A comparative study to evaluate the effect of limited access dressing (LAD) on burn wound healing

Near-Infrared Fluorescence Probe for Indication of the Pathological Stages of Wound Healing Process and Its Clinical Application

Chronic wound healing is one of the most complicated biological processes in human life, which is also a serious challenge for human health. During the healing process, multiple biological pathways are activated, and various kinds of reactive oxygen species participate in this process. Hydrogen peroxide (H2O2) involves in chronic wounds and its concentration is fluctuated in different pathological stages during the wound healing process. Therefore, H2O2 may be recognized as a powerful biomarker to indicate the wound healing process. However, the pathological roles of H2O2 cannot be fully understood yet. Herein, we proposed a near-infrared fluorescent probe DCM-H2O2 for highly sensitive and rapid detection of H2O2 in living cells and scald and incision wound mice models. DCM-H2O2 exhibited a low detection limit and high specificity with low cytotoxicity for H2O2, which had great potential for its application in vivo. The probe was successfully utilized to monitor the fluctuation of endogenous H2O2 in the proliferation process of human immortalized epidermal (HACAT) cells, which confirmed that H2O2 participated in the cells' proliferation activity through a growth factor signaling pathway. In the scald and incision wound mice models, H2O2 concentration fluctuations at different pathological stages during the wound healing process could be obtained by in vivo fluorescence imaging. Finally, H2O2 concentrations in different stages of human diabetic foot tissues were also confirmed by the proposed probe. We expect that H2O2 could be a sensitive biomarker to indicate the wound healing process.

The eggshell membrane: A potential biomaterial for corneal wound healing

The eggshell membrane (ESM) is an abundant resource with innate complex structure and composition provided by nature. With at least 60 million tonnes of hen eggs produced globally per annum, utilisation of this waste resource is highly attractive in positively impacting sustainability worldwide. Given the morphology and mechanical properties of this membrane, it has great potential as a biomaterials for wound dressing. However, to date, no studies have demonstrated nor reported this application. As such, the objective of this investigation was to identify and optimise a reproducible extraction protocol of the ESM and to assess the physical, chemical, mechanical and biological properties of the substrate with a view to use as a wound dressing. ESM samples were isolated by either manual peeling (ESM-strip) or via extraction using acetic acid [ESM-A0.5] or ethylenediaminetetraacetic acid, EDTA [ESM-E0.9]. Energy dispersive X-ray spectroscopy (EDS) confirmed that there were no traces of calcium residues from the extraction process. Fourier transform infrared (FTIR) spectroscopy revealed that the extraction method (acetic acid and EDTA) did not alter the chemical structures of the ESM and also clarified the composition of the fibrous proteins of the ESM. Scanning electron microscopy (SEM) analyses revealed a three-layer composite structure of the ESM: an inner layer as continuous, dense and non-fibrous (limiting membrane), a middle layer with a network of fibres (inner shell membrane) and the outer layer (outer shell membrane) of larger fibres. Material properties including optical transparency, porosity, fluid absorption/uptake, thermal stability, mechanical profiling of the ESM samples were performed and demonstrated suitable profiles for translational applications. Biological in vitro studies using SV40 immortalised corneal epithelial cells (ihCEC) and corneal mesenchymal stromal cells (C-MSC) demonstrated excellent biocompatibility. Taken together, these results document the development of a novel sustainable biomaterial that may be used for ophthalmic wounds and/or other biomedical therapies.

A Novel Approach to Negative Pressure Wound Therapy: Use of High Suction Capillary Device to Improve Wound Healing

INTRODUCTION

Negative Pressure Wound Therapy (NPWT) is a procedure used for nonhealing wounds. In NPWT, a special sealed dressing of large cell foam (>400 µm) or gauze is connected to a pump. Most commonly, negative pressures between -10 and -125 millimeters of mercury (mm Hg) are used. The mechanism of healing is unknown but maybe attributable to removal of the exudate and bacteria, and the stimulation of tissue repair through microdeformation. Reticulated foams with micron-size open cells, Capillary Suction Devices (CSD; 100 to 5 µm) exert capillary suction between 10 and 70 mm of Hg with a multilayered foam dressing.

MATERIALS AND METHODS

Yorkshire pigs received 5 surgical excision wounds, 3 cm2, on each side of the back. The wounds were covered with a NPWT dressing (110 mm Hg negative pressure by a pump), CSD with capillary suctions of 30 mm Hg (CSD-30) and 70 mm Hg (CSD-70), and a conventional gauze dressing. The wounds were measured on day 2, and then every 4-5 days thereafter; the total fluid collected by the various dressing over time.

RESULTS

By post-wound day 20, the wounds treated with CSD-70 and NPWT were 100% closed while the wounds treated with CSD-30 and gauze were 65% and 45%, respectively. This indicated comparable wound closure efficacies for CSD-70 and NPWT. The average total fluid uptake measured in grams dry weight were similar for CSD-70 and NPWT, 36 and 38 g, respectively, while the values were 24 g for CSD-30 and 12 g for gauze. However, the maximum fluid uptake observed at day 2 indicated that CSD-70 and CSD 30, 24 and 14 g, respectively, were superior to NPWT and gauze 12 and 7 g, respectively.

CONCLUSION

This data indicate comparable wound closure efficacies for CSD-70 and NPWT. It is felt that CSD is an effective, safe, and lower cost alternative to vacuum-assisted NPWT.