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Bacterial responsive hydrogels based on quaternized chitosan and GQDs-ε-PL for chemo-photothermal synergistic anti-infection in diabetic wounds. Int J Biol Macromol 2022; 210:377-393. [PMID: 35526764 DOI: 10.1016/j.ijbiomac.2022.05.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/27/2022] [Accepted: 05/02/2022] [Indexed: 01/18/2023]
Abstract
Clinically, systemic antibiotic therapy and traditional dressings care are not satisfactory in treating chronic diabetic ulcers (DU). Therefore, we presented sprayable antibacterial hydrogel for effective treatment of DU by using antibacterial macromolecules (quaternized chitosan, QCS, Mn ≈ 1.5 × 105), photothermal antibacterial nanoparticles (ε-poly-l-lysine grafted graphene quantum dots, GQDs-ε-PL) and miocompatible macromolecules (benzaldehyde-terminated four-arm poly(ethylene glycol), 4 arm PEG-BA) as materials. The results revealed that the hydrogel could be in situ formed in 70-89 s through dynamic imine bonds crosslinking and exhibited a pH-dependent swelling ability and degradability. The hydrogel could respond to bacterial triggered acidic environment to play a synergistic effect of chemotherapy and xenon light irradiated PTT, leading to the rupture of the bacterial membrane and the inactivation of bacteria, promoting the migration and proliferation of fibroblast cell, enhancing the adhesion of platelet endothelial cell, and finally accelerating the healing of infected diabetic wound. Moreover, the hydrogel displayed self-healing, hemostatic, and biocompatible abilities, which could provide a better healing environment for wound and further promote wound healing. Hence, the multifunctional hydrogel is expected to be a potential dressing for the clinical treatment of DU.
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Masunaga A, Kawahara T, Morita H, Nakazawa K, Tokunaga Y, Akita S. Fatty acid potassium improves human dermal fibroblast viability and cytotoxicity, accelerating human epidermal keratinocyte wound healing in vitro and in human chronic wounds. Int Wound J 2021; 18:467-477. [PMID: 33433959 PMCID: PMC8273623 DOI: 10.1111/iwj.13547] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 12/19/2020] [Accepted: 12/31/2020] [Indexed: 12/11/2022] Open
Abstract
Effective cleaning of a wound promotes wound healing and favours wound care as it can prevent and control biofilms. The presence of biofilm is associated with prolonged wound healing, increased wound propensity to infection, and delayed wound closure. Anionic potassium salts of fatty acids are tested with commonly used anionic surfactants, such as sodium laureth sulphate (SLES) and sodium lauryl sulphate/sodium dodecyl sulphate (SLS/SDS). The normal human dermal cells demonstrated significantly greater viability in fatty acid potassium, including caprylic acid (C8), capric acid (C10), lauric acid (C12), oleic acid (C18:1), and linoleic acid (C18:2), than in SLES or SLS after a 24-hour incubation. Cytotoxicity by LDH assay in a 5-minute culture in fatty acid potassium was significantly lower than in SLES or SLS. in vitro wound healing of human epidermal keratinocytes during the scratch assay in 24-hour culture was more significantly improved by fatty acid treatment than by SLES or SLS/SDS. In a live/dead assay of human epidermal keratinocytes, C8K and C18:1K demonstrated only green fluorescence, indicating live cells, whereas synthetic surfactants, SLES and SLS, demonstrated red fluorescence on staining with propidium iodide, indicating dead cells after SLES and SLS/SDS treatment. Potassium salts of fatty acids are useful wound cleaning detergents that do not interfere with wound healing, as observed in the scratch assay using human epidermal keratinocytes. As potassium salts of fatty acids are major components of natural soap, which are produced by natural oil and caustic potash using a saponification method, this may be clinically important in wound and peri-wound skin cleaning. In human chronic wounds, natural soap containing fatty acid potassium increased tissue blood flow based on laser speckle flowgraphs after 2 weeks (P < .05), in addition to removing the eschars and debris. Wound cleansing by natural soap of fatty acid potassium is beneficial for wound healing.
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Affiliation(s)
| | | | | | - Kohji Nakazawa
- Department of Life and Environment Engineering, The University of Kitakyushu, Kitakyushu, Japan
| | - Yuto Tokunaga
- Department of Life and Environment Engineering, The University of Kitakyushu, Kitakyushu, Japan
| | - Sadanori Akita
- Department of Plastic Surgery, Wound Repair and Regeneration, Fukuoka University, Fukuoka, Japan
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Abstract
Wound healing is a complex, dynamic process supported by a myriad of cellular events that must be tightly coordinated to efficiently repair damaged tissue. Derangement in wound-linked cellular behaviours, as occurs with diabetes and ageing, can lead to healing impairment and the formation of chronic, non-healing wounds. These wounds are a significant socioeconomic burden due to their high prevalence and recurrence. Thus, there is an urgent requirement for the improved biological and clinical understanding of the mechanisms that underpin wound repair. Here, we review the cellular basis of tissue repair and discuss how current and emerging understanding of wound pathology could inform future development of efficacious wound therapies.
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Affiliation(s)
- Holly N Wilkinson
- Centre for Atherothrombosis and Metabolic Disease, Hull York Medical School, The University of Hull, Hull HU6 7RX, United Kingdom
| | - Matthew J Hardman
- Centre for Atherothrombosis and Metabolic Disease, Hull York Medical School, The University of Hull, Hull HU6 7RX, United Kingdom
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Das Ghatak P, Mathew-Steiner SS, Pandey P, Roy S, Sen CK. A surfactant polymer dressing potentiates antimicrobial efficacy in biofilm disruption. Sci Rep 2018; 8:873. [PMID: 29343818 PMCID: PMC5772662 DOI: 10.1038/s41598-018-19175-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 12/13/2017] [Indexed: 12/26/2022] Open
Abstract
A 100% water-soluble surfactant polymer dressing (SPD) that is bio-compatible and non-ionic has been reported to improve wound closure in preliminary clinical studies. The mechanism of action of SPD in wound healing remains unclear. Biofilm infection is a significant problem that hinders proper wound closure. The objective of this study was to characterize the mechanism of action of SPD inhibition of bacterial biofilm development. Static biofilms (48 h) of the primary wound pathogens Pseudomonas aeruginosa (PA01), Staphylococcus aureus (USA300) were grown on polycarbonate membranes and treated with SPD with and without antibiotics for an additional 24 h. The standard antibiotics - tobramycin (10 μg/ml) for PA01 and rifampicin (10 μg/ml) for USA300, were used in these studies. Following 24 h treatment with and without antibiotics, the biofilms were characterized using scanning electron microscopy (SEM) structural imaging, in vitro imaging system (IVIS) proliferation imaging, colony forming units (CFU), viability assay, quantitative PCR (qPCR) for virulence gene expression. Because SPD is a surfactant based dressing, it potentially has a direct effect on Gram negative bacteria such as Pseudomonas primarily due to the lipid-based outer membrane of the bacteria. SPD is a surfactant based dressing that has potent anti-biofilm properties directly or in synergy with antibiotics.
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Affiliation(s)
- Piya Das Ghatak
- Department of Surgery, Davis Heart and Lung Research Institute, Center for Regenerative Medicine & Cell-Based Therapies, Wexner Medical Center, The Ohio State University, Columbus, 43210, United States of America
- Center for Regenerative Medicine and Cell-Based Therapies, The Ohio State University, Columbus, 43210, United States of America
| | - Shomita S Mathew-Steiner
- Department of Surgery, Davis Heart and Lung Research Institute, Center for Regenerative Medicine & Cell-Based Therapies, Wexner Medical Center, The Ohio State University, Columbus, 43210, United States of America
- Center for Regenerative Medicine and Cell-Based Therapies, The Ohio State University, Columbus, 43210, United States of America
| | - Priyanka Pandey
- Department of Surgery, Davis Heart and Lung Research Institute, Center for Regenerative Medicine & Cell-Based Therapies, Wexner Medical Center, The Ohio State University, Columbus, 43210, United States of America
- Center for Regenerative Medicine and Cell-Based Therapies, The Ohio State University, Columbus, 43210, United States of America
| | - Sashwati Roy
- Department of Surgery, Davis Heart and Lung Research Institute, Center for Regenerative Medicine & Cell-Based Therapies, Wexner Medical Center, The Ohio State University, Columbus, 43210, United States of America
- Center for Regenerative Medicine and Cell-Based Therapies, The Ohio State University, Columbus, 43210, United States of America
| | - Chandan K Sen
- Department of Surgery, Davis Heart and Lung Research Institute, Center for Regenerative Medicine & Cell-Based Therapies, Wexner Medical Center, The Ohio State University, Columbus, 43210, United States of America.
- Center for Regenerative Medicine and Cell-Based Therapies, The Ohio State University, Columbus, 43210, United States of America.
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Morgan HM, Entwistle VA, Cribb A, Christmas S, Owens J, Skea ZC, Watt IS. We need to talk about purpose: a critical interpretive synthesis of health and social care professionals' approaches to self-management support for people with long-term conditions. Health Expect 2016; 20:243-259. [PMID: 27075246 PMCID: PMC5354019 DOI: 10.1111/hex.12453] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2016] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Health policies internationally advocate 'support for self-management', but it is not clear how the promise of the concept can be fulfilled. OBJECTIVE To synthesize research into professional practitioners' perspectives, practices and experiences to help inform a reconceptualization of support for self-management. DESIGN Critical interpretive synthesis using systematic searches of literature published 2000-2014. FINDINGS We summarized key insights from 164 relevant papers in an annotated bibliography. The literature illustrates striking variations in approaches to support for self-management and interpretations of associated concepts. We focused particularly on the somewhat neglected question of the purpose of support. We suggest that this can illuminate and explain important differences between narrower and broader approaches. Narrower approaches support people to manage their condition(s) well in terms of disease control. This purpose can underpin more hierarchical practitioner-patient communication and more limited views of patient empowerment. It is often associated with experiences of failure and frustration. Broader approaches support people to manage well with their condition(s). They can keep work on disease control in perspective as attention focuses on what matters to people and how they can be supported to shape their own lives. Broader approaches are currently less evident in practice. DISCUSSION AND CONCLUSION Broader approaches seem necessary to fulfil the promise of support for self-management, especially for patient empowerment. A commitment to enable people to live well with long-term conditions could provide a coherent basis for the forms and outcomes of support that policies aspire to. The implications of such a commitment need further attention.
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Affiliation(s)
| | | | - Alan Cribb
- Centre for Public Policy Research, King's College London, London, UK
| | - Simon Christmas
- Centre for Public Policy Research, King's College London, London, UK
| | - John Owens
- Centre for Public Policy Research, King's College London, London, UK
| | - Zoë C Skea
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Ian S Watt
- Department of Health Sciences/Hull York Medical School, Faculty of Science, University of York, Heslington, York, UK
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Rushforth B, McCrorie C, Glidewell L, Midgley E, Foy R. Barriers to effective management of type 2 diabetes in primary care: qualitative systematic review. Br J Gen Pract 2016; 66:e114-27. [PMID: 26823263 PMCID: PMC4723210 DOI: 10.3399/bjgp16x683509] [Citation(s) in RCA: 157] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 07/28/2015] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Despite the availability of evidence-based guidance, many patients with type 2 diabetes do not achieve treatment goals. AIM To guide quality improvement strategies for type 2 diabetes by synthesising qualitative evidence on primary care physicians' and nurses' perceived influences on care. DESIGN AND SETTING Systematic review of qualitative studies with findings organised using the Theoretical Domains Framework. METHOD Databases searched were MEDLINE, Embase, CINAHL, PsycInfo, and ASSIA from 1980 until March 2014. Studies included were English-language qualitative studies in primary care of physicians' or nurses' perceived influences on treatment goals for type 2 diabetes. RESULTS A total of 32 studies were included: 17 address general diabetes care, 11 glycaemic control, three blood pressure, and one cholesterol control. Clinicians struggle to meet evolving treatment targets within limited time and resources, and are frustrated with resulting compromises. They lack confidence in knowledge of guidelines and skills, notably initiating insulin and facilitating patient behaviour change. Changing professional boundaries have resulted in uncertainty about where clinical responsibility resides. Accounts are often couched in emotional terms, especially frustrations over patient compliance and anxieties about treatment intensification. CONCLUSION Although resources are important, many barriers to improving care are amenable to behaviour change strategies. Improvement strategies need to account for differences between clinical targets and consider tailored rather than 'one size fits all' approaches. Training targeting knowledge is necessary but insufficient to bring about major change; approaches to improve diabetes care need to delineate roles and responsibilities, and address clinicians' skills and emotions around treatment intensification and facilitation of patient behaviour change.
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Affiliation(s)
| | | | - Liz Glidewell
- Leeds Institute of Health Sciences, University of Leeds, Leeds
| | - Eleanor Midgley
- Leeds Institute of Health Sciences, University of Leeds, Leeds
| | - Robbie Foy
- Leeds Institute of Health Sciences, University of Leeds, Leeds
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Menon J. Maggot therapy: a literature review of methods and patient experience. ACTA ACUST UNITED AC 2012; 21:S38-42. [DOI: 10.12968/bjon.2012.21.sup5.s38] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Affiliation(s)
- Karen Ousey
- advancing clinical practice, School of Human and Health Sciences, University of Huddersfield
| | - Leanne Cook
- School of Human and Health Sciences, University of Huddersfield
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Laplaud AL, Blaizot X, Gaillard C, Morice A, Lebreuilly I, Clément CÃ, Parienti JJ, Dompmartin A. Wound debridement: Comparative reliability of three methods for measuring fibrin percentage in chronic wounds. Wound Repair Regen 2010; 18:13-20. [DOI: 10.1111/j.1524-475x.2009.00555.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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