the extracellular matrix (ECM). Human stromal fibroblasts were inoculated in vitro with ORC and ONRC. Cell proliferation was assayed over time, and migration was evaluated by Live Cell imaging microscopy. Fibroblasts grown in collagen-gels were treated with ORC or ONRC, and ECM contraction was measured utilizing a contraction assay. An absolute pH decline was observed with both ORC and ONRC after 1 hour. Mean daily cell proliferation, migration and matrix contraction were more strongly inhibited by ONRC when compared with ORC (p < 0.05). When control media was pH-lowered to match the lower pH values typically seen with ORC and ONRC, significant differences in cell proliferation and migration were still observed between ONRC and ORC (p < 0.05). However, in these pH conditions, inhibition of matrix contraction was only significant for ONRC (p < 0.05). We find that ORC and ONRC inhibit fibroblast proliferation, migration and matrix contraction, and stronger inhibition of these essential cellular processes of wound healing were observed for ONRC when compared with ORC. These results will require further validation in future in vivo experiments to clarify the clinical implications for hemostat use in post-surgical wound healing.
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Dickinson LE, Gerecht S. Engineered Biopolymeric Scaffolds for Chronic Wound Healing. Front Physiol 2016; 7:341. [PMID: 27547189 PMCID: PMC4975021 DOI: 10.3389/fphys.2016.00341] [Citation(s) in RCA: 120] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 07/22/2016] [Indexed: 12/13/2022] Open
Abstract
Skin regeneration requires the coordinated integration of concomitant biological and molecular events in the extracellular wound environment during overlapping phases of inflammation, proliferation, and matrix remodeling. This process is highly efficient during normal wound healing. However, chronic wounds fail to progress through the ordered and reparative wound healing process and are unable to heal, requiring long-term treatment at high costs. There are many advanced skin substitutes, which mostly comprise bioactive dressings containing mammalian derived matrix components, and/or human cells, in clinical use. However, it is presently hypothesized that no treatment significantly outperforms the others. To address this unmet challenge, recent research has focused on developing innovative acellular biopolymeric scaffolds as more efficacious wound healing therapies. These biomaterial-based skin substitutes are precisely engineered and fine-tuned to recapitulate aspects of the wound healing milieu and target specific events in the wound healing cascade to facilitate complete skin repair with restored function and tissue integrity. This mini-review will provide a brief overview of chronic wound healing and current skin substitute treatment strategies while focusing on recent engineering approaches that regenerate skin using synthetic, biopolymeric scaffolds. We discuss key polymeric scaffold design criteria, including degradation, biocompatibility, and microstructure, and how they translate to inductive microenvironments that stimulate cell infiltration and vascularization to enhance chronic wound healing. As healthcare moves toward precision medicine-based strategies, the potential and therapeutic implications of synthetic, biopolymeric scaffolds as tunable treatment modalities for chronic wounds will be considered.
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Affiliation(s)
| | - Sharon Gerecht
- Department of Chemical and Biomolecular Engineering, Institute for NanoBioTechnology, Johns Hopkins University Baltimore, MD, USA
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Sharma PR, Kamble S, Sarkar D, Anand A, Varma AJ. Shape and size engineered cellulosic nanomaterials as broad spectrum anti-microbial compounds. Int J Biol Macromol 2016; 87:460-5. [DOI: 10.1016/j.ijbiomac.2016.02.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Revised: 01/28/2016] [Accepted: 02/08/2016] [Indexed: 02/04/2023]
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Khamaisi M, Katagiri S, Keenan H, Park K, Maeda Y, Li Q, Qi W, Thomou T, Eschuk D, Tellechea A, Veves A, Huang C, Orgill DP, Wagers A, King GL. PKCδ inhibition normalizes the wound-healing capacity of diabetic human fibroblasts. J Clin Invest 2016; 126:837-53. [PMID: 26808499 DOI: 10.1172/jci82788] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 12/08/2015] [Indexed: 12/21/2022] Open
Abstract
Abnormal fibroblast function underlies poor wound healing in patients with diabetes; however, the mechanisms that impair wound healing are poorly defined. Here, we evaluated fibroblasts from individuals who had type 1 diabetes (T1D) for 50 years or more (Medalists, n = 26) and from age-matched controls (n = 7). Compared with those from controls, Medalist fibroblasts demonstrated a reduced migration response to insulin, lower VEGF expression, and less phosphorylated AKT (p-AKT), but not p-ERK, activation. Medalist fibroblasts were also functionally less effective at wound closure in nude mice. Activation of the δ isoform of protein kinase C (PKCδ) was increased in postmortem fibroblasts from Medalists, fibroblasts from living T1D subjects, biopsies of active wounds of living T1D subjects, and granulation tissues from mice with streptozotocin-induced diabetes. Diabetes-induced PKCD mRNA expression was related to a 2-fold increase in the mRNA half-life. Pharmacologic inhibition and siRNA-mediated knockdown of PKCδ or expression of a dominant-negative isoform restored insulin signaling of p-AKT and VEGF expression in vitro and improved wound healing in vivo. Additionally, increasing PKCδ expression in control fibroblasts produced the same abnormalities as those seen in Medalist fibroblasts. Our results indicate that persistent PKCδ elevation in fibroblasts from diabetic patients inhibits insulin signaling and function to impair wound healing and suggest PKCδ inhibition as a potential therapy to improve wound healing in diabetic patients.
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Cheng W, Li H, Zheng X, Chen L, Cheng F, He J, Liu K, Cai P, Wang X, Huang Y. Processing, characterization and hemostatic mechanism of a ultraporous collagen/ORC biodegradable composite with excellent biological effectiveness. Phys Chem Chem Phys 2016; 18:29183-29191. [DOI: 10.1039/c6cp01374k] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
To overcome the hemostatic limitations, ultraporous Col/ORC composites were prepared in this paper.
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Gould LJ. Topical Collagen-Based Biomaterials for Chronic Wounds: Rationale and Clinical Application. Adv Wound Care (New Rochelle) 2016; 5:19-31. [PMID: 26858912 DOI: 10.1089/wound.2014.0595] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Significance: The extracellular matrix (ECM) is known to be deficient in chronic wounds. Collagen is the major protein in the ECM. Many claims are made while extolling the virtues of collagen-based biomaterials in promoting cell growth and modulating matrix metalloproteinases. This review will explore the rationale for using topical collagen or ECM as an interface for healing. Recent Advances: Rapid improvements in electrospinning and nanotechnology have resulted in the creation of third-generation biomaterials that mimic the native ECM, stimulate cellular and genetic responses in the target tissue, and provide a platform for controlled release of bioactive molecules and live cells. Although the major focus is currently on development of artificial tissues and organ regeneration, better understanding of the mechanisms that stimulate wound healing can be applied to specific deficits in the chronic wound. Critical Issues: When choosing between the various advanced wound-care products and dressings, the clinician is challenged to select the most appropriate material at the right time. Understanding how the ECM components promote tissue regeneration and modulate the wound microenvironment will facilitate those choices. Laboratory discoveries of biomolecular and cellular strategies that promote skin regeneration rather than repair should be demonstrated to translate to deficits in the chronic wound. Future Directions: Cost-effective production of materials that utilize non-mammalian sources of collagen or ECM components combined with synthetic scaffolding will provide an optimal structure for cellular ingrowth and modulation of the chronic wound microenvironment to facilitate healing. These bioengineered materials will be customizable to provide time-released delivery of bioactive molecules or drugs based on the degradation rate of the scaffold or specific signals from the wound.
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Affiliation(s)
- Lisa J. Gould
- Wound Recovery and Hyperbaric Medicine Center, Kent Hospital, Warwick, Rhode Island
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41
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Westby MJ, Dumville JC, Stubbs N, Norman G, Cullum N. Protease-modulating matrix treatments for healing venous leg ulcers. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2015. [DOI: 10.1002/14651858.cd011918] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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42
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Franceschini G, Visconti G, Sanchez AM, Di Leone A, Salgarello M, Masetti R. Oxidized regenerated cellulose in breast surgery: experimental model. J Surg Res 2015; 198:237-44. [DOI: 10.1016/j.jss.2015.05.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Revised: 04/20/2015] [Accepted: 05/07/2015] [Indexed: 12/22/2022]
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Basagaoglu Demirekin Z, Aydemir Sezer U, Ulusoy Karatopuk D, Sezer S. Development of Metal Ion Binded Oxidized Regenerated Cellulose Powder as Hemostatic Agent: A Comparative Study with in Vivo Performance. Ind Eng Chem Res 2015. [DOI: 10.1021/ie504985b] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Zeynep Basagaoglu Demirekin
- Faculty of Dentistry, Department of Prosthodontics and ‡Faculty of Medicine,
Department of
Histology and Embryology, Suleyman Demirel University, 32260 Isparta, Turkey
- Materials
Institute and ⊥Chemistry Institute, TUBITAK Marmara Research Center, 41470 Kocaeli, Turkey
| | - Umran Aydemir Sezer
- Faculty of Dentistry, Department of Prosthodontics and ‡Faculty of Medicine,
Department of
Histology and Embryology, Suleyman Demirel University, 32260 Isparta, Turkey
- Materials
Institute and ⊥Chemistry Institute, TUBITAK Marmara Research Center, 41470 Kocaeli, Turkey
| | - Dilek Ulusoy Karatopuk
- Faculty of Dentistry, Department of Prosthodontics and ‡Faculty of Medicine,
Department of
Histology and Embryology, Suleyman Demirel University, 32260 Isparta, Turkey
- Materials
Institute and ⊥Chemistry Institute, TUBITAK Marmara Research Center, 41470 Kocaeli, Turkey
| | - Serdar Sezer
- Faculty of Dentistry, Department of Prosthodontics and ‡Faculty of Medicine,
Department of
Histology and Embryology, Suleyman Demirel University, 32260 Isparta, Turkey
- Materials
Institute and ⊥Chemistry Institute, TUBITAK Marmara Research Center, 41470 Kocaeli, Turkey
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Ding C, Zhang M, Li G. Preparation and characterization of collagen/hydroxypropyl methylcellulose (HPMC) blend film. Carbohydr Polym 2015; 119:194-201. [DOI: 10.1016/j.carbpol.2014.11.057] [Citation(s) in RCA: 137] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 08/30/2014] [Accepted: 11/26/2014] [Indexed: 11/15/2022]
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45
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Peršin Z, Maver U, Pivec T, Maver T, Vesel A, Mozetič M, Stana-Kleinschek K. Novel cellulose based materials for safe and efficient wound treatment. Carbohydr Polym 2014; 100:55-64. [DOI: 10.1016/j.carbpol.2013.03.082] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Revised: 02/27/2013] [Accepted: 03/25/2013] [Indexed: 12/25/2022]
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46
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Hua K, Carlsson DO, Ålander E, Lindström T, Strømme M, Mihranyan A, Ferraz N. Translational study between structure and biological response of nanocellulose from wood and green algae. RSC Adv 2014. [DOI: 10.1039/c3ra45553j] [Citation(s) in RCA: 104] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
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47
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Synthesis and properties of regenerated cellulose-based hydrogels with high strength and transparency for potential use as an ocular bandage. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2013; 33:3069-76. [DOI: 10.1016/j.msec.2013.03.037] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Revised: 03/16/2013] [Accepted: 03/24/2013] [Indexed: 11/19/2022]
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48
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McCarty SM, Percival SL, Clegg PD, Cochrane CA. The role of polyphosphates in the sequestration of matrix metalloproteinases. Int Wound J 2013; 12:89-99. [PMID: 23590276 DOI: 10.1111/iwj.12058] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2012] [Revised: 01/02/2013] [Accepted: 01/28/2013] [Indexed: 11/26/2022] Open
Abstract
This study outlines the potential of a novel therapeutic dressing for the management of chronic wounds. The dressing incorporates polyphosphate, a non toxic compound with a number of beneficial characteristics in terms of wound healing, in a foam matrix. The aim of this study was to identify the potential of polyphosphate incorporated in the foam dressing to sequester the activity of matrix metalloproteinases (MMPs) and proteases derived from Pseudomonas aeruginosa. Methods used included gelatin zymography and milk-casein agar plate analysis. Results have shown that this dressing is effectively capable of reducing the levels of MMP-2 and MMP-9 in both their active and latent forms using an in vitro model. The dressing also demonstrated the compound's potential in the regulation of P. aeruginosa derived proteases.
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Affiliation(s)
- Sara M McCarty
- Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK
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Gottrup F, Cullen BM, Karlsmark T, Bischoff-Mikkelsen M, Nisbet L, Gibson MC. Randomized controlled trial on collagen/oxidized regenerated cellulose/silver treatment. Wound Repair Regen 2013; 21:216-25. [PMID: 23438054 DOI: 10.1111/wrr.12020] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2012] [Accepted: 11/07/2012] [Indexed: 01/13/2023]
Abstract
Collagen/oxidized regenerated cellulose (ORC)/silver therapy has been designed to facilitate wound healing by normalizing the microenvironment and correcting biochemical imbalances in chronic wounds. The aim of this study was to compare collagen/ORC/silver therapy to control (standard treatment). Patients with diabetic foot ulcers were randomized to either collagen/ORC/silver (24) or control treatment (15). Wound area measurements and wound fluid samples were taken weekly. Protease levels were measured in wound fluid samples to investigate differences between responders (≥50% reduction in wound area by week 4) and nonresponders (<50% reduction in wound area by week 4). There were significantly more responders in the collagen/ORC/silver group compared with the control group (79% vs. 43%, p = 0.035). There were significantly fewer withdrawals from the study because of infection in the collagen/ORC/silver group compared with the control group (0% vs. 31%, p = 0.012). The sum of matrix metalloproteinase-9 and elastase concentration was higher in nonresponders compared with responders at baseline (p = 0.0705) and week 4 (p = 0.012). The results suggest that collagen/ORC/silver normalizes the wound microenvironment and protects against infection, resulting in improved wound healing. It was also demonstrated that measuring a combination of proteases may be a more relevant prognostic healing marker than any individual protease alone.
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Affiliation(s)
- Finn Gottrup
- Copenhagen Wound Healing Center, Department of Dermatology, Bispebjerg University Hospital, Copenhagen
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Dugan JM, Collins RF, Gough JE, Eichhorn SJ. Oriented surfaces of adsorbed cellulose nanowhiskers promote skeletal muscle myogenesis. Acta Biomater 2013; 9:4707-15. [PMID: 22963849 DOI: 10.1016/j.actbio.2012.08.050] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2012] [Revised: 08/22/2012] [Accepted: 08/31/2012] [Indexed: 01/17/2023]
Abstract
Cellulose nanowhiskers (CNWs) are high-aspect-ratio rod-like nanoparticles prepared via partial hydrolysis of cellulose. For the first time, CNWs have been extracted from the marine invertebrate Ascidiella aspersa, yielding animal-derived CNWs with particularly small diameters of only a few nanometres. Oriented surfaces of adsorbed CNWs were prepared using a flexible and facile spin-coating method, allowing the modulation of CNW adsorption and relative orientation. Due to the shape and nanoscale dimensions of the CNWs, C2C12 myoblasts adopted increasingly oriented morphologies in response to more densely adsorbed and oriented CNW surfaces. In addition, the degree of myoblast fusion was greatest on the highly oriented CNW surfaces, and even low-orientation CNW surfaces promoted more extensive fusion than flat control surfaces. Highly oriented multinuclear myotubes formed on the oriented CNW surfaces and fibrillar fibronectin deposited on the surfaces was also modelled in a highly oriented arrangement after only 4 days in culture. With a mean feature height of only 5-6 nm, the CNW surfaces present the smallest features ever reported to induce contact guidance in skeletal muscle myoblasts, highlighting the potential for nanoscale materials for engineering oriented tissues such as skeletal muscle.
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