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da Cruz Nizer WS, Adams ME, Allison KN, Montgomery MC, Mosher H, Cassol E, Overhage J. Oxidative stress responses in biofilms. Biofilm 2024; 7:100203. [PMID: 38827632 PMCID: PMC11139773 DOI: 10.1016/j.bioflm.2024.100203] [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: 02/28/2024] [Revised: 05/22/2024] [Accepted: 05/22/2024] [Indexed: 06/04/2024] Open
Abstract
Oxidizing agents are low-molecular-weight molecules that oxidize other substances by accepting electrons from them. They include reactive oxygen species (ROS), such as superoxide anions (O2-), hydrogen peroxide (H2O2), and hydroxyl radicals (HO-), and reactive chlorine species (RCS) including sodium hypochlorite (NaOCl) and its active ingredient hypochlorous acid (HOCl), and chloramines. Bacteria encounter oxidizing agents in many different environments and from diverse sources. Among them, they can be produced endogenously by aerobic respiration or exogenously by the use of disinfectants and cleaning agents, as well as by the mammalian immune system. Furthermore, human activities like industrial effluent pollution, agricultural runoff, and environmental activities like volcanic eruptions and photosynthesis are also sources of oxidants. Despite their antimicrobial effects, bacteria have developed many mechanisms to resist the damage caused by these toxic molecules. Previous research has demonstrated that growing as a biofilm particularly enhances bacterial survival against oxidizing agents. This review aims to summarize the current knowledge on the resistance mechanisms employed by bacterial biofilms against ROS and RCS, focussing on the most important mechanisms, including the formation of biofilms in response to oxidative stressors, the biofilm matrix as a protective barrier, the importance of detoxifying enzymes, and increased protection within multi-species biofilm communities. Understanding the complexity of bacterial responses against oxidative stress will provide valuable insights for potential therapeutic interventions and biofilm control strategies in diverse bacterial species.
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Affiliation(s)
| | - Madison Elisabeth Adams
- Department of Health Sciences, Carleton University, 1125 Colonel By Drive, Ottawa, K1S 5B6, ON, Canada
| | - Kira Noelle Allison
- Department of Health Sciences, Carleton University, 1125 Colonel By Drive, Ottawa, K1S 5B6, ON, Canada
| | | | - Hailey Mosher
- Department of Health Sciences, Carleton University, 1125 Colonel By Drive, Ottawa, K1S 5B6, ON, Canada
| | - Edana Cassol
- Department of Health Sciences, Carleton University, 1125 Colonel By Drive, Ottawa, K1S 5B6, ON, Canada
| | - Joerg Overhage
- Department of Health Sciences, Carleton University, 1125 Colonel By Drive, Ottawa, K1S 5B6, ON, Canada
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van Zyl EM, Coburn JM. Functionalization of Bacterial Cellulose with the Antimicrobial Peptide KR-12 via Chimerical Cellulose-Binding Peptides. Int J Mol Sci 2024; 25:1462. [PMID: 38338739 PMCID: PMC10855235 DOI: 10.3390/ijms25031462] [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: 12/19/2023] [Revised: 01/16/2024] [Accepted: 01/20/2024] [Indexed: 02/12/2024] Open
Abstract
Bacterial-derived cellulose (BC) has been studied as a promising material for biomedical applications, including wound care, due to its biocompatibility, water-holding capacity, liquid/gas permeability, and handleability properties. Although BC has been studied as a dressing material for cutaneous wounds, to date, BC inherently lacks antibacterial properties. The current research utilizes bifunctional chimeric peptides containing carbohydrate binding peptides (CBP; either a short version or a long version) and an antimicrobial peptide (AMP), KR-12. The secondary structure of the chimeric peptides was evaluated and confirmed that the α-helix structure of KR-12 was retained for both chimeric peptides evaluated (Long-CBP-KR12 and Short-CBP-KR12). Chimeric peptides and their individual components were assessed for cytotoxicity, where only higher concentrations of Short-CBP and longer timepoints of Short-CBP-KR12 exposure exhibited negative effects on metabolic activity, which was attributed to solubility issues. All KR-12-containing peptides exhibited antibacterial activity in solution against Escherichia coli (E. coli) and Pseudomonas aeruginosa (P. aeruginosa). The lipopolysaccharide (LPS) binding capability of the peptides was evaluated and the Short-CBP-KR12 peptide exhibited enhanced LPS-binding capabilities compared to KR-12 alone. Both chimeric peptides were able to bind to BC and were observed to be retained on the surface over a 7-day period. All functionalized materials exhibited no adverse effects on the metabolic activity of both normal human dermal fibroblasts (NHDFs) and human epidermal keratinocyte (HaCaT) epithelial cells. Additionally, the BC tethered chimeric peptides exhibited antibacterial activity against E. coli. Overall, this research outlines the design and evaluation of chimeric CBP-KR12 peptides for developing antimicrobial BC membranes with potential applications in wound care.
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Affiliation(s)
| | - Jeannine M. Coburn
- Department of Biomedical Engineering, Worcester Polytechnic Institute, Worcester, MA 01609, USA
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Autologous adipose-derived stromal vascular fraction and platelet concentrates for the treatment of complex perianal fistulas. Tech Coloproctol 2023; 27:135-143. [PMID: 36063257 PMCID: PMC9839808 DOI: 10.1007/s10151-022-02675-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 07/27/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Complex perianal fistulas are a major challenge for modern surgery since 10-35% of patients have functional problems after treatment. Sphincter-saving techniques have a wide range of efficacy (10-80%). We hypothesised that autologous adipose-derived stromal vascular fraction in combination with platelet rich plasma is a new therapeutic strategy with enhanced cure and function preservation rates. METHODS Adult patients with complex cryptoglandular perianal fistulas were treated with injection of autologous adipose-derived stromal vascular fraction in combination with platelet rich plasma around and inside the fistulous tract between May 2018 and April 2019 at the General and Emergency Surgery Operative Unit of the University Hospital "P. Giaccone" of Palermo. Fistulas were confirmed by magnetic resonance imaging. Patients completed the Short Form-36 score on quality of life and the Wexner and Vaizey scores on faecal incontinence, and they were functionally studied using a three-dimensional anorectal manometry. The clinical and functional follow-up was performed at 1 year and 2 years after surgery. RESULTS Nine patients (4 males, 5 females; median age 42 years [19-63 years]) with high trans-sphincteric or horseshoe fistulas were treated. The average number of previous surgeries per patient was 4.8. At 1 year follow-up, 77.7% of patients were cured, while at 2 years there was 1case of relapse. The variation in Short Form-36 score in cured patients was not significant (p = 0.0936). No statistically significant differences were found in continence scores. CONCLUSIONS The proposed treatment is a treatment option that preserves sphincter integrity and function, potentially avoiding postoperative incontinence and the need of repeated treatments.
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Histopathological Evaluation of the Healing Process of Standardized Skin Burns in Rabbits: Assessment of a Natural Product with Honey and Essential Oils. J Clin Med 2022; 11:jcm11216417. [DOI: 10.3390/jcm11216417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/16/2022] [Accepted: 10/27/2022] [Indexed: 11/16/2022] Open
Abstract
Skin burns are one of the most difficult medical problems. Recently, studies have been directed towards development of natural products in order to identify effective and safe remedies. In the present study, we evaluated the efficacy of a natural composite (formulated from honey and essential oils) compared with MEBO® (0.25% β-sitosterol) and DERMAZIN® creams (1% silver-sulfadiazine) in the treatment of thermally induced skin burns. For this purpose, four burn-wounds were created on the back of male New Zealand rabbits (n = 10) using a thermal stamp under the effect of general anesthesia. Each wound represents one of the following groups: non-treated, natural composite-cream, MEBO®-cream, and silver-sulfadiazine treated groups, respectively. Treatments were applied once a day topically until one of these wounds appeared to be healed grossly. The non-treated group received no treatment. Grossly, skin burns have been healed after 28 days of the treatment in all groups except of the non-treated group. The healing efficacy of the natural composite, MEBO® and silver-sulfadiazine creams was quite similar macroscopically. However, microscopically, the epidermal layer of the composite-cream treated group was more mature than those of both MEBO® and silver-sulfadiazine creams treated groups. In conclusion, the tested composite may be a promising effective and inexpensive treatment of skin burns.
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Müller-Heupt LK, Wiesmann N, Schröder S, Korkmaz Y, Vierengel N, Groß J, Dahm R, Deschner J, Opatz T, Brieger J, Al-Nawas B, Kämmerer PW. Extracts of Rheum palmatum and Aloe vera Show Beneficial Properties for the Synergistic Improvement of Oral Wound Healing. Pharmaceutics 2022; 14:pharmaceutics14102060. [PMID: 36297494 PMCID: PMC9610717 DOI: 10.3390/pharmaceutics14102060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 09/16/2022] [Accepted: 09/22/2022] [Indexed: 11/29/2022] Open
Abstract
Various local and systemic factors compromise oral wound healing and may lead to wound dehiscence, inflammation, or ulcers. Currently, there is a lack of topical therapeutical options. Thus, this study aimed to investigate the effect of Aloe vera (AV) and Rheum palmatum root (RPR) on oral wound healing capacity in vitro. The effect of AV and RPR on human primary fibroblast viability and migration was studied by measuring metabolic activity and gap closure in a scratch assay. Furthermore, cell cycle distribution and cytoskeletal features were analyzed. Antimicrobial activity against the oral pathogen Porphyromonas gingivalis was evaluated by broth microdilution assay. AV and RPR increased fibroblast migration after single agent treatment. Synergistic effects of the plant extract combination were observed regarding cellular migration which were confirmed by calculation of the phenomenological combination index (pCI), whereas the cell cycle distribution was not influenced. Furthermore, the combination of AV and RPR showed synergistic antibacterial effects as determined by the fractional inhibitory concentration index. This study demonstrated that the combination of AV and RPR can promote the migration of human primary fibroblasts in vitro and exert antimicrobial efficacy against P. gingivalis, suggesting these compounds for the topical treatment of wound healing disorders.
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Affiliation(s)
- Lena Katharina Müller-Heupt
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
- Correspondence: ; Tel.: +49-6131-17-5086
| | - Nadine Wiesmann
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
- Department of Otorhinolaryngology, University Medical Center Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Sofia Schröder
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - Yüksel Korkmaz
- Department of Periodontology and Operative Dentistry, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - Nina Vierengel
- Department of Chemistry, Johannes Gutenberg-University, Duesbergweg 10-14, 55128 Mainz, Germany
| | - Jonathan Groß
- Department of Chemistry, Johannes Gutenberg-University, Duesbergweg 10-14, 55128 Mainz, Germany
| | - Rolf Dahm
- Beratung für Informationssysteme und Systemintegration, Gärtnergasse 1, 55116 Mainz, Germany
| | - James Deschner
- Department of Periodontology and Operative Dentistry, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - Till Opatz
- Department of Chemistry, Johannes Gutenberg-University, Duesbergweg 10-14, 55128 Mainz, Germany
| | - Juergen Brieger
- Department of Otorhinolaryngology, University Medical Center Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Bilal Al-Nawas
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - Peer W. Kämmerer
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
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Cheong JZA, Liu A, Rust CJ, Tran CL, Hassan SE, Kalan LR, Gibson ALF. Robbing Peter to Pay Paul: Chlorhexidine gluconate demonstrates short-term efficacy and long-term cytotoxicity. Wound Repair Regen 2022; 30:573-584. [PMID: 36638156 PMCID: PMC9542784 DOI: 10.1111/wrr.13044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/30/2022] [Accepted: 07/11/2022] [Indexed: 01/27/2023]
Abstract
Wound cleansing agents are routine in wound care and preoperative preparation. Antiseptic activity intends to prevent contaminating microbes from establishing an infection while also raising concerns of cytotoxicity and delayed wound healing. We evaluated the cytotoxicity of five clinically used wound cleaning agents (saline, povidone iodine, Dove® and Dial® soaps, and chlorhexidine gluconate [CHG]) using both an ex vivo and in vivo human skin xenograft mouse model, in contrast to classical in vitro models that lack the structural and compositional heterogeneity of human skin. We further established an ex vivo wound contamination model inoculated with ~100 cells of Pseudomonas aeruginosa or Staphylococcus aureus to evaluate antimicrobial efficacy. Scanning electron microscopy and confocal microscopy were used to evaluate phenotypic and spatial characteristics of bacterial cells in wound tissue. CHG significantly reduced metabolic activity of the skin explants, while all treatments except saline affected local cellular viability. CHG cytotoxicity persisted and progressed over 14 days, impairing wound healing in vivo. Within the contamination model, CHG treatment resulted in a significant reduction of P. aeruginosa wound surface counts at 24 h post-treatment. However, this effect was transient and serial application of CHG had no effect on both P. aeruginosa or S. aureus microbial growth. Microscopy revealed that viable cells of P. aeruginosa reside deep within wound tissue post-CHG application, likely serving as a reservoir to re-populate the tissue to a high bioburden. We reveal concerning cytotoxicity and limited antimicrobial activity of CHG in human skin using clinically relevant models, with the ability to resolve spatial localization and temporal dynamics of tissue viability and microbial growth.
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Affiliation(s)
- J. Z. Alex Cheong
- Department of Medical Microbiology and ImmunologyUniversity of Wisconsin–Madison, School of Medicine and Public HealthMadisonWisconsinUSA
- Microbiology Doctoral Training ProgramUniversity of Wisconsin–MadisonMadisonWisconsinUSA
| | - Aiping Liu
- Department of SurgeryUniversity of Wisconsin–Madison, School of Medicine and Public HealthMadisonWisconsinUSA
| | - Clayton J. Rust
- Department of SurgeryUniversity of Wisconsin–Madison, School of Medicine and Public HealthMadisonWisconsinUSA
| | - Collin L. Tran
- Department of SurgeryUniversity of Wisconsin–Madison, School of Medicine and Public HealthMadisonWisconsinUSA
| | - Sameeha E. Hassan
- Department of SurgeryUniversity of Wisconsin–Madison, School of Medicine and Public HealthMadisonWisconsinUSA
| | - Lindsay R. Kalan
- Department of Medical Microbiology and ImmunologyUniversity of Wisconsin–Madison, School of Medicine and Public HealthMadisonWisconsinUSA
- Department of Medicine, Division of Infectious DiseaseUniversity of Wisconsin–Madison, School of Medicine and Public HealthMadisonWisconsinUSA
| | - Angela L. F. Gibson
- Department of SurgeryUniversity of Wisconsin–Madison, School of Medicine and Public HealthMadisonWisconsinUSA
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Pen Hung DC, Yung Tan DH. Meticillin-susceptible Staphylococcus aureus pyomyositis and cellulitis in right thigh of a 15-year-old boy: a case study. J Wound Care 2022; 31:S22-S28. [PMID: 36004941 DOI: 10.12968/jowc.2022.31.sup8.s22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Pyomyositis is a purulent infection of striated muscle and postoperative management remains the mainstay. If delayed primary wound closure is not managed in a timely manner, it often results in recurrent infection and sinus tract creation. Cavity wounds with sinus formation are known to complicate treatment, are problematic to manage and persist for long periods of time. The aim of this case report is to present the challenges in the assessment and management of a sinus tract with deep cavity wound, between the vastus lateralis and biceps femoris muscles, originating from liquefaction of a haematoma. Our review of the literature revealed limited research evidence in the management of deep cavity wounds. This is a rare case where the sinus tract route which leads to the rim-shaped cavity is embedded deep between the muscles, posing a high risk of recurrent infection from the premature closure of the wound tract. Successful management was attributed to: the accuracy in the initial wound assessment; appropriate dressing plans; the rationale for each action; and an outcome goal as each treatment progressed. Daily dressing change and reassessment of the wound was required to ensure progress and to address any complications in a timely manner. Finally, concerns of the patient and their family and regular discussions on the treatment plans are important to encourage adherence with management goals.
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Clinical and cytological assessment of platelet-rich fibrin versus topical ozonated oil in palatal wound healing after free gingival graft harvesting: Randomized controlled trial. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, MEDICINE, AND PATHOLOGY 2022. [DOI: 10.1016/j.ajoms.2021.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Cytotoxicity and Wound Closure Evaluation in Skin Cell Lines after Treatment with Common Antiseptics for Clinical Use. Cells 2022; 11:cells11091395. [PMID: 35563705 PMCID: PMC9099882 DOI: 10.3390/cells11091395] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 04/07/2022] [Accepted: 04/18/2022] [Indexed: 02/06/2023] Open
Abstract
In recent years, new therapies, such as skin cell lines injections, have emerged to promote re-epithelialization of damaged areas such as chronic ulcers or to treat patients with severe burns. Antiseptics are commonly used during wound clinical management to avoid serious infections, but they may delay the healing process due to their apparent cytotoxicity to skin cells. The cytotoxicity of ethanol, chlorhexidine digluconate, sodium hypochlorite, povidone iodine and polyhexanide was evaluated in this in vitro study on human fibroblasts and keratinocytes. Treatments were applied to each cell type culture every 48 h for 14 days. To determine the cytotoxic of antiseptics, cell viability (Live/Dead®) and cell proliferation (AlamarBlue™) assays were performed on cell monolayers. Cell migration capacity was evaluated with a wound closure assay. Results showed how chlorhexidine digluconate and ethanol significantly reduced the viability of keratinocytes and inhibited cell migration. Povidone iodine followed by chlorhexidine digluconate significantly reduced fibroblast cell viability. Povidone iodine also inhibited cell migration. Sodium hypochlorite was the least detrimental to both cell types. If epithelial integrity is affected, the wound healing process may be altered, so the information gathered in this study may be useful in selecting the least aggressive antiseptic after treatment with new emerging therapies.
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Assorted Skin Procedures. Prim Care 2022; 49:47-62. [DOI: 10.1016/j.pop.2021.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Effect of dental antiseptic agents on the viability of human periodontal ligament cells. Saudi Dent J 2021; 33:904-911. [PMID: 34938032 PMCID: PMC8665172 DOI: 10.1016/j.sdentj.2021.09.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 05/18/2021] [Accepted: 09/05/2021] [Indexed: 01/09/2023] Open
Abstract
Cell viability is key for tissue regeneration. Dental antiseptics were cytotoxic in periodontal ligament cells. Real-time impedimetry proved to be a non-invasive method to monitor cell viability.
Objectives We aimed to study whether or not various dental antiseptic agents affect the viability and proliferation of human periodontal ligament cells (PDLCs). Materials and methods Human PDLCs were isolated from a total of 10 surgically extracted impacted third molars and were. cultured in-vitro. The cells were exposed to commonly used dental antiseptics, including chlorhexidine, cetylpyridinium chloride, triclosan, povidone-iodine and sodium bicarbonate for ultra-short-term (10, 20, 30 sec), short-term (10, 20, 30 min) and long-term (24, 48 h) at various concentrations. Cell morphology was observed with light microscopy. Cell viability was studied with impedimetric real-time xCELLigence and resazurin-based alamarBlue® assays. We used one-way ANOVA with Tukey’s and Bonferroni test (p < 0.05) for statistical analysis. Results Both alamarBlue® and xCELLigence analysis results were in agreement that ultra-short-term contact with cetylpyridinium chloride ≥ 0.01 mg/ml, chlorhexidine ≥ 1 mg/ml, triclosan ≥ 1 mg/ml and povidone-iodine ≥ 1 mg/ml as well as long-term exposure to cetylpyridinium chloride ≥ 0.001 mg/ml, chlorhexidine ≥ 0.01 mg/ml, triclosan ≥ 1 mg/ml, povidone-iodine ≥ 1 mg/ml and sodium bicarbonate ≥ 10 mg/ml was able to reduce the viability of human PDLCs significantly. According to the half-maximal inhibitory concentration (IC50) the rank of cytotoxicity was cetylpyridinium chloride > chlorhexidine > triclosan > povidone-iodine > sodium bicarbonate. Conclusions Our findings suggest that the tested antiseptic agents were cytotoxic to human PDLCs at lower than practically applied concentrations in dental interventions.
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Pilloni A, Ceccarelli S, Bosco D, Gerini G, Marchese C, Marini L, Rojas MA. Effect of Chlorhexidine Digluconate in Early Wound Healing of Human Gingival Tissues. A Histological, Immunohistochemical and Biomolecular Analysis. Antibiotics (Basel) 2021; 10:antibiotics10101192. [PMID: 34680773 PMCID: PMC8532903 DOI: 10.3390/antibiotics10101192] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 09/19/2021] [Accepted: 09/29/2021] [Indexed: 01/18/2023] Open
Abstract
Chlorhexidine digluconate (CHX) is considered the gold standard for oral cavity antiseptic treatment. Nevertheless, several in vitro studies have reported detrimental effects in oral tissue repair. The aim of the present study was to evaluate the in vivo effect of post-surgical CHX mouth rinse on gingival tissue (G) 24 h after injury. G biopsies were obtained in three patients 24 h after surgery with the indication of post-surgical 0.12% CHX use and were compared with those obtained from the same patients without any antiseptic use. Changes in collagen production, cell proliferation, and apoptosis were examined by histological and Ki-67/P53 immunohistochemical analysis. Fibrotic markers (COL1A1, αSMA), proapoptotic protein (BAX) expression, and wound healing-related gene modulation (RAC1, SERPINE1, TIMP1) were analyzed by quantitative real-time PCR analysis. CHX was able to reduce cellular proliferation and increase collagen deposition, proapoptotic molecule and fibrotic marker expression, and myofibroblast differentiation, reduce expression of RAC1 and trigger expression of SERPINE1 and TIMP1, showing “scar wound healing response” pattern. This study assessed for the first time the in vivo effects of CHX on gingival tissue. The demonstration of a CHX-induced fibrotic transformation, leading to scar repair, supports the need for new post-surgical clinical protocols based on a strategic and personalized use of CHX.
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Affiliation(s)
- Andrea Pilloni
- Department of Oral and Maxillofacial Sciences, Section of Periodontics, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (A.P.); (L.M.)
| | - Simona Ceccarelli
- Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161 Rome, Italy; (S.C.); (G.G.); (C.M.)
| | - Daniela Bosco
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy;
| | - Giulia Gerini
- Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161 Rome, Italy; (S.C.); (G.G.); (C.M.)
| | - Cinzia Marchese
- Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161 Rome, Italy; (S.C.); (G.G.); (C.M.)
| | - Lorenzo Marini
- Department of Oral and Maxillofacial Sciences, Section of Periodontics, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (A.P.); (L.M.)
| | - Mariana A. Rojas
- Department of Oral and Maxillofacial Sciences, Section of Periodontics, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (A.P.); (L.M.)
- Correspondence:
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Comparative evaluation of antimicrobial and anti-gingivitis effect of Ocimum tenuiflorum Linn. gel with 0.2% chlorhexidine gel – Randomized controlled clinical trial. J Herb Med 2021. [DOI: 10.1016/j.hermed.2021.100478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Rai S, Gupta TP, Shaki O, Kale A. Hydrogen Peroxide: Its Use in an Extensive Acute Wound to Promote Wound Granulation and Infection Control - Is it Better Than Normal Saline? INT J LOW EXTR WOUND 2021:15347346211032555. [PMID: 34338578 DOI: 10.1177/15347346211032555] [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] [Indexed: 01/22/2023]
Abstract
Background: Hydrogen peroxide (H2O2) is used as a topical antiseptic in contaminated wounds caused by road traffic accidents. It kills bacteria by producing oxidation through local, nascent, free oxygen radicals. It also removes dirt from the wound due to its frothing action. H2O2 is synthesized by various cells as an active biochemical agent that affects cell biological behavior through complex chemical reactions. H2O2 has also been used as a wound cleaning agent, removing debris, preventing infection, and causing hemostasis due to its exothermic reaction with blood. Despite its widespread use, there is scanty literature on its use to promote granulation tissue formation. Objective: In the orthopaedics literature, studies on H2O2 use are very limited and its potential is underestimated. In the present study, we would like to report our protocol of use of H2O2 for its tremendous potential for stimulating granulation and early wound healing. Material and Methods: A total of 53 patients with large acute extensive lower limb contaminated wounds reported to the emergency department have been included with and without lower limb fracture. In group A (43 patients) wound management was done using 7% H2O2 and group B (10 patients) was treated by only saline dressing as a control group. Results: In the present study, daily dressing by 7% H2O2 solution and provide solution gives excellent results compared to the Saline group. Granulation tissue appeared much earlier with a mean SD 6.3 ± 6.8 days in the hydrogen peroxide group as compared to the Saline group where granulation tissue appeared in 9.3 ± 8.4 days. Conclusion: Spontaneous wound healing is a controlled balance between destructive and healing processes. It is mandatory to remove damaged tissue to promote healing by secondary intention and minimize infection. The dynamic effect of H2O2 promotes faster healing, stimulates granulation, and minimizes infection by oxidative stress.
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Affiliation(s)
- Sanjay Rai
- Base Hospital Guwahati, Basistha Guwahati, India
| | | | - Omna Shaki
- Base Hospital Guwahati, Basistha Guwahati, India
| | - Amit Kale
- Base Hospital Guwahati, Basistha Guwahati, India
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Rippon MG, Rogers AA, Ousey K. Estrategias de protección antimicrobiana en el cuidado de heridas: evidencia para el uso de apósitos recubiertos con DACC. J Wound Care 2021; 30:21-35. [PMID: 34558974 DOI: 10.12968/jowc.2021.30.latam_sup_1.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Antimicrobial resistance (AMR) is one of the most serious health threats globally. The development of new antimicrobials is not keeping pace with the evolution of resistant microorganisms, and novel ways of tackling this problem are required. One of such initiatives has been the development of antimicrobial stewardship programmes (AMS). The use of wound dressings that employ a physical sequestration and retention approach to reduce bacterial burden offers a novel approach to support AMS. Bacterial-binding by dressings and their physical removal can minimise their damage and prevent the release of harmful endotoxins. OBJECTIVE To highlight AMS to promote the correct use of antimicrobials and to investigate how dialkylcarbamyl chloride (DACC)-coated dressings can support AMS. METHOD MEDLINE, Cochrane Database of Systematic Reviews, and Google Scholar were searched to identify articles relating to AMS, and the use of wound dressings in the prevention and treatment of wound infections. The evidence supporting alternative wound dressings that can reduce bioburden and prevent wound infection in a way that does not kill or damage the microorganisms were reviewed. RESULTS The evidence demonstrated that using bacterial-binding wound dressings that act in a physical manner (eg, DACC-coated dressings) to preventing infection in both acute and hard-to-heal wounds does not exacerbate AMR and supports AMS. CONCLUSION Some wound dressings work via a mechanism that promotes the binding and physical sequestration and removal of intact microorganisms from the wound bed (eg, a wound dressing that uses DACC technology to prevent/reduce infection). They provide a valuable tool that aligns with the requirements of AMS by effectively reducing wound bioburden without inducing/selecting for resistant bacteria.
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Affiliation(s)
| | | | - Karen Ousey
- Huddersfield University, Reino Unido.,School of Nursing, Faculty of Health at the Queensland University of Technology, Australia.,Royal College of Surgeons in Ireland, Dublin, Irlanda
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16
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Wu S, Liu Y, Lei L, Zhang H. Antisense yycG modulates the susceptibility of Staphylococcus aureus to hydrogen peroxide via the sarA. BMC Microbiol 2021; 21:160. [PMID: 34053439 PMCID: PMC8165985 DOI: 10.1186/s12866-021-02218-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 05/05/2021] [Indexed: 02/08/2023] Open
Abstract
Background The infectious pathogen Staphylococcus aureus (S. aureus) is primarily associated with osteomyelitis. Hydrogen peroxide drainage is an effective antimicrobial treatment that has been adopted to combat S. aureus infections. Previous investigations have indicated that the antisense RNA (asRNA) strategy negatively modulates S. aureus YycFG TCS, and it significantly disrupts biofilm formation. However, the effects of the antisense yycG RNA (ASyycG) strategy on the susceptibility of biofilm-producing S. aureus to hydrogen peroxide and the mechanisms underlying this effect have not been elucidated to date. Results Overexpression of ASyycG inhibited the transcription of biofilm formation-related genes, including sarA and icaA. Additionally, the CFU counts and the live bacterial ratios of ASyycG biofilm-producing S. aureus treated with H2O2 were notably reduced across the groups. Notably, the predicted promoter regions of the sarA and icaA genes were directly regulated by YycF. Conclusions ASyycG was observed to sensitize biofilm-producing S. aureus to H2O2 intervention synergistically via the sarA and thus may represent a supplementary strategy for managing osteomyelitis. However, future in-depth studies should attempt to replicate our findings in animal models, such as the rat osteomyelitis model. Supplementary Information The online version contains supplementary material available at 10.1186/s12866-021-02218-x.
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Affiliation(s)
- Shizhou Wu
- Department of Orthopedics, West China Hospital, Sichuan University, No.37 Guoxue Alley, Sichuan, 610041, Chengdu, P.R. China
| | - Yunjie Liu
- West China School of Public Health, Sichuan University, Chengdu, China
| | - Lei Lei
- Department of Preventive Dentistry, Hospital of Stomatology, State Key Laboratory of Oral Diseases,, Sichuan University, NO.14 Third Section, Renmin South Road, Sichuan, 610041, Chengdu, P.R. China.
| | - Hui Zhang
- Department of Orthopedics, West China Hospital, Sichuan University, No.37 Guoxue Alley, Sichuan, 610041, Chengdu, P.R. China.
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17
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Banerjee K, Madhyastha R, Nakajima Y, Maruyama M, Madhyastha H. Nanoceutical Adjuvants as Wound Healing Material: Precepts and Prospects. Int J Mol Sci 2021; 22:4748. [PMID: 33947121 PMCID: PMC8124138 DOI: 10.3390/ijms22094748] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/26/2021] [Accepted: 04/27/2021] [Indexed: 02/07/2023] Open
Abstract
Dermal wound healing describes the progressive repair and recalcitrant mechanism of 12 damaged skin, and eventually, reformatting and reshaping the skin. Many probiotics, nutritional supplements, metal nanoparticles, composites, skin constructs, polymers, and so forth have been associated with the improved healing process of wounds. The exact mechanism of material-cellular interaction is a point of immense importance, particularly in pathological conditions such as diabetes. Bioengineered alternative agents will likely continue to dominate the outpatient and perioperative management of chronic, recalcitrant wounds as new products continue to cut costs and improve the wound healing process. This review article provides an update on the various remedies with confirmed wound healing activities of metal-based nanoceutical adjuvanted agents and also other nano-based counterparts from previous experiments conducted by various researchers.
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Affiliation(s)
- Kaushita Banerjee
- Department of Biomedical Sciences, School of Biosciences and Technology, Vellore Institute of Technology, Vellore 632014, India;
| | - Radha Madhyastha
- Department of Applied Physiology, Faculty of Medicine, University of Miyazaki, Miyazaki 8891692, Japan; (R.M.); (Y.N.); (M.M.)
| | - Yuichi Nakajima
- Department of Applied Physiology, Faculty of Medicine, University of Miyazaki, Miyazaki 8891692, Japan; (R.M.); (Y.N.); (M.M.)
| | - Masugi Maruyama
- Department of Applied Physiology, Faculty of Medicine, University of Miyazaki, Miyazaki 8891692, Japan; (R.M.); (Y.N.); (M.M.)
| | - Harishkumar Madhyastha
- Department of Applied Physiology, Faculty of Medicine, University of Miyazaki, Miyazaki 8891692, Japan; (R.M.); (Y.N.); (M.M.)
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18
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Rippon MG, Rogers AA, Ousey K. Antimicrobial stewardship strategies in wound care: evidence to support the use of dialkylcarbamoyl chloride (DACC)- coated wound dressings. J Wound Care 2021; 30:284-296. [PMID: 33856907 DOI: 10.12968/jowc.2021.30.4.284] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Traditionally, infections are treated with antimicrobials (for example, antibiotics, antiseptics, etc), but antimicrobial resistance (AMR) has become one of the most serious health threats of the 21st century (before the emergence of COVID-19). Wounds can be a source of infection by allowing unconstrained entry of microorganisms into the body, including antimicrobial-resistant bacteria. The development of new antimicrobials (particularly antibiotics) is not keeping pace with the evolution of resistant microorganisms and novel ways of addressing this problem are urgently required. One such initiative has been the development of antimicrobial stewardship (AMS) programmes, which educate healthcare workers, and control the prescribing and targeting of antimicrobials to reduce the likelihood of AMR. Of great importance has been the European Wound Management Association (EWMA) in supporting AMS by providing practical recommendations for optimising antimicrobial therapy for the treatment of wound infection. The use of wound dressings that use a physical sequestration and retention approach rather than antimicrobial agents to reduce bacterial burden offers a novel approach that supports AMS. Bacterial-binding by dressings and their physical removal, rather than active killing, minimises their damage and hence prevents the release of damaging endotoxins. AIM Our objective is to highlight AMS for the promotion of the judicious use of antimicrobials and to investigate how dialkylcarbamoyl chloride (DACC)-coated dressings can support AMS goals. METHOD MEDLINE, Cochrane Database of Systematic Reviews, and Google Scholar were searched to identify published articles describing data relating to AMS, and the use of a variety of wound dressings in the prevention and/or treatment of wound infections. The evidence supporting alternative wound dressings that can reduce bioburden and prevent and/or treat wound infection in a manner that does not kill or damage the microorganisms (for example, by actively binding and removing intact microorganisms from wounds) were then narratively reviewed. RESULTS The evidence reviewed here demonstrates that using bacterial-binding wound dressings that act in a physical manner (for example, DACC-coated dressings) as an alternative approach to preventing and/or treating infection in both acute and hard-to-heal wounds does not exacerbate AMR and supports AMS. CONCLUSION Some wound dressings work via a mechanism that promotes the binding and physical uptake, sequestration and removal of intact microorganisms from the wound bed (for example, a wound dressing that uses DACC technology to successfully prevent/reduce infection). They provide a valuable tool that aligns with the requirements of AMS (for example, reducing the use of antimicrobials in wound treatment regimens) by effectively reducing wound bioburden without inducing/selecting for resistant bacteria.
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Affiliation(s)
| | | | - Karen Ousey
- WoundCareSol Consultancy, UK.,School of Nursing, Faculty of Health at the Queensland University of Technology, Australia.,Royal College of Surgeons in Ireland, Dublin, Ireland
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19
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Webb DR, Churchill SR, Hill GD, McGee CA, Shi M, King-Herbert AP, Blankenship-Paris TL. Effects of Buprenorphine, Chlorhexidine, and Low-level Laser Therapy on Wound Healing in Mice. Comp Med 2021; 71:191-202. [PMID: 33863402 DOI: 10.30802/aalas-cm-20-000104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Systemic buprenorphine and topical antiseptics such as chlorhexidine are frequently used in research animals to aid in pain control and to reduce infection, respectively. These therapeutics are controversial, especially when used in wound healing studies, due to conflicting data suggesting that they delay wound healing. Low-level laser therapy (LLLT) has been used to aid in wound healing without exerting the systemic effects of therapies such as buprenorphine. We conducted 2 studies to investigate the effects of these common treatment modalities on the rate of wound healing in mice. The first study used models of punch biopsy and dermal abrasion to assess whether buprenorphine HCl or 0.12% chlorhexidine delayed wound healing. The second study investigated the effects of sustained-released buprenorphine, 0.05% chlorhexidine, and LLLT on excisional wound healing. The rate of wound healing was assessed by obtaining photographs on days 0, 2, 4, 7, and 9 for the punch biopsy model in study 1, days 0, 1, 2, 4, 6, 8, 11, and 13 for the dermal abrasion model in study 1, and days 0, 3, 6, and 10 for the mice in study 2. Image J software was used to analyze the photographed wounds to determine the wound area. When comparing the wound area on the above days to the original wound area, no significant differences in healing were observed for any of the treatment groups at any time period for either study. Given the results of these studies, we believe that systemic buprenorphine, topical chlorhexidine, and LLLT can be used without impairing or delaying wound healing in mice.
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Affiliation(s)
- Donna R Webb
- National Institute of Environmental Health Sciences, Comparative & Molecular Pathogenesis Branch, National Toxicology Program, Durham, North Carolina;,
| | | | - Georgette D Hill
- Integrated Laboratory Systems, LLC., Research Triangle Park, North Carolina
| | - Christopher A McGee
- National Institute of Environmental Health Sciences, Clinical Research Branch, Durham, North Carolina
| | - Min Shi
- National Institute of Environmental Health Sciences, Biostatistics & Computational Biology Branch, Durham, North Carolina
| | - Angela P King-Herbert
- National Institute of Environmental Health Sciences, Comparative & Molecular Pathogenesis Branch, National Toxicology Program, Durham, North Carolina
| | - Terry L Blankenship-Paris
- National Institute of Environmental Health Sciences, Comparative Medicine Branch, Durham, North Carolina
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20
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Faraji A, Aghdaki M, Hessami K, Hosseinkhani A, Roozmeh S, Asadi N, Vafaei H, Kasraeian M, Bagheri R, Bazrafshan K, Foroughinia L. Episiotomy wound healing by Commiphora myrrha (Nees) Engl. and Boswellia carteri Birdw. in primiparous women: A randomized controlled trial. JOURNAL OF ETHNOPHARMACOLOGY 2021; 264:113396. [PMID: 32971163 DOI: 10.1016/j.jep.2020.113396] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 07/15/2020] [Accepted: 09/15/2020] [Indexed: 06/11/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Traditional Persian medicine manuscripts refer to plants such as Commiphora myrrha (Nees) Engl. (myrrh) and Boswellia carteri Birdw. (frankincense), which could be used to improve wound healing process. Since that time, local midwives in Iran continue to provide these herbs to precipitate episiotomy wound healing. AIM OF THE STUDY To investigate the efficacy and safety of myrrh- and frankincense-based sitz-baths on episiotomy wound healing in primiparous women. MATERIALS AND METHODS This randomized controlled trial was conducted on 90 primiparous women with singleton pregnancies after normal vaginal delivery at Hafez hospital affiliated to Shiraz University of Medical Sciences from July to October 2019. Study participants were randomly allocated in three groups (2 intervention groups and 1 control group). Women in intervention groups were assigned to receive either 10-min sitz-bath of myrrh extract or frankincense extract twice a day for 1 week. While the women in control group received the betadine sitz-bath for the same period of time. The main outcome was the episiotomy wound healing, which was measured using the REEDA scale before intervention, on 2nd and 7th postpartum days. RESULTS An improvement in the episiotomy wound healing was significantly greater in patients receiving myrrh than those receiving the frankincense or betadine on 2nd (p = 0.003 and p < 0.001) and 7th (p = 0.043 and p = 0.015) postpartum days. However, the total REEDA score was not statistically different between the frankincense and betadine groups on 2nd and 7th postpartum days (p > 0.05). CONCLUSION The present results suggest that myrrh was more efficient than frankincense and betadine in healing of the episiotomy wound and could be recommended as a safe natural therapy.
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Affiliation(s)
- Azam Faraji
- Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Maryam Aghdaki
- Obstetrics and Gynecology Department, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Kamran Hessami
- Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Ayda Hosseinkhani
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Shohreh Roozmeh
- Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Nasrin Asadi
- Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Homeira Vafaei
- Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Maryam Kasraeian
- Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Roya Bagheri
- School of Nursing &Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Khadije Bazrafshan
- Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
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21
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Berner T, Nakahara K, Kobayashi E, Tanaka A, Taniguchi Y, Iizuka T, Sawada K. Investigating the effect of antiseptic solution on the release of interleukin-6 and transforming growth factor beta 1 from human gingival fibroblasts using wound healing assays. J Oral Sci 2020; 62:293-297. [PMID: 32581176 DOI: 10.2334/josnusd.19-0151] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
This in vitro study evaluated the effect of different antiseptics and different concentrations thereof in a model of wound healing using human gingival fibroblasts. The fibroblasts were rinsed with four different antiseptic solutions: sodium hypochlorite (HYP), hydrogen peroxide (H2O2), chlorhexidine digluconate (CHX), and benzalkonium chloride (BC). The effect on the release of interleukin-6 (IL-6) and transforming growth factor beta 1 (TGF-β1) was investigated using enzyme-linked immunosorbent assays (ELISAs). In addition, the effects of the antiseptics on wound healing at 1, 12, 24, and 48 h were assessed through a wound healing assay. The viability of the fibroblasts rinsed with antiseptics was investigated with respect to the concentrations inhibiting cell growth by 50% (IC50), 25% (IC25), and ≤2% (IC2). A statistically significant increased release of IL-6 was obtained with BC IC25 and IC2 after 12, 24, and 48 h (P < 0.01). For TGF-β1, no significant release was found for CHX IC2 after 24 and 48 h or for IC50 and IC25 after 12 h. There was no significant effect on wound healing capacity for CHX or for BC IC25 and IC2. This study demonstrated that antiseptic rinses of human gingival fibroblasts alter the release of IL-6 and TGF-β1 and impact wound healing capacity, with both BC and CHX conferring neutral effects.
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Affiliation(s)
- Tanja Berner
- Department of Oral and Maxillofacial Surgery, The Nippon Dental University School of Life Dentistry at Niigata.,Center of Dental Medicine, University of Zurich
| | - Ken Nakahara
- Advanced Research Center, The Nippon Dental University School of Life Dentistry at Niigata
| | - Eizaburo Kobayashi
- Department of Oral and Maxillofacial Surgery, The Nippon Dental University School of Life Dentistry at Niigata
| | - Akira Tanaka
- Department of Oral and Maxillofacial Surgery, The Nippon Dental University School of Life Dentistry at Niigata
| | - Yoichi Taniguchi
- Department of Periodontology, Graduate School, Tokyo Medical and Dental University
| | - Tateyuki Iizuka
- Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, University of Bern
| | - Kosaku Sawada
- Advanced Research Center, The Nippon Dental University School of Life Dentistry at Niigata
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22
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Culbertson EJ, Felder-Scott C, Deva AK, Greenberg DE, Adams WP. Optimizing Breast Pocket Irrigation: The Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) Era. Aesthet Surg J 2020; 40:619-625. [PMID: 31501857 DOI: 10.1093/asj/sjz246] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Specific antimicrobial breast pocket irrigations have been proven over the past 20 years to reduce the incidence of capsular contracture by a factor of 10, and the emergence of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) and its link to bacteria/technique has created renewed interest in different antimicrobial breast pocket preparation agents. Our previous studies have identified that both Betadine-containing and non-Betadine-containing antimicrobial irrigations provide excellent broad-spectrum bacterial coverage. The current science of BIA-ALCL has implicated the Gram-negative microbiome as a key in pathogenesis. OBJECTIVES The aim of this study was to revisit the antimicrobial effectiveness of clinically utilized Betadine and non-Betadine solutions, along with other antimicrobial agents that have not yet been tested, against multiple organisms, including additional common Gram-negative bacteria associated with chronic breast implant infections/inflammation. METHODS Current and new antimicrobial breast irrigations were tested via standard techniques for bactericidal activity against multiple Gram-positive and Gram-negative strains. Test results are detailed and clinical recommendations for current antimicrobial irrigations are provided. RESULTS Betadine-containing irrigations were found to be superior according to the testing performed. CONCLUSIONS There are quite few misconceptions with regard to antimicrobial breast pocket irrigation. These are discussed and final evidence-based recommendations for practice are given.
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Affiliation(s)
| | | | - Anand K Deva
- Department of Plastic and Reconstructive Surgery, Macquarie University, Sydney, Australia
- Integrated Specialist Healthcare Education and Research Foundation
| | - David E Greenberg
- Departments of Internal Medicine and Microbiology, University of Texas Southwestern Medical Center, Dallas, TX
| | - William P Adams
- Department of Plastic Surgery, and Program Director of the Aesthetic Surgery Fellowship at University of Texas Southwestern, University of Texas Southwestern Medical Center, Dallas, TX
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23
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Mayandi V, Wen Choong AC, Dhand C, Lim FP, Aung TT, Sriram H, Dwivedi N, Periayah MH, Sridhar S, Fazil MHUT, Goh ETL, Orive G, W Beuerman R, Barkham TMS, Loh XJ, Liang ZX, Barathi VA, Ramakrishna S, Chong SJ, Verma NK, Lakshminarayanan R. Multifunctional Antimicrobial Nanofiber Dressings Containing ε-Polylysine for the Eradication of Bacterial Bioburden and Promotion of Wound Healing in Critically Colonized Wounds. ACS APPLIED MATERIALS & INTERFACES 2020; 12:15989-16005. [PMID: 32172559 DOI: 10.1021/acsami.9b21683] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Bacterial colonization of acute and chronic wounds is often associated with delayed wound healing and prolonged hospitalization. The rise of multi-drug resistant bacteria and the poor biocompatibility of topical antimicrobials warrant safe and effective antimicrobials. Antimicrobial agents that target microbial membranes without interfering with the mammalian cell proliferation and migration hold great promise in the treatment of traumatic wounds. This article reports the utility of superhydrophilic electrospun gelatin nanofiber dressings (NFDs) containing a broad-spectrum antimicrobial polymer, ε-polylysine (εPL), crosslinked by polydopamine (pDA) for treating second-degree burns. In a porcine model of partial thickness burns, NFDs promoted wound closure and reduced hypertrophic scarring compared to untreated burns. Analysis of NFDs in contact with the burns indicated that the dressings trap early colonizers and elicit bactericidal activity, thus creating a sterile wound bed for fibroblasts migration and re-epithelialization. In support of these observations, in porcine models of Pseudomonas aeruginosa and Staphylococcus aureus colonized partial thickness burns, NFDs decreased bacterial bioburden and promoted wound closure and re-epithelialization. NFDs displayed superior clinical outcome than standard-of-care silver dressings. The excellent biocompatibility and antimicrobial efficacy of the newly developed dressings in pre-clinical models demonstrate its potential for clinical use to manage infected wounds without compromising tissue regeneration.
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Affiliation(s)
- Venkatesh Mayandi
- Anti-Infectives Research Group, Singapore Eye Research Institute, The Academia, 20 College Road, Discovery Tower, 169856 Singapore
- School of Biological Sciences, Nanyang Technological University Singapore, 60 Nanyang Drive, 637551 Singapore
| | - Alvin Chua Wen Choong
- Department of Plastic Reconstructive & Aesthetic Surgery, Singapore General Hospital, 20 College Road, 169856 Singapore
- Skin Bank Unit, Singapore General Hospital, 169608 Singapore
| | - Chetna Dhand
- Anti-Infectives Research Group, Singapore Eye Research Institute, The Academia, 20 College Road, Discovery Tower, 169856 Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Graduate Medical School, 169857 Singapore
| | - Fui Ping Lim
- Alice Lee Centre for Nursing Studies, National University of Singapore, 117597 Singapore
| | - Thet Tun Aung
- Anti-Infectives Research Group, Singapore Eye Research Institute, The Academia, 20 College Road, Discovery Tower, 169856 Singapore
- Department of Microbiology and Immunology, National University of Singapore, 119077 Singapore
| | - Harini Sriram
- Anti-Infectives Research Group, Singapore Eye Research Institute, The Academia, 20 College Road, Discovery Tower, 169856 Singapore
| | - Neeraj Dwivedi
- Department of Electrical and Computer Engineering, National University of Singapore, 117583 Singapore
| | - Mercy Halleluyah Periayah
- Anti-Infectives Research Group, Singapore Eye Research Institute, The Academia, 20 College Road, Discovery Tower, 169856 Singapore
| | - Sreepathy Sridhar
- Anti-Infectives Research Group, Singapore Eye Research Institute, The Academia, 20 College Road, Discovery Tower, 169856 Singapore
| | - Mobashar Hussain Urf Turabe Fazil
- Lee Kong Chian School of Medicine, Clinical Sciences Building, Nanyang Technological University Singapore, 11 Mandalay Road, 308232 Singapore
| | - Eunice Tze Leng Goh
- Anti-Infectives Research Group, Singapore Eye Research Institute, The Academia, 20 College Road, Discovery Tower, 169856 Singapore
| | - Gorka Orive
- NanoBioCel Group, Laboratory of Pharmaceutics, School of Pharmacy, University of the Basque Country UPV/EHU, Paseo de la Universidad 7, Vitoria-Gasteiz 01006, Spain
- Biomedical Research Networking Centre in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Vitoria-Gasteiz 01006, Spain
- University Institute for Regenerative Medicine and Oral Implantology - UIRMI (UPV/EHU-Fundación Eduardo Anitua), Vitoria 01006, Spain
| | - Roger W Beuerman
- Anti-Infectives Research Group, Singapore Eye Research Institute, The Academia, 20 College Road, Discovery Tower, 169856 Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Graduate Medical School, 169857 Singapore
| | | | - Xian Jun Loh
- Institute of Materials Research and Engineering (IMRE), Agency for Science, Technology and Research (A*STAR), 138634 Singapore
| | - Zhao-Xun Liang
- School of Biological Sciences, Nanyang Technological University Singapore, 60 Nanyang Drive, 637551 Singapore
| | - Veluchamy Amutha Barathi
- Anti-Infectives Research Group, Singapore Eye Research Institute, The Academia, 20 College Road, Discovery Tower, 169856 Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Graduate Medical School, 169857 Singapore
| | - Seeram Ramakrishna
- Center for Nanofibers & Nanotechnology, National University of Singapore, 119077 Singapore
| | - Si Jack Chong
- Department of Plastic Reconstructive & Aesthetic Surgery, Singapore General Hospital, 20 College Road, 169856 Singapore
- Skin Bank Unit, Singapore General Hospital, 169608 Singapore
| | - Navin Kumar Verma
- Anti-Infectives Research Group, Singapore Eye Research Institute, The Academia, 20 College Road, Discovery Tower, 169856 Singapore
- Lee Kong Chian School of Medicine, Clinical Sciences Building, Nanyang Technological University Singapore, 11 Mandalay Road, 308232 Singapore
- Skin Research Institute of Singapore, Clinical Sciences Building, 11 Mandalay Road, 308232 Singapore
| | - Rajamani Lakshminarayanan
- Anti-Infectives Research Group, Singapore Eye Research Institute, The Academia, 20 College Road, Discovery Tower, 169856 Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Graduate Medical School, 169857 Singapore
- Department of Pharmacy, National University of Singapore, 18 Science Drive, 117543 Singapore
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24
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Measures to reduce end-of-case wound contamination: the impact of intra-wound vancomycin powder and betadine irrigation on surgical site infections in posterior spinal fusion. Spine Deform 2020; 8:45-50. [PMID: 31981142 DOI: 10.1007/s43390-020-00033-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 07/11/2019] [Indexed: 10/25/2022]
Abstract
STUDY DESIGN Retrospective descriptive, single-center study. OBJECTIVES To determine the effect of standardized intrawound vancomycin powder and betadine irrigation on surgical site infection (SSI) rates after posterior spinal fusion (PSF) in idiopathic scoliosis. Since 2005, our pediatric spine center has implemented a series of changes to lower the risk of SSI. The most recent interventions-intrawound vancomycin powder and betadine irrigation-are applied just before closure, aiming to reduce the culture-positive bacterial contamination known to occur in many cases. We sought to determine the impact of these end-of-case measures on our center's SSI rate. METHODS We retrospectively reviewed patients who underwent PSF for idiopathic scoliosis at our institution from January 1, 2010, to June 30, 2018, identifying all cases that returned to the operating room for surgical debridement within 90 days of PSF. Cases were surgeon-audited to ensure inclusion of all infections that met Centers for Disease Control and Prevention (CDC) criteria for acute SSI. Vertical expandable prosthetic titanium ribs, growing rods, staged procedures, and nonidiopathic cases were excluded. Annual rates of SSIs were correlated with the initiation of each SSI prevention measure. RESULTS Among 740 cases of PSF for idiopathic scoliosis from 2010 to 2018, the overall acute SSI rate by CDC criteria was 0.68%. The idiopathic SSI rate dropped significantly, from 1.70 to 0.20%, after the standardized introduction of intrawound vancomycin powder and betadine irrigation before closure (p < 0.04). The implementation of these end-of-case measures in 2012-2013 was soon followed by an institution best 3.5-year SSI-free period for idiopathic cases. CONCLUSIONS Since intrawound vancomycin powder and betadine irrigation were added to our SSI prevention bundle, we have seen a significantly lower SSI rate after PSFs for idiopathic scoliosis. These findings suggest that anti-SSI interventions to reduce wound contamination at the end of the case may have a particularly positive impact on SSI reduction. LEVEL OF EVIDENCE Level III, therapeutic.
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The Use of Antiseptic and Antibacterial Agents on Wounds and the Skin. LOCAL WOUND CARE FOR DERMATOLOGISTS 2020. [DOI: 10.1007/978-3-030-28872-3_5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Mercan U, Gonen ZB, Salkin H, Yalcin Ulker GM, Meral DG. Comparison of the effect of postoperative care agents on human gingival fibroblasts: a preliminary study. Eur Oral Res 2019; 53:67-73. [PMID: 31309196 PMCID: PMC6614693 DOI: 10.26650/eor.20197456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 05/03/2018] [Accepted: 10/25/2018] [Indexed: 12/02/2022] Open
Abstract
Purpose: The aim of this study is to compare effects of postoperative care agents;
chlorhexidine, octenidine dihydrochloride and hyaluronic acid on human gingival
fibroblasts’ viability, proliferation, apoptosis and migration. Materials and methods: After cell culturing; chlorhexidine, octenidine dihydrochloride and hyaluronic acid
solutions were applied on cells and nothing was applied for control group. The cells
were monitored to investigate cytotoxicity; the percentage of apoptotic, living and
dead cells at the time of 24, 48, and 72 hours (h). A scratch wound assay was performed
to detect cell migration and cells were monitored at baseline, at 24 and 48h. Results: At 24h, chlorhexidine showed statistically lower percentage of total apoptotic
cells’ than octenidine dihydrochloride (p=0.049), hyaluronic acid (p=0.049) and
control (p=0.049). At 48h, hyaluronic acid showed statistically lower percentage
than chlorhexidine (p=0.049), and control (p=0.049). All agents were found to
have statistically and significantly more cytotoxic than control. However, there
was no difference between experimental groups for proliferation rate. Octenidine
dihydrochloride showed statistically negative effects on cell migration than
chlorhexidine and hyaluronic acid at 24h. Chlorhexidine and hyaluronic acid
maintained migration ability of cells than octenidine dihydrochloride at 48h. Conclusion: All agents have similar effects on cell behavior such as viability, apoptosis and cell
proliferation. However, octenidine dihydrochloride showed statistically negative
effects on migration ability than chlorhexidine and hyaluronic acid.
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Affiliation(s)
- Ugur Mercan
- Department of Oral and Maxillofacial Surgery, Dentistry School, Okan University, Istanbul Turkey
| | - Z Burcin Gonen
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Erciyes University, Kayseri Turkey
| | - Hasan Salkin
- Department of Histology, Faculty of Medicine, Erciyes University, Kayseri Turkey
| | - Gul Merve Yalcin Ulker
- Department of Oral and Maxillofacial Surgery, Dentistry School, Okan University, Istanbul Turkey
| | - Deniz Gokce Meral
- Department of Oral and Maxillofacial Surgery, Dentistry School, Okan University, Istanbul Turkey
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Sulaiman M, Mahadevan RK, Kurup MG. Effect of Ascophyllan from Brown Algae Padina tetrastromatica on Cell Migration and Extracellular Matrix Stabilisation in Burn Wounds. ACTA ACUST UNITED AC 2019. [DOI: 10.2174/1573407214666180327123118] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Burn injuries are the most common injuries and a major health problem affecting
communities worldwide. Many alternative therapies are used as treatment for burns. The healing
efficacy of sulphated polysaccharide ascophyllan was evaluated and studied its mechanism of action on
experimental burn wounds in rats.
Methods:
Ascophyllan fractions were extracted from marine brown algae Padina tetrastromatica (Dictyotaceae)
and evaluated its burn wound healing potential. Full thickness burn wounds induced in male
albino rats were used for in vivo study and evaluated wound healing parameters.
Results:
The results showed that Ascophyllan Fraction 3 (AF3) had no cytotoxic effect and it increases
cell migration and production of VEGF in fibroblasts. AF3 significantly reduced in vitro secretion of
cytokines in blood mononuclear cells treated with Lipopolysaccharide (LPS). In vivo study showed that
AF3 (5%) has significant wound healing activity in albino rats and this dose was used for studying the
healing mechanism. The reference control used for the study was povidone-iodine ointment. Wound
area contraction and reepithelialisation was faster in AF3 (5%) administered group. When applied topically,
AF3 (5%) increased hydroxyproline and hexosamine content at the wound site. Uronic acid, DNA
and proteins levels were also increased. Compared to the control groups, AF3 (5%) treatment showed an
increase in neovascularization and fibroblast proliferation as evidenced by histopathology of granulation
tissue.
Conclusion:
Sulphated polysaccharide ascophyllan is beneficial for the wound environment as it
enhances the healing process and suggested the safe usage of this algal polysaccharide as an alternative
for replacing current synthetic wound healing agents in medicine.
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Affiliation(s)
- Mohsin Sulaiman
- Department of Aridland Agriculture, College of Food and Agriculture, United Arab Emirates University, Al Ain -15551, United Arab Emirates
| | | | - Muraleedhara G. Kurup
- Department of Biochemistry, University of Kerala, Thiruvananthapuram- 695581, Kerala, India
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Eroglu ZT, Kurtis B, Altug HA, Sahin S, Tuter G, Baris E. Effect of topical ozonetherapy on gingival wound healing in pigs: histological and immuno-histochemical analysis. J Appl Oral Sci 2018; 27:e20180015. [PMID: 30540068 PMCID: PMC6296287 DOI: 10.1590/1678-7757-2018-0015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 07/25/2018] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES In this study, the effects of ozonetherapy on secondary wound healing were evaluated histologically and immuno-histochemically. MATERIAL AND METHODS Material and Methods: 8 healthy pigs were used in this study. Six wounds with 10 mm in diameter were created through the punch technique on the palatinal gingiva of each pig. Ozone gas was applied on only 3 wounds (test group) and the remaining 3 were left to natural healing (control group). Biopsy samples were taken from one of the wounds in each group on the third day, from another wound of each group on the seventh day, and from another one on the tenth day. Routine histological analysis and immuno-histochemical staining were performed to investigate transforming growth factor-beta (TGF-β) and (VEGF) expressions. RESULTS Results: No statistical difference was found between the test and control groups in terms of collagen fibers, epithelial formation and inflammation scores. A VEGF expression found in the test group was statistically higher than control group samples taken on the 3rd and 7th day. There was no statistical difference between the test and control groups in terms of TGF-β expression on any of the sampling days. CONCLUSIONS Conclusion: The topical application of ozone gas could be effective in the early stages of wound healing by increasing the amount of VEGF expression. Clinical Relevance: Topical application of ozone gas may be effective in the early stages of oral wound healing.
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Affiliation(s)
| | - Bulent Kurtis
- Gazi University, Faculty of Dentistry, Department of Periodontology, Ankara, Turkey
| | - Hasan Ayberk Altug
- University of Health Sciences, Gulhane Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Ankara, Turkey
| | - Sermet Sahin
- Biruni University, Faculty of Dentistry, Department of Periodontology, İstanbul, Turkey
| | - Gulay Tuter
- Gazi University, Faculty of Dentistry, Department of Periodontology, Ankara, Turkey
| | - Emre Baris
- Gazi University, Faculty of Dentistry, Department of Oral Pathology, Ankara, Turkey
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Goorani S, Zangeneh MM, Koohi MK, Seydi N, Zangeneh A, Souri N, Hosseini MS. Assessment of antioxidant and cutaneous wound healing effects of Falcaria vulgaris aqueous extract in Wistar male rats. ACTA ACUST UNITED AC 2018. [DOI: 10.1007/s00580-018-2866-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Georgiev-Hristov T, Guadalajara H, Herreros MD, Lightner AL, Dozois EJ, García-Arranz M, García-Olmo D. A Step-By-Step Surgical Protocol for the Treatment of Perianal Fistula with Adipose-Derived Mesenchymal Stem Cells. J Gastrointest Surg 2018; 22:2003-2012. [PMID: 30066070 DOI: 10.1007/s11605-018-3895-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 07/20/2018] [Indexed: 01/31/2023]
Abstract
Anal fistula is a challenging condition both for surgeons and patients. Recurrent fistula, Crohn's disease, or autoimmune disorders add further complexity to this situation. Numerous clinical trials have now demonstrated that cell-based therapy appears to be a good complement to fistulous surgery. As in any new treatment, especially that involving living cells, appropriate application is paramount to achieve optimal outcomes. As stem cell-based treatments are gaining a strong foothold in fistula management worldwide, we herein aim to share our mesenchymal stem cell surgical protocol. With the goal of optimizing results of this emerging therapy, we have improved and refined our protocol over the past 17 years of working with stem cells in clinical trials. The protocol consists of nine reproducible steps for mesenchymal stem cell application inside the fistulous tract, and has proven to be safe and effective in several studies, including international phase III clinical trials.
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Affiliation(s)
- Tihomir Georgiev-Hristov
- Department of Surgery, Hospital General de Villalba, Carretera de Alpedrete a Moralzarzal, M-608, Km. 41, 28400 Collado Villalba, Madrid, Spain.
| | - H Guadalajara
- Department of Surgery, Hospital Universitario Fundación Jiménez Díaz, Avda Reyes Católicos 2, 28040, Madrid, Spain
| | - M D Herreros
- Department of Surgery, Hospital Universitario Fundación Jiménez Díaz, Avda Reyes Católicos 2, 28040, Madrid, Spain
| | - A L Lightner
- Department of Colon and Rectal Surgery, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - E J Dozois
- Department of Colon and Rectal Surgery, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - M García-Arranz
- New Therapy Laboratory, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Avda. Reyes Católicos 2, 28040, Madrid, Spain
| | - D García-Olmo
- Department of Surgery, Hospital Universitario Fundación Jiménez Díaz, Avda Reyes Católicos 2, 28040, Madrid, Spain
- New Therapy Laboratory, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Avda. Reyes Católicos 2, 28040, Madrid, Spain
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Alamoudi NM, Baik AM, El-Housseiny AA, Abu Haimed TS, Bakry AS. Influence of povidone-iodine on micro-tensile bonding strength to dentin under simulated pulpal pressure. BMC Oral Health 2018; 18:178. [PMID: 30373571 PMCID: PMC6206633 DOI: 10.1186/s12903-018-0645-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 10/18/2018] [Indexed: 11/10/2022] Open
Abstract
Background Previous studies had reported that bond strength deteriorate over time following the dentin surface pretreatment with chlorhexidine. Therefore, further investigations are needed to evaluate the effect of other materials such as povidone iodine. The purpose of this study was to investigate the effects of 10% povidone-iodine pretreatment on the resin-dentin micro-tensile bond strength of a single bond adhesive system in permanent teeth over time, and compare it with 2% chlorhexidine. Methods Flat dentin surfaces were prepared in 63 extracted permanent teeth. Teeth were randomly assigned to a 10% povidone-iodine pretreatment, a 2% chlorhexidine pretreatment, or a control group. Composite resin blocks were built up over treated surfaces under pulp pressure simulation. The prepared specimens were assigned to three storage time, 24 h, 1 week, and 2 months. Samples were vertically sectioned to obtain specimens of 0.7 to 1.2 mm2 cross-sectional area. Results No significant reduction of bond strength of povidone iodine group was found among the three storage times (p = 0.477). A significant reduction of bond strength for both chlorhexidine and control groups was found in the three storage times (p < 0.001). Conclusion Povidone iodine pretreatment of etched dentin was effective in reducing the loss of bond strength over time, while the chlorhexidine pretreatment and negative control showed significant deterioration in micro-tensile bond strength over time in permanent teeth.
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Affiliation(s)
- Najlaa M Alamoudi
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, P.O. Box 80209, Jeddah, 21589, Saudi Arabia.
| | - Alaa M Baik
- Pediatric Dentistry Department, King Abdulaziz University Dental Hospital, Jeddah, Saudi Arabia
| | - Azza A El-Housseiny
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, P.O. Box 80209, Jeddah, 21589, Saudi Arabia.,Pediatric Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Tariq S Abu Haimed
- Biomaterial Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ahmed S Bakry
- Operative Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.,Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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The downside of antimicrobial agents for wound healing. Eur J Clin Microbiol Infect Dis 2018; 38:39-54. [DOI: 10.1007/s10096-018-3393-5] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 09/26/2018] [Indexed: 02/01/2023]
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Wiesenmueller S, Cierniak P, Juebner M, Koerner E, Hegemann D, Mercer-Chalmers Bender K. Tailored antimicrobial activity and long-term cytocompatibility of plasma polymer silver nanocomposites. J Biomater Appl 2018; 33:327-339. [PMID: 30223732 DOI: 10.1177/0885328218793488] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The deposition of coatings enabling antibacterial properties in combination with cytocompatibility remains a challenge for biomaterial applications, such as in medical devices. Silver is one of the most utilized antibacterial surface components, due to its efficacy and extensive applicability. In this work, silver-containing plasma polymer nanocomposites (single layer and multilayers) were developed and tested, with a focus on cytotoxicity and bactericidal function, on the NIH3T3 mammalian cell line as well as Gram-negative ( Pseudomonas aeruginosa) and Gram-positive ( Staphylococcus aureus) bacterial strains. The data demonstrate that a tuneable Ag+ release is required, allowing sufficient antimicrobial activity while retaining appropriate cytocompatibility over the entire testing period of up to eight days.
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Affiliation(s)
- Steffi Wiesenmueller
- 1 Institute of Legal Medicine, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Peter Cierniak
- 2 EMPA Material Science and Technology, St. Gallen, Switzerland
| | - Martin Juebner
- 3 Institute of Forensic Medicine, University of Basel, Health Department Basel-Stadt, Basel, Switzerland
| | - Enrico Koerner
- 3 Institute of Forensic Medicine, University of Basel, Health Department Basel-Stadt, Basel, Switzerland
| | - Dirk Hegemann
- 3 Institute of Forensic Medicine, University of Basel, Health Department Basel-Stadt, Basel, Switzerland
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Benzie AL, Clark J, Farrah J, Garcia A, Hagan J, Richards W, Ang D. Skin-Sparing Wide Local Debridement of Necrotizing Soft Tissue Infection: Can Less be More? Am Surg 2018. [DOI: 10.1177/000313481808400913] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Annie Laurie Benzie
- University of Central Florida College of Medicine HCA GME Consortium at Ocala Health General Surgery Residency Program Ocala, Florida
| | - Jason Clark
- University of Central Florida College of Medicine HCA GME Consortium at Ocala Health General Surgery Residency Program Ocala, Florida
| | - Jason Farrah
- University of Central Florida College of Medicine HCA GME Consortium at Ocala Health General Surgery Residency Program Ocala, Florida
| | - Alejandro Garcia
- University of Central Florida College of Medicine HCA GME Consortium at Ocala Health General Surgery Residency Program Ocala, Florida
| | - Joshua Hagan
- University of Central Florida College of Medicine HCA GME Consortium at Ocala Health General Surgery Residency Program Ocala, Florida
| | - Winston Richards
- University of Central Florida College of Medicine HCA GME Consortium at Ocala Health General Surgery Residency Program Ocala, Florida
| | - Darwin Ang
- University of Central Florida College of Medicine HCA GME Consortium at Ocala Health General Surgery Residency Program Ocala, Florida
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Liu JX, Werner J, Kirsch T, Zuckerman JD, Virk MS. Cytotoxicity evaluation of chlorhexidine gluconate on human fibroblasts, myoblasts, and osteoblasts. J Bone Jt Infect 2018; 3:165-172. [PMID: 30155401 PMCID: PMC6098817 DOI: 10.7150/jbji.26355] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 07/25/2018] [Indexed: 12/12/2022] Open
Abstract
Introduction: Chlorhexidine gluconate (CHX) is widely used as a preoperative surgical skin-preparation solution and intra-wound irrigation agent, with excellent efficacy against wide variety of bacteria. The cytotoxic effect of CHX on local proliferating cells following orthopaedic procedures is largely undescribed. Our aim was to investigate the in vitro effects of CHX on primary fibroblasts, myoblasts, and osteoblasts. Methods: Cells were exposed to CHX dilutions (0%, 0.002%, 0.02%, 0.2%, and 2%) for either a 1, 2, or 3-minute duration. Cell survival was measured using a cytotoxicity assay (Cell Counting Kit-8). Cell migration was measured using a scratch assay: a "scratch" was made in a cell monolayer following CHX exposure, and time to closure of the scratch was measured. Results: All cells exposed to CHX dilutions of ≥ 0.02% for any exposure duration had cell survival rates of less than 6% relative to untreated controls (p < 0.001). Cells exposed to CHX dilution of 0.002% all had significantly lower survival rates relative to control (p < 0.01) with the exception of 1-minute exposure to fibroblasts, which showed 96.4% cell survival (p = 0.78). Scratch defect closure was seen in < 24 hours in all control conditions. However, cells exposed to CHX dilutions ≥ 0.02% had scratch defects that remained open indefinitely. Conclusions: The clinically used concentration of CHX (2%) permanently halts cell migration and significantly reduces survival of in vitro fibroblasts, myoblasts, and osteoblasts. Further in vivo studies are required to examine and optimize CHX safety and efficacy when applied near open incisions or intra-wound application.
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Affiliation(s)
- James X Liu
- NYU Langone Medical Center, Hospital for Joint Diseases, 301 E. 17th St., New York, NY 10003
| | - Jordan Werner
- NYU Langone Medical Center, Hospital for Joint Diseases, 301 E. 17th St., New York, NY 10003
| | - Thorsten Kirsch
- NYU Langone Medical Center, Hospital for Joint Diseases, 301 E. 17th St., New York, NY 10003
| | - Joseph D Zuckerman
- NYU Langone Medical Center, Hospital for Joint Diseases, 301 E. 17th St., New York, NY 10003
| | - Mandeep S Virk
- NYU Langone Medical Center, Hospital for Joint Diseases, 301 E. 17th St., New York, NY 10003
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Myatt T, Nguyen BJ, Clark RF, Coffey CH, O'Connell CW. A Prospective Study of Stingray Injury and Envenomation Outcomes. J Emerg Med 2018; 55:213-217. [DOI: 10.1016/j.jemermed.2018.04.035] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 04/12/2018] [Indexed: 10/16/2022]
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Heidari M, Bahramsoltani R, Abdolghaffari AH, Rahimi R, Esfandyari M, Baeeri M, Hassanzadeh G, Abdollahi M, Farzaei MH. Efficacy of topical application of standardized extract of Tragopogon graminifolius in the healing process of experimental burn wounds. J Tradit Complement Med 2018; 9:54-59. [PMID: 30671366 PMCID: PMC6335475 DOI: 10.1016/j.jtcme.2018.02.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 01/26/2018] [Accepted: 02/18/2018] [Indexed: 12/28/2022] Open
Abstract
Tragopogon graminifolius DC. is a perennial plant from the family Asteraceae which grows in West parts of Iran. Several biological activities like antimicrobial, antioxidant and anti-inflammatory effects are reported for the plant. The aim of this study was to assess the wound healing activity of standardized extract from T. graminifolius (TG) aerial parts. Topical standardized TG extract with 5% and 10% concentrations in eucerine base was assessed for its healing properties on second degree burn in rats during a 14-day period. Biomarkers of oxidative damage including total antioxidant power, lipid peroxidation and total thiol molecules of the skin tissue samples were also evaluated. Results showed that 10%TG had the best efficacy with 80 ± 3% wound closure and tissue repair in comparison to negative control (p < 0.05). Significant reduction of tissue oxidative stress biomarkers was also observed. Histological analyses confirmed wound healing activity of TG extract, as well. Considering the antioxidative stress and anti-inflammatory activities of TG, explained by the high content of phenolic compounds of the plant, standardized TG extract could be considered as a natural remedy for the treatment of burn wounds. Further clinical studies are suggested to confirm the effectiveness of TG as a wound healing agent.
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Affiliation(s)
- Mohammad Heidari
- Department of Pharmaceutics, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
- Department of Pharmaceutics, Faculty of Pharmacy, Kerman University of Medical Sciences, Kerman, Iran
| | - Roodabeh Bahramsoltani
- Department of Pharmacy in Persian Medicine, School of Persian Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Hossein Abdolghaffari
- Medicinal Plants Research Center, Institute of Medicinal Plants, ACECR, Karaj, Iran
- Faculty of Pharmacy and Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Roja Rahimi
- Department of Pharmacy in Persian Medicine, School of Persian Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammadamin Esfandyari
- Department of Pharmaceutics, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Baeeri
- Faculty of Pharmacy and Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Gholamreza Hassanzadeh
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Abdollahi
- Faculty of Pharmacy and Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hosein Farzaei
- Pharmaceutical Sciences Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Corresponding author. Pharmaceutical Sciences Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Investigation of eucalyptus essence 1% and its mixture with licorice gel 10% on the infected third-degree burn wound in rat model. ACTA ACUST UNITED AC 2018. [DOI: 10.1007/s00580-018-2732-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Schmidt K, Estes C, McLaren A, Spangehl MJ. Chlorhexidine Antiseptic Irrigation Eradicates Staphylococcus epidermidis From Biofilm: An In Vitro Study. Clin Orthop Relat Res 2018; 476:648-653. [PMID: 29443852 PMCID: PMC6260035 DOI: 10.1007/s11999.0000000000000052] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Antiseptic and antibacterial solutions used for intraoperative irrigation are intended to kill bacteria and thereby decrease the incidence of surgical site infections. It is unknown if the concentrations and exposure times of irrigation solutions commonly used for prophylaxis in clean cases (povidone-iodine 0.35% for 3 minutes) are effective against bacteria in biofilm that are present in implant infections. Currently, povidone-iodine (0.35%), chlorhexidine (0.05%), sodium hypochlorite (0.125%), and triple antibacterial solution are all being used off-label for wound irrigation after surgical débridement for orthopaedic infections. QUESTIONS/PURPOSES Do commonly used antibacterials and antiseptics kill bacteria in established biofilm at clinically relevant concentrations and exposure times? METHODS Staphylococcus epidermidis (ATCC#35984) biofilms were exposed to chlorhexidine (0.025%, 0.05%, and 0.1%), povidone-iodine (0.35%, 1.0%, 3.5%, and 10%), sodium hypochlorite (0.125%, 0.25%, and 0.5%,), and triple antibacterial solution (bacitracin 50,000 U/L, gentamicin 80 mg/L, and polymyxin 500,000 U/L) for 1, 5, and 10 minutes in triplicate. Surviving bacteria were detected by 21-day subculture. Failure to eradicate all bacteria in any of the three replicates was considered to be "not effective" for that respective solution, concentration, and exposure time. RESULTS Chlorhexidine 0.05% and 0.1% at all three exposure times, povidone-iodine 10% at all three exposure times, and povidone-iodine 3.5% at 10 minutes only were effective at eradicating S epidermidis from biofilm. All concentrations and all exposure times of sodium hypochlorite and triple antibacterial solution were not effective. CONCLUSIONS Chlorhexidine is capable of eradicating S epidermidis from biofilm in vitro in clinically relevant concentrations and exposure times. Povidone-iodine at commonly used concentrations and exposure times, sodium hypochlorite, and triple antibacterial solutions are not. CLINICAL RELEVANCE This in vitro study suggests that chlorhexidine may be a more effective irrigation solution for S epidermidis in biofilm than other commonly used solutions, such as povidone-iodine, Dakin's solution, and triple antibiotic solution. Clinical outcomes should be studied to determine the most effective antiseptic agent, concentration, and exposure time when intraoperative irrigation is used in the presence of biofilm.
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Affiliation(s)
- Kenneth Schmidt
- K. Schmidt OrthoArizona, Phoenix, AZ, USA C. Estes Portland Adventist Medical Center, Portland, OR, USA A. McLaren University of Arizona, College of Medicine, Phoenix Department of Orthopaedic Surgery, Phoenix, AZ, USA M. J. Spangehl Department of Orthopaedic Surgery, Mayo Clinic Arizona, Phoenix, AZ, USA
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41
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Cambiaso-Daniel J, Boukovalas S, Bitz GH, Branski LK, Herndon DN, Culnan DM. Topical Antimicrobials in Burn Care: Part 1-Topical Antiseptics. Ann Plast Surg 2018; Publish Ahead of Print:10.1097/SAP.0000000000001297. [PMID: 29319571 PMCID: PMC6037606 DOI: 10.1097/sap.0000000000001297] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Burn wounds disrupt the body's primary defense against invasion and colonization by microorganisms. Topical antimicrobials are one component in burn wound care. These agents suppress microbial growth to advantage skin cells and wound healing. Topical antimicrobials can be divided into 2 superclasses: antiseptics and antibiotics. We review the 4 main classes of topical antiseptics (emulsifiers, acids, oxidizers, and heavy metals) and antiseptic-impregnated dressings in current clinical use and address the mechanisms, as well as the advantages and disadvantages of each antiseptic for burn wound management.
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Affiliation(s)
- Janos Cambiaso-Daniel
- Department of Surgery, University of Texas Medical Branch, and Shriners Hospitals for Children, Galveston, Texas, USA
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Austria
| | - Stafanos Boukovalas
- Division of Plastic Surgery, University of Texas Medical Branch, Galveston, Texas, USA
| | - Genevieve H. Bitz
- JMS Burn and Reconstructive Center, Merit Health Central Hospital, Jackson, Mississippi, USA
| | - Ludwik K. Branski
- Department of Surgery, University of Texas Medical Branch, and Shriners Hospitals for Children, Galveston, Texas, USA
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Austria
| | - David N. Herndon
- Department of Surgery, University of Texas Medical Branch, and Shriners Hospitals for Children, Galveston, Texas, USA
- Division of Plastic Surgery, University of Texas Medical Branch, Galveston, Texas, USA
| | - Derek M. Culnan
- JMS Burn and Reconstructive Center, Merit Health Central Hospital, Jackson, Mississippi, USA
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42
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Pharaon SK, Schoch S, Marchand L, Mirza A, Mayberry J. Orthopaedic traumatology: fundamental principles and current controversies for the acute care surgeon. Trauma Surg Acute Care Open 2018; 3:e000117. [PMID: 29766123 PMCID: PMC5887772 DOI: 10.1136/tsaco-2017-000117] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 09/20/2017] [Accepted: 11/15/2017] [Indexed: 12/11/2022] Open
Abstract
Multiply injured patients with fractures are co-managed by acute care surgeons and orthopaedic surgeons. In most centers, orthopaedic surgeons definitively manage fractures, but preliminary management, including washouts, splinting, reductions, and external fixations, may be performed by selected acute care surgeons. The acute care surgeon should have a working knowledge of orthopaedic terminology to communicate with colleagues effectively. They should have an understanding of the composition of bone, periosteum, and cartilage, and their reaction when there is an injury. Fractures are usually fixed urgently, but some multiply injured patients are better served with a damage control strategy. Extremity compartment syndrome should be suspected in all critically injured patients with or without fractures and a low threshold for compartment pressure measurements or empiric fasciotomy maintained. Acute care surgeons performing rib fracture fixation and other chest wall injury reconstructions should follow the principles of open fracture reduction and stabilization.
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Affiliation(s)
- Shad K Pharaon
- Trauma and Acute Care Surgery, PeaceHealth Southwest Medical Center, Vancouver, Washington, USA
| | - Shawn Schoch
- Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, Washington, USA
| | - Lucas Marchand
- Department of Orthopaedic Surgery, University of Utah, Salt Lake City, Utah, USA
| | - Amer Mirza
- Orthopaedic Trauma Surgery, Legacy Emanuel Medical Center, Portland, Oregon, USA
| | - John Mayberry
- Trauma and Acute Care Surgery, Saint Alphonsus Regional Medical Center, Boise, Idaho, USA.,Department of Surgery, WWAMI Regional Medical Education, University of Washington School of Medicine, Seattle, Washington, USA
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43
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Povidone-iodine Solutions Inhibit Cell Migration and Survival of Osteoblasts, Fibroblasts, and Myoblasts. Spine (Phila Pa 1976) 2017; 42:1757-1762. [PMID: 28505031 DOI: 10.1097/brs.0000000000002224] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN In vitro laboratory study. OBJECTIVE The purpose of this study was to identify the effect of dilute povidone-iodine (PVI) solutions on human osteoblast, fibroblast and myoblast cells in vitro. SUMMARY OF BACKGROUND DATA Dilute PVI wound lavage has been used successfully in spine and joint arthroplasty procedures to prevent postoperative surgical site infection, but their biologic effect on host cells is largely unknown. METHODS Human primary osteoblasts, fibroblasts, and myoblasts were expanded in cell culture and subjected to various concentrations of PVI (0%, 0.001%, 0.01%, 0.1%, 0.35%, 1%) for 3 minutes. To assess the effect of PVI on cell migration, a scratch assay was performed, in which a "scratch" was made by a standard pipette tip in a cell monolayer following PVI exposure, and time to closure of the scratch was evaluated. Cell survival and proliferation was measured 48 hours post-PVI exposure using a cell viability and cytotoxicity assay. RESULTS Closure of the scratch defect in all cell monolayers was achieved in <24 hours in untreated controls and following exposure to PVI concentrations <0.1%. The scratch defect remained open indefinitely following exposure to PVI concentrations of ≥0.1%. PVI concentrations <0.1% did not have significant effect on survival rates compared with control for all cell types. Cells exposed to PVI ≥ 0.1% had cell survival rates of less than 6% (P < 0.05). CONCLUSIONS Clinically used concentration of PVI (0.35%) exerts a pronounced cytotoxic effect on osteoblasts, fibroblast, and myoblasts in vitro. Further investigation is required to systematically study the effect of PVI on tissue healing in vivo and also determine a safe and clinically potent concentration for PVI lavage. LEVEL OF EVIDENCE N/A.
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Nagoba B, Davane M, Gandhi R, Wadher B, Suryawanshi N, Selkar S. Treatment of skin and soft tissue infections caused by Pseudomonas aeruginosa —A review of our experiences with citric acid over the past 20 years. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.wndm.2017.09.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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45
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Duan X, Peng D, Zhang Y, Huang Y, Liu X, Li R, Zhou X, Liu J. Sub-cytotoxic concentrations of ionic silver promote the proliferation of human keratinocytes by inducing the production of reactive oxygen species. Front Med 2017; 12:289-300. [PMID: 29101755 DOI: 10.1007/s11684-017-0550-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 04/26/2017] [Indexed: 12/14/2022]
Abstract
Silver-containing preparations are widely used in the management of skin wounds, but the effects of silver ions on skin wound healing remain poorly understood. This study investigated the effects of silver ions (Ag+) on the proliferation of human skin keratinocytes (HaCaT) and the production of intracellular reactive oxygen species (ROS). After treating HaCaT cells with Ag+ and/or the active oxygen scavenger N-acetyl cysteine (NAC), cell proliferation and intracellular ROS generation were assessed using CCK-8 reagent and DCFH-DA fluorescent probe, respectively. In addition, 5-bromo-2-deoxyUridine (BrdU) incorporation assays, cell cycle flow cytometry, and proliferating cell nuclear antigen (PCNA) immunocytochemistry were conducted to further evaluate the effects of sub-cytotoxic Ag+ concentrations on HaCaT cells. The proliferation of HaCaT cells was promoted in the presence of 10-6 and 10-5 mol/L Ag+ at 24, 48, and 72 h. Intracellular ROS generation also significantly increased for 5-60 min after exposure to Ag+. The number of BrdU-positive cells and the presence of PCNA in HaCaT cells increased 48 h after the addition of 10-6 and 10-5 mol/L Ag+, with 10-5 mol/L Ag+ markedly increasing the cell proliferation index. These effects of sub-cytotoxic Ag+ concentrations were repressed by 5 mmol/L NAC. Our results suggest that sub-cytotoxic Ag+ concentrations promote the proliferation of human keratinocytes and might be associated with a moderate increase in intracellular ROS levels. This study provides important experimental evidence for developing novel silver-based wound agents or dressings with few or no cytotoxicity.
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Affiliation(s)
- Xiaodong Duan
- Institute of Burn Research, Southwest Hospital, Third Military Medical University, Chongqing, 400038, China.,Burn and Plastic Surgery Department, 209 Hospital of PLA, Mudanjiang, 157011, China
| | - Daizhi Peng
- Institute of Burn Research, Southwest Hospital, Third Military Medical University, Chongqing, 400038, China. .,Tissue Engineering Research Unit, State Key Laboratory of Trauma, Burns and Combined Injury, Third Military Medical University, Chongqing, 400038, China.
| | - Yilan Zhang
- Institute of Burn Research, Southwest Hospital, Third Military Medical University, Chongqing, 400038, China
| | - Yalan Huang
- Institute of Burn Research, Southwest Hospital, Third Military Medical University, Chongqing, 400038, China
| | - Xiao Liu
- Institute of Burn Research, Southwest Hospital, Third Military Medical University, Chongqing, 400038, China
| | - Ruifu Li
- Institute of Burn Research, Southwest Hospital, Third Military Medical University, Chongqing, 400038, China
| | - Xin Zhou
- Institute of Burn Research, Southwest Hospital, Third Military Medical University, Chongqing, 400038, China
| | - Jing Liu
- Institute of Burn Research, Southwest Hospital, Third Military Medical University, Chongqing, 400038, China
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Venkatesh M, Barathi VA, Goh ETL, Anggara R, Fazil MHUT, Ng AJY, Harini S, Aung TT, Fox SJ, Liu S, Yang L, Barkham TMS, Loh XJ, Verma NK, Beuerman RW, Lakshminarayanan R. Antimicrobial Activity and Cell Selectivity of Synthetic and Biosynthetic Cationic Polymers. Antimicrob Agents Chemother 2017; 61:e00469-17. [PMID: 28784676 PMCID: PMC5610535 DOI: 10.1128/aac.00469-17] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Accepted: 07/29/2017] [Indexed: 12/20/2022] Open
Abstract
The mammalian and microbial cell selectivity of synthetic and biosynthetic cationic polymers has been investigated. Among the polymers with peptide backbones, polymers containing amino side chains display greater antimicrobial activity than those with guanidine side chains, whereas ethylenimines display superior activity over allylamines. The biosynthetic polymer ε-polylysine (εPL) is noncytotoxic to primary human dermal fibroblasts at concentrations of up to 2,000 μg/ml, suggesting that the presence of an isopeptide backbone has greater cell selectivity than the presence of α-peptide backbones. Both εPL and linear polyethylenimine (LPEI) exhibit bactericidal properties by depolarizing the cytoplasmic membrane and disrupt preformed biofilms. εPL displays broad-spectrum antimicrobial properties against antibiotic-resistant Gram-negative and Gram-positive strains and fungi. εPL elicits rapid bactericidal activity against both Gram-negative and Gram-positive bacteria, and its biocompatibility index is superior to those of cationic antiseptic agents and LPEI. εPL does not interfere with the wound closure of injured rabbit corneas. In a rabbit model of bacterial keratitis, the topical application of εPL (0.3%, wt/vol) decreases the bacterial burden and severity of infections caused by Pseudomonas aeruginosa and Staphylococcus aureus strains. In vivo imaging studies confirm that εPL-treated corneas appeared transparent and nonedematous compared to untreated infected corneas. Taken together, our results highlight the potential of εPL in resolving topical microbial infections.
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Affiliation(s)
- Mayandi Venkatesh
- Anti-Infectives Research Group, Singapore Eye Research Institute, The Academia, Singapore
| | - Veluchamy Amutha Barathi
- Anti-Infectives Research Group, Singapore Eye Research Institute, The Academia, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Graduate Medical School, Singapore
| | - Eunice Tze Leng Goh
- Anti-Infectives Research Group, Singapore Eye Research Institute, The Academia, Singapore
| | - Raditya Anggara
- Anti-Infectives Research Group, Singapore Eye Research Institute, The Academia, Singapore
| | | | - Alice Jie Ying Ng
- Anti-Infectives Research Group, Singapore Eye Research Institute, The Academia, Singapore
| | - Sriram Harini
- Anti-Infectives Research Group, Singapore Eye Research Institute, The Academia, Singapore
| | - Thet Tun Aung
- Anti-Infectives Research Group, Singapore Eye Research Institute, The Academia, Singapore
| | - Stephen John Fox
- Bioinformatics Institute, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Shouping Liu
- Anti-Infectives Research Group, Singapore Eye Research Institute, The Academia, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Graduate Medical School, Singapore
| | - Liang Yang
- Singapore Centre for Environmental Life Sciences, Nanyang Technological University, Singapore
- School of Biological Sciences, Nanyang Technological University, Singapore
| | | | - Xian Jun Loh
- Institute of Materials Research and Engineering, A*STAR, Singapore
| | - Navin Kumar Verma
- Lee Kong Chian School of Medicine, Nanyang Technological University, Experimental Medicine Building, Singapore
| | - Roger W Beuerman
- Anti-Infectives Research Group, Singapore Eye Research Institute, The Academia, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Graduate Medical School, Singapore
| | - Rajamani Lakshminarayanan
- Anti-Infectives Research Group, Singapore Eye Research Institute, The Academia, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Graduate Medical School, Singapore
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Abstract
BACKGROUND Although chemical antiseptics are the most basic measure to control wound infection and frequently come into contact with subcutaneous adipose tissue, no studies have evaluated their toxicity on adipose tissue and its cell fractions. In the present study, the effects of five different antiseptics on adipose-derived stem cells were evaluated. METHODS Human adipose-derived stem cells were harvested from healthy donors. Adipose-derived stem cell viability was measured after treatment with different concentrations of antiseptics over 5 days. Furthermore, the effect on the proliferation, adipogenic differentiation, and apoptosis/necrosis of adipose-derived stem cells was analyzed. Finally, the mRNA expression of the stem cell markers CD29, CD34, CD73, CD90, and CD105 was detected. RESULTS Octenisept and Betaisodona significantly reduced cell proliferation and differentiation and led to considerable adipose-derived stem cell necrosis. Octenisept decreased stem cell viability at the lowest concentrations tested, and all stem cell markers were down-regulated by Octeniseptr and Betaisodona. Lavasept and Prontosan both led to reduced stem cell viability, proliferation, and differentiation, and increased apoptosis/necrosis, although the effects were less pronounced compared with Octenisept and Betaisodona. Adipose-derived stem cells survived treatment with mafenide acetate even at high concentrations, and mafenide acetate showed minimal negative effects on their proliferation, adipogenic differentiation, cell death, and stem cell marker expression. CONCLUSIONS Mafenide acetate may be regarded as a feasible antiseptic for the treatment of wounds with exposed adipose tissue because of its low adipose-derived stem cell toxicity. Lavasept and Prontosan are possible alternatives to mafenide acetate. Octenisept and Betaisodona, by contrast, may be used only in highly diluted solutions. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, V.
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48
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Fry DE. Pressure Irrigation of Surgical Incisions and Traumatic Wounds. Surg Infect (Larchmt) 2017; 18:424-430. [DOI: 10.1089/sur.2016.252] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Affiliation(s)
- Donald E. Fry
- MPA Healthcare Solutions, Chicago, Illinois; Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Department of Surgery, University of New Mexico School of Medicine, Albuquerque, New Mexico
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Abstract
As the burden of deep hardware infections continues to rise in orthopaedics, there is increasing interest in strategies for more effective debridement of colonized tissues and biofilm. Hydrogen peroxide has been used medically for almost a century, but its applications in orthopaedic surgery have yet to be fully determined. The basic science and clinical research on the antiseptic efficacy of hydrogen peroxide have demonstrated its efficacy against bacteria, and it has demonstrated potential synergy with other irrigation solutions such as chlorhexidine and povidone-iodine. While hydrogen peroxide is effective in infection reduction, there are concerns with wound healing, cytotoxicity, and embolic phenomena, and we recommend against hydrogen peroxide usage in the treatment of partial knee replacements, hemiarthroplasties, or native joints. Additionally, due to the potential for oxygen gas formation, hydrogen peroxide should not be used in cases of dural compromise, when pressurizing medullary canals, or when irrigating smaller closed spaces to avoid the possibility of air embolism. Finally, we present our protocol for irrigation and debridement and exchange of modular components in total joint arthroplasty, incorporating hydrogen peroxide in combination with povidone-iodine and chlorhexidine.
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Affiliation(s)
- Min Lu
- Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, California, USA
| | - Erik Nathan Hansen
- Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, California, USA
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50
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Zhu G, Wang Q, Lu S, Niu Y. Hydrogen Peroxide: A Potential Wound Therapeutic Target? Med Princ Pract 2017; 26:301-308. [PMID: 28384636 PMCID: PMC5768111 DOI: 10.1159/000475501] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 04/05/2017] [Indexed: 12/21/2022] Open
Abstract
Hydrogen peroxide (H2O2) is a topical antiseptic used in wound cleaning which kills pathogens through oxidation burst and local oxygen production. H2O2 has been reported to be a reactive biochemical molecule synthesized by various cells that influences biological behavior through multiple mechanisms: alterations of membrane potential, generation of new molecules, and changing intracellular redox balance, which results in activation or inactivation of different signaling transduction pathways. Contrary to the traditional viewpoint that H2O2 probably impairs tissue through its high oxidative property, a proper level of H2O2 is considered an important requirement for normal wound healing. Although the present clinical use of H2O2 is still limited to the elimination of microbial contamination and sometimes hemostasis, better understanding towards the sterilization ability and cell behavior regulatory function of H2O2 within wounds will enhance the potential to exogenously augment and manipulate healing.
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Affiliation(s)
| | | | | | - Yiwen Niu
- *Yiwen Niu, Department of Burns and Plastic Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai (China), E-Mail
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