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Yang Y, Chen Q, Fan S, Lu Y, Huang Q, Liu X, Peng X. Glutamine sustains energy metabolism and alleviates liver injury in burn sepsis by promoting the assembly of mitochondrial HSP60-HSP10 complex via SIRT4 dependent protein deacetylation. Redox Rep 2024; 29:2312320. [PMID: 38329114 PMCID: PMC10854458 DOI: 10.1080/13510002.2024.2312320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2024] Open
Abstract
Burns and burn sepsis, characterized by persistent and profound hypercatabolism, cause energy metabolism dysfunction that worsens organ injury and systemic disorders. Glutamine (Gln) is a key nutrient that remarkably replenishes energy metabolism in burn and sepsis patients, but its exact roles beyond substrate supply is unclear. In this study, we demonstrated that Gln alleviated liver injury by sustaining energy supply and restoring redox balance. Meanwhile, Gln also rescued the dysfunctional mitochondrial electron transport chain (ETC) complexes, improved ATP production, reduced oxidative stress, and protected hepatocytes from burn sepsis injury. Mechanistically, we revealed that Gln could activate SIRT4 by upregulating its protein synthesis and increasing the level of Nicotinamide adenine dinucleotide (NAD+), a co-enzyme that sustains the activity of SIRT4. This, in turn, reduced the acetylation of shock protein (HSP) 60 to facilitate the assembly of the HSP60-HSP10 complex, which maintains the activity of ETC complex II and III and thus sustain ATP generation and reduce reactive oxygen species release. Overall, our study uncovers a previously unknown pharmacological mechanism involving the regulation of HSP60-HSP10 assembly by which Gln recovers mitochondrial complex activity, sustains cellular energy metabolism and exerts a hepato-protective role in burn sepsis.
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Affiliation(s)
- Yongjun Yang
- Clinical Medical Research Center, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, People’s Republic of China
| | - Qian Chen
- Clinical Medical Research Center, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, People’s Republic of China
| | - Shijun Fan
- Clinical Medical Research Center, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, People’s Republic of China
| | - Yongling Lu
- Clinical Medical Research Center, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, People’s Republic of China
| | - Qianyin Huang
- Clinical Medical Research Center, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, People’s Republic of China
| | - Xin Liu
- Clinical Medical Research Center, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, People’s Republic of China
| | - Xi Peng
- Clinical Medical Research Center, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, People’s Republic of China
- State Key Laboratory of Trauma, Burns and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), ChongqingPeople’s Republic of China
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Rousseau AF, Fadeur M, Misset B. Nutritional approach of patients with minor burns: A neglected aspect of burn care? JPEN J Parenter Enteral Nutr 2024. [PMID: 39102303 DOI: 10.1002/jpen.2677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2024] [Accepted: 07/15/2024] [Indexed: 08/07/2024]
Affiliation(s)
| | - Marjorie Fadeur
- Multidisciplinary Nutrition Team, University Hospital, University of Liège, Liège, Belgium
| | - Benoit Misset
- Department of Intensive Care, University Hospital, University of Liège, Liège, Belgium
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3
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Qu M, Qu M. Comment on: "Obesity increases the risk of major wound complications following pelvic resection for bone sarcoma". J Surg Oncol 2024. [PMID: 39104088 DOI: 10.1002/jso.27804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2024] [Accepted: 07/27/2024] [Indexed: 08/07/2024]
Affiliation(s)
- Mengde Qu
- Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
| | - Mengqi Qu
- Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
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Donnelly HR, Clarke ED, Collins CE, Tehan PE. 'Nutrition has everything to do with wound healing'-health professionals' perceptions of assessment and management of nutrition in individuals with diabetes-related foot ulceration. Int Wound J 2024; 21:e14898. [PMID: 38745257 PMCID: PMC11093920 DOI: 10.1111/iwj.14898] [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: 01/22/2024] [Accepted: 04/19/2024] [Indexed: 05/16/2024] Open
Abstract
Determine how healthcare professionals perceive their role in nutrition assessment and management, and explore barriers and enablers to assessment and management of nutrition in individuals with DFU. Mixed methods including a cross-sectional online survey derived from current international guidelines and theoretical domains framework, and semi-structured interviews with conventional content analysis was performed. One hundred and ninety-one participants completed the survey, with 19 participating in interviews. Many health professionals are not confident in their ability in this area of practice, are uncertain their nutrition advice or management will be effective in assisting wound healing outcomes and are uncertain their intervention would result in adequate behaviour change by the individual with DFU. Major barriers to implementation of nutrition assessment and management were: inadequate time, lack of knowledge and lack of clinical guidance and enablers were as follows: professional development, a standardised clinical pathway and screening tool and a resource addressing wound healing and diabetes management. Nutrition assessment and management in individuals with DFU is not consistently applied. Whilst health professionals believed nutrition was important for wound healing, they lacked confidence in implementing into their practice. Further dissemination of existing guidance and implementation of education programs and resources would help overcome cited barriers.
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Affiliation(s)
- Hailey R. Donnelly
- School of Health Sciences, College of Health, Medicine and WellbeingUniversity of NewcastleCallaghanNew South WalesAustralia
- Food and Nutrition Research ProgramHunter Medical Research InstituteNew Lambton HeightsNew South WalesAustralia
| | - Erin D. Clarke
- School of Health Sciences, College of Health, Medicine and WellbeingUniversity of NewcastleCallaghanNew South WalesAustralia
- Food and Nutrition Research ProgramHunter Medical Research InstituteNew Lambton HeightsNew South WalesAustralia
| | - Clare E. Collins
- School of Health Sciences, College of Health, Medicine and WellbeingUniversity of NewcastleCallaghanNew South WalesAustralia
- Food and Nutrition Research ProgramHunter Medical Research InstituteNew Lambton HeightsNew South WalesAustralia
| | - Peta E. Tehan
- Food and Nutrition Research ProgramHunter Medical Research InstituteNew Lambton HeightsNew South WalesAustralia
- Department of Surgery, School of Clinical SciencesMonash UniversityMelbourneVictoriaAustralia
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5
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Chu Y, Kong J, Xu J, Han G, Yu W, Xu X. Role of nutritional support in nursing practice for improving surgical site wound healing in patients post-surgery with risk of pressure ulcers. Int Wound J 2024; 21:e14855. [PMID: 38562093 PMCID: PMC10985497 DOI: 10.1111/iwj.14855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 03/12/2024] [Indexed: 04/04/2024] Open
Abstract
To explore the role of nutritional support in nursing practice on postoperative surgical site wound healing in patients undergoing surgery at risk for pressure ulcers. This study adopted a retrospective experimental design and included a total of 60 patients at risk of pressure ulcers, divided into a nutritional support group and a control group, with 30 people in each group. The nutritional support group implemented specific nutritional support measures after surgery, while the control group received standard postoperative care. Outcome measures included redness and swelling scores, edema scores, anxiety assessments, pain scores, bleeding volume, recovery time and incidence of pressure ulcers. The result indicates that patients who received nutritional support exhibited lower postoperative wound redness and swelling scores compared to the control group (3.11 ± 0.45 vs. 4.85 ± 0.74, p < 0.05). Additionally, the nutritional support group showed significantly lower edema scores (2.75 ± 0.37 vs. 3.53 ± 0.62, p < 0.05). Anxiety levels, as measured by the anxiety assessment scale (SAS), were also lower in the nutritional support group (6.52 ± 1.19 vs. 7.60 ± 1.62, p < 0.05). Moreover, the average healing time was shorter for the nutritional support group (7.27 ± 1.36 days) compared to the control group (9.71 ± 1.84 days, p < 0.05). Postoperative pain scores were lower in the nutritional support group (4.13 ± 0.72 vs. 5.43 ± 0.62, p < 0.05), and patient satisfaction scores were higher (9.42 ± 0.76 vs. 7.25 ± 0.81, p < 0.05). Nutritional support has a positive effect on postoperative wound healing at surgical sites in patients at risk of pressure ulcers in nursing practice. It can significantly reduce redness, swelling, edema, anxiety, and pain scores, reduce bleeding, shorten recovery time, and reduce pressure ulcers. incidence rate.
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Affiliation(s)
- Yali Chu
- Department of General SurgeryQilu Hospital of Shandong UniversityJinanChina
| | - Juan Kong
- Department of NeurologyQilu Hospital of Shandong UniversityJinanChina
| | - Jin Xu
- School of Nursing and RehabilitationShandong UniversityJinanChina
| | - Guangxue Han
- School of NursingShandong University of TCMJinanChina
| | - Wenbin Yu
- Department of General SurgeryQilu Hospital of Shandong UniversityJinanChina
| | - Xiulian Xu
- Department of General SurgeryQilu Hospital of Shandong UniversityJinanChina
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Williams JL, Lien KM, Kirschner R, Allen G, Chapman K. Feeding Management and Palate Repair Timing in Infants with Cleft Palate with and without Pierre Robin Sequence: A Multisite Study. Cleft Palate Craniofac J 2024:10556656241239766. [PMID: 38490219 DOI: 10.1177/10556656241239766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024] Open
Abstract
OBJECTIVES Compare the feeding management practices in infants with cleft palate with and without Pierre Robin sequence (PRS) and determine if specific feeding difficulties or interventions predict delayed palate repair. DESIGN Retrospective cross-sectional study. SETTING Seventeen cleft palate teams contributed data. PATIENTS 414 infants were included in this study: 268 infants with cleft palate only and 146 infants with cleft palate and PRS. PROCEDURES Data were collected via parent interview and electronic health records. MAIN OUTCOME MEASURES Outcomes for the primary objective included categorical data for: history of poor growth, feeding therapy, milk fortification, use of enteral feeding, and feeding difficulties. The outcome for the secondary objective was age in months at primary palate repair. RESULTS Infants with PRS had a significantly higher prevalence of feeding difficulties (81% versus 61%) and poor growth (29% versus 15%) compared to infants with cleft palate only. Infants with PRS received all feeding interventions-including feeding therapy, milk fortification, and enteral feeding-at a significantly higher frequency. Infants with PRS underwent primary palate repair at a mean age of 13.55 months (SD = 3.29) which was significantly (P < .00001) later than infants with cleft palate only who underwent palate repair at a mean age of 12.05 months (SD = 2.36). Predictors of delayed palate repair included diagnosis of PRS as well as Hispanic ethnicity and a history of poor growth. CONCLUSIONS These findings can be used to establish clinical directives focused on providing early, multimodal feeding interventions to promote optimal growth and timely palate repair for infants with PRS.
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Affiliation(s)
- Jessica L Williams
- Phoenix Children's Center for Cleft and Craniofacial Care a Division of Plastic Surgery, Phoenix Children's Hospital, Phoenix, AZ, USA
- Program of Speech and Hearing Science, College of Health Solutions, Arizona State University, Tempe, AZ, USA
| | - Kari M Lien
- Department of Communication Sciences and Disorders, College of Health, University of Utah, Salt Lake City, UT, USA
| | - Richard Kirschner
- Department of Plastic and Reconstructive Surgery, Nationwide Children's Hospital, Columbus, OH, USA
- Department of Plastic Surgery, The Ohio State University Medical College, Columbus, OH, USA
| | - Gregory Allen
- Department of Otolaryngology, Children's Hospital Colorado, Aurora, CO, USA
| | - Kathy Chapman
- Department of Communication Sciences and Disorders, College of Health, University of Utah, Salt Lake City, UT, USA
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Torsy T, Tency I, Beeckman D, De Vylder F. Effectiveness of glutamine and arginine in wound healing of pressure ulcers: A systematic review protocol. J Tissue Viability 2024:S0965-206X(24)00026-3. [PMID: 38448329 DOI: 10.1016/j.jtv.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 03/01/2024] [Indexed: 03/08/2024]
Abstract
INTRODUCTION Various nutrients play a physiological role in the healing process of pressure ulcers (PUs). Nutritional interventions include the administration of enteral nutritional supplements and formulas containing arginine, glutamine, and micronutrients. The aim of this systematic review is to evaluate the effectiveness of enteral nutritional supplements and formulas containing arginine and glutamine on wound-related outcomes. These include (1) time to healing, (2) changes in wound size, (3) local wound infection, (4) PU recurrence, and (5) PU-related pain. MATERIALS AND METHODS This protocol was developed according to the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). A search will be conducted in the Cochrane Library, EMBASE, PubMed (MEDLINE), CINAHL (EBSCOhost interface) and Web of Science. In addition, a manual search will be conducted to identify relevant records. Except for systematic reviews, no restrictions will be placed on the study design, the population studied or the setting. Studies that do not address PUs, in vitro studies and studies that do not report wound-related outcomes will be excluded. Study selection, risk of bias assessment and data extraction will be performed independently by three researchers. Depending on the extent of heterogeneity of interventions, follow-up time and populations, results will be summarised either by meta-analysis or narrative synthesis. CONCLUSIONS This is the first systematic review to identify, evaluate and summarise the current evidence for enteral arginine and glutamine supplementation on wound-related outcomes in PUs. The review will provide a solid basis for deriving valid and clinically relevant conclusions in this area.
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Affiliation(s)
- Tim Torsy
- Odisee University College, Faculty of Healthcare, Department of Nursing and Midwifery, Belgium; Ghent University, Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Belgium.
| | - Inge Tency
- Odisee University College, Faculty of Healthcare, Department of Nursing and Midwifery, Belgium; Ghent University, Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Belgium
| | - Dimitri Beeckman
- Ghent University, Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Belgium; Örebro University, School of Health Sciences, Sweden
| | - Flore De Vylder
- Odisee University College, Faculty of Healthcare, Department of Nursing and Midwifery, Belgium; Ghent University, Faculty of Medicine and Health Sciences, Department of Movement and Sports Sciences, Belgium
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Sheriff MM, Alotaibi SD, Alharbi GH, Alghamdi MMO, Aljadani NM, Alzahrani HA, Abdulhaq SHM, Mualla Aljuhani BA, Abdulaziz Sultan HM, Ba Rahma AEA, Alghamdi RD, Albishri MM, Eldabai NK, Mohammed Alharbi HA. A Cross-Sectional Study on the Awareness and Practice of the Use of Supplemental Vitamin C, Arginine, and Zinc in Managing Wounds Among Healthcare Workers in Saudi Arabia. Cureus 2023; 15:e51235. [PMID: 38283517 PMCID: PMC10821765 DOI: 10.7759/cureus.51235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2023] [Indexed: 01/30/2024] Open
Abstract
Introduction The intricate connection between nutrition and compromised wound healing exposes patients to heightened risks of pressure ulcers, infections, and delayed recovery from wounds or traumatic injuries. In-depth scientific investigations have shed light on the potential of specialized nutritional supplements, combined with regular wound care, to significantly boost the management of pressure ulcers and the wound healing process. The study focuses on supplemental Vitamin C, Arginine, and Zinc due to their established roles in wound healing, aiming to assess the awareness and practice of healthcare workers in Saudi Arabia regarding these essential nutrients for effective wound management. This cross-sectional study aimed to assess awareness and practice among healthcare workers in Saudi Arabia regarding the use of supplemental Vitamin C, Arginine, and Zinc in managing wounds. Methods This study adopts a cross-sectional research design to explore the dynamics to assess the awareness and practice among healthcare workers about the use of supplemental Vitamin C, Arginine, and Zinc in managing wounds in Saudi Arabia. The research methodology encompasses developing and validating a questionnaire, data collection, and subsequent analysis. Thorough statistical analyses, encompassing descriptive statistics, validated assessment scales, and inferential statistics, were conducted using SPSS and Microsoft Excel to explore intricacy prevalence and severity relationships with various factors, maintaining a statistical power of 80% at a cutoff value of 0.05. Result In a cross-sectional survey of 510 healthcare professionals, the socio-demographic analysis revealed a predominant hospital workplace (61.56%), with pharmacists representing 10.19%, and comprehensive tabulation of response rates and p-values, while the knowledge and awareness assessment demonstrated varied understanding and perceptions of wound care supplements, including frequent encounters with pressure ulcers or wounds (36.5%), diverse awareness levels for Vitamin C, Arginine, and Zinc, with the collaboration and communication dynamics among healthcare workers, detailed in tabulated response rates and p-values. Conclusion The findings reveal a diverse understanding landscape, with varying levels of awareness, perceived effectiveness, and confidence in applying these supplements.
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Affiliation(s)
- Muazzam M Sheriff
- Microbiology and Immunology, Ibn Sina National College for Medical Studies, Jeddah, SAU
| | | | | | | | | | - Hend A Alzahrani
- Gastrointestinal Oncology Clinical Nursing, National Guard Hospital, King Abdulaziz Medical City, Jeddah, SAU
| | | | | | | | | | - Rawabi D Alghamdi
- Medicine, Ibn Sina National College for Medical Studies, Jeddah, SAU
| | - Maram M Albishri
- Medicine, Ibn Sina National College for Medical Studies, Jeddah, SAU
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Song Y, Chu W, Zhang M, Liu Z, Li D, Zhao F, Zhang B, Gao M, Yuan H, Shen C. A study on the preoperative risk factors for primary healing failure in the reconstruction of deep sternal wound infection with platelet-rich plasma and negative pressure trauma therapy. Int Wound J 2023; 20:3457-3466. [PMID: 37269235 PMCID: PMC10588312 DOI: 10.1111/iwj.14216] [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: 03/02/2023] [Revised: 04/12/2023] [Accepted: 04/17/2023] [Indexed: 06/05/2023] Open
Abstract
Deep sternal wound infection (DSWI) is a relatively complex wound in wound reconstruction surgery. Because plastic surgeons deal with DSWI patients late. The primary healing (healing by first intention) after reconstruction of DSWI is restricted by many preoperative risk factors. The purpose of this study is to explore and analyse the risk factors of primary healing failure in patients with DSWI treated with platelet-rich plasma (PRP) and negative pressure trauma therapy (NPWT). 115 DSWI patients treated with the PRP and NPWT (PRP + NPWT) modality were retrospectively (2013-2021) analysed. They were divided into two groups according to primary healing results after the first PRP + NPWT treatment. Univariate and multivariate analyses were used to compare the data of the two groups to find out the risk factors and their optimal cut-off values were identified by ROC analysis. The primary healing results, debridement history, wound size, sinus, osteomyelitis, renal function, bacterial culture, albumin (ALB), platelet (PLT) between the two groups were significantly different (P < 0.05). Binary logistic regression showed that osteomyelitis, sinus, ALB and PLT were the risk factors affecting primary healing outcomes (P < 0.05). ROC analysis showed that AUC for ALB in the non-primary healing group was 0.743 (95% CI: 0.650-0.836, P < 0.05) and its optimal cutoff value of 31 g/L was associated with primary healing failure with a sensitivity of 96.9% and specificity of 45.1%. AUC for PLT in the non-primary healing group was 0.670 (95% CI: 0.571 ~ 0.770, P < 0.05) its optimal cutoff value of 293 × 109 /L was associated with primary healing failure with a sensitivity of 72.5% and specificity of 56.3%. In the cases included in this study, the success rate of primary healing of DSWI treated with PRP + NPWT was not affected by the most common preoperative risk factors for wound non-union. It is indirectly confirmed that PRP + NPWT is an ideal treatment. However, it should be noted that it will still be adversely affected by sinus osteomyelitis, ALB and PLT. The patients need to be carefully evaluated and corrected before reconstruction.
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Affiliation(s)
- Yaoyao Song
- Department of Burns and Plastic SurgeryFourth Medical Center of Chinese PLA General Hospital, (PLA:People's Liberation Army)BeijingChina
| | - Wanli Chu
- Department of Burns and Plastic SurgeryFourth Medical Center of Chinese PLA General Hospital, (PLA:People's Liberation Army)BeijingChina
| | - Ming Zhang
- Department of Burns and Plastic SurgeryFourth Medical Center of Chinese PLA General Hospital, (PLA:People's Liberation Army)BeijingChina
| | - Zhaoxing Liu
- Department of Burns and Plastic SurgeryFourth Medical Center of Chinese PLA General Hospital, (PLA:People's Liberation Army)BeijingChina
| | - Dawei Li
- Department of Burns and Plastic SurgeryFourth Medical Center of Chinese PLA General Hospital, (PLA:People's Liberation Army)BeijingChina
| | - Fan Zhao
- Department of Burns and Plastic SurgeryFourth Medical Center of Chinese PLA General Hospital, (PLA:People's Liberation Army)BeijingChina
| | - Bohan Zhang
- Department of Burns and Plastic SurgeryFourth Medical Center of Chinese PLA General Hospital, (PLA:People's Liberation Army)BeijingChina
| | - Mengmeng Gao
- Department of Burns and Plastic SurgeryFourth Medical Center of Chinese PLA General Hospital, (PLA:People's Liberation Army)BeijingChina
| | - Huageng Yuan
- Department of Burns and Plastic SurgeryFourth Medical Center of Chinese PLA General Hospital, (PLA:People's Liberation Army)BeijingChina
| | - Chuanan Shen
- Department of Burns and Plastic SurgeryFourth Medical Center of Chinese PLA General Hospital, (PLA:People's Liberation Army)BeijingChina
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Yoshikawa Y, Maeshige N, Yamaguchi A, Uemura M, Hiramatsu T, Tsuji Y, Terashi H. Association between Patients' Body Mass Index and the Effect of Monophasic Pulsed Microcurrent Stimulation on Pressure Injury Healing. Biomedicines 2023; 11:2379. [PMID: 37760820 PMCID: PMC10526075 DOI: 10.3390/biomedicines11092379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/15/2023] [Accepted: 08/23/2023] [Indexed: 09/29/2023] Open
Abstract
This secondary analysis study aimed to detect individual variables that influence the efficacy of monophasic pulsed microcurrent on pressure injury healing. Eleven patients with pressure injuries showing delayed healing underwent a microcurrent stimulation period and a placebo period. We analyzed the correlation between the individual variables and the following three outcomes using monophasic pulsed microcurrent: the wound reduction rate in the electrical stimulation period, the reduction rate in the placebo period, and the difference between these two reduction rates. Furthermore, the patients were divided into two groups, one with a wound reduction rate of more than 10% and the other with less than 10%, and the relationship between each variable was compared. As a result, the wound reduction rate in the electrical stimulation period and the difference in the reduction rate between the two periods showed significant positive correlations with patients' body mass index. In addition, a significant difference was observed in the body mass index between subjects with a reduction rate of 10% or higher and those with a reduction rate of less than 10%. This study found a correlation between the effect of monophasic pulsed microcurrent for pressure injury healing and the level of patients' body mass index.
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Affiliation(s)
- Yoshiyuki Yoshikawa
- Department of Rehabilitation, Faculty of Health Sciences, Naragakuen University, Nara 631-0003, Japan
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Kobe 654-0142, Japan
| | - Noriaki Maeshige
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Kobe 654-0142, Japan
| | - Atomu Yamaguchi
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Kobe 654-0142, Japan
| | - Mikiko Uemura
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Kobe 654-0142, Japan
- Department of Rehabilitation, Faculty of Health Sciences, Kansai University of Welfare Sciences, Kashiwara 582-0026, Japan
| | | | - Yoriko Tsuji
- Unit of Podiatric Medicine, Department of Plastic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Hiroto Terashi
- Department of Plastic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
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11
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Fernández Forné Á, García Anaya MJ, Segado Guillot SJ, Plaza Andrade I, de la Peña Fernández L, Lorca Ocón MJ, Lupiáñez Pérez Y, Queipo-Ortuño MI, Gómez-Millán J. Influence of the microbiome on radiotherapy-induced oral mucositis and its management: A comprehensive review. Oral Oncol 2023; 144:106488. [PMID: 37399707 DOI: 10.1016/j.oraloncology.2023.106488] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 06/29/2023] [Indexed: 07/05/2023]
Abstract
Radiation-induced mucositis is the most common, debilitating and painful acute toxicity associated with active treatment in head and neck cancer area, severely affecting more than 65% of patients. Oral microbiota significantly changes during cancer therapy and appears to be involved on its pathophysiology. This review aims to present a comprehensive update of new etiopathogenic factors and treatments that may decrease the incidence of mucositis, mainly modifications of dietary interventions to modify microbiome. Despite advances in recent years, its management is mainly symptomatic opioid-based with variable results on different substances analyzed for its prevention. Immunonutrition seems to play a significant role, particularly the supplementation of compounds such as fatty acids, polyphenols or selected probiotics have shown to promote commensal bacteria diversity and reduced incidence of ulcerative mucositis. Modification of the microbiome is a promising preventive treatment for mucositis although its evidence is still scarce. Large studies are needed to demonstrate the efficacy of interventions on microbiome and its clinical impact on radiation-induced mucositis.
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Affiliation(s)
- África Fernández Forné
- Department of Radiation Oncology. Punta Europa University Hospital. Algeciras, Cádiz, Spain
| | - María Jesús García Anaya
- Department of Radiation Oncology, Virgen de la Victoria University Hospital, 29010 Málaga, Spain
| | | | - Isaac Plaza Andrade
- Intercenter Clinical Unit of Medical Oncology, Regional and Virgen de la Victoria University Hospitals, Biomedical Research Institute of Malaga (IBIMA)-CIMES-UMA, University of Malaga, 29010 Málaga, Spain
| | | | - María Jesús Lorca Ocón
- Department of Radiation Oncology, Virgen de la Victoria University Hospital, 29010 Málaga, Spain
| | - Yolanda Lupiáñez Pérez
- Department of Radiation Oncology, Virgen de la Victoria University Hospital, 29010 Málaga, Spain
| | - María Isabel Queipo-Ortuño
- Intercenter Clinical Unit of Medical Oncology, Regional and Virgen de la Victoria University Hospitals, Biomedical Research Institute of Malaga (IBIMA)-CIMES-UMA, University of Malaga, 29010 Málaga, Spain; Department of Surgical Specialties, Biochemical and Immunology, Faculty of Medicine, University of Málaga, 29010 Malaga, Spain.
| | - Jaime Gómez-Millán
- Department of Radiation Oncology, Virgen de la Victoria University Hospital, 29010 Málaga, Spain
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12
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Evans JP, Sen CK. Electrochemical Devices in Cutaneous Wound Healing. Bioengineering (Basel) 2023; 10:711. [PMID: 37370642 PMCID: PMC10295280 DOI: 10.3390/bioengineering10060711] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 05/30/2023] [Accepted: 06/01/2023] [Indexed: 06/29/2023] Open
Abstract
In healthy skin, vectorial ion transport gives rise to a transepithelial potential which directly impacts many physiological aspects of skin function. A wound is a physical defect that breaches the epithelial barrier and changes the electrochemical environment of skin. Electroceutical dressings are devices that manipulate the electrochemical environment, host as well as microbial, of a wound. In this review, electroceuticals are organized into three mechanistic classes: ionic, wireless, and battery powered. All three classes of electroceutical dressing show encouraging effects on infection management and wound healing with evidence of favorable impact on keratinocyte migration and disruption of wound biofilm infection. This foundation sets the stage for further mechanistic as well as interventional studies. Successful conduct of such studies will determine the best dosage, timing, and class of stimulus necessary to maximize therapeutic efficacy.
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Affiliation(s)
| | - Chandan K. Sen
- Indiana Center for Regenerative Medicine & Engineering, Indiana University Health Comprehensive Wound Center, Department of Surgery, Indiana University School of Medicine, Indianapolis, IN 46202, USA
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Kurian SJ, Baral T, Unnikrishnan MK, Benson R, Munisamy M, Saravu K, Rodrigues GS, Rao M, Kumar A, Miraj SS. The association between micronutrient levels and diabetic foot ulcer: A systematic review with meta-analysis. Front Endocrinol (Lausanne) 2023; 14:1152854. [PMID: 37065742 PMCID: PMC10090454 DOI: 10.3389/fendo.2023.1152854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 03/14/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND Diabetic foot ulcers (DFU) are a major complication of diabetes mellitus (DM). Nutrient deficiencies are among the major risk factors in DFU development and healing. In this context, we aimed to investigate the possible association between micronutrient status and risk of DFU. METHODS A systematic review (Prospero registration: CRD42021259817) of articles, published in PubMed, Web of Science, Scopus, CINAHL Complete, and Embase, that measured the status of micronutrients in DFU patients was performed. RESULTS Thirty-seven studies were considered, of which thirty were included for meta-analysis. These studies reported levels of 11 micronutrients: vitamins B9, B12, C, D, E, calcium, magnesium, iron, selenium, copper, and zinc. DFU, compared to healthy controls (HC) had significantly lower vitamin D (MD: -10.82 14 ng/ml, 95% CI: -20.47, -1.16), magnesium (MD: -0.45 mg/dL, 95% CI: -0.78, -0.12) and selenium (MD: -0.33 µmol/L, 95% CI: -0.34, -0.32) levels. DFU, compared to DM patients without DFU, had significantly lower vitamin D (MD: -5.41 ng/ml, 95% CI: -8.06, -2.76), and magnesium (MD: -0.20 mg/dL, 95% CI: -0.25, -0.15) levels. The overall analysis showed lower levels of vitamin D [15.55ng/ml (95% CI:13.44, 17.65)], vitamin C [4.99µmol/L (95% CI:3.16, 6.83)], magnesium [1.53mg/dL (95% CI:1.28, 1.78)] and selenium [0.54µmol/L (95% CI:0.45, 0.64)]. CONCLUSION This review provides evidence that micronutrient levels significantly differ in DFU patients, suggesting an association between micronutrient status and risk of DFU. Therefore, routine monitoring and supplementations are warranted in DFU patients. We suggest that personalized nutrition therapy may be considered in the DFU management guidelines. SYSTEMATIC REVIEW REGISTRATION https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=259817, identifier CRD42021259817.
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Affiliation(s)
- Shilia Jacob Kurian
- Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of High Education, Manipal, Karnataka, India
- Manipal Centre for Infectious Diseases, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Tejaswini Baral
- Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of High Education, Manipal, Karnataka, India
- Manipal Centre for Infectious Diseases, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | | | - Ruby Benson
- Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of High Education, Manipal, Karnataka, India
| | - Murali Munisamy
- Department of Translational Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Kavitha Saravu
- Manipal Centre for Infectious Diseases, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
- Department of Infectious Diseases, Kasturba Medical College and Hospital, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | | | - Mahadev Rao
- Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of High Education, Manipal, Karnataka, India
| | - Amit Kumar
- Department of Laboratory Medicine, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Sonal Sekhar Miraj
- Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of High Education, Manipal, Karnataka, India
- Manipal Centre for Infectious Diseases, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
- *Correspondence: Sonal Sekhar Miraj,
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Clark RK, Stampas A, Kerr KW, Nelson JL, Sulo S, Leon‐Novelo L, Ngan E, Pandya D. Evaluating the impact of using a wound-specific oral nutritional supplement to support wound healing in a rehabilitation setting. Int Wound J 2022; 20:145-154. [PMID: 35684975 PMCID: PMC9797929 DOI: 10.1111/iwj.13849] [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: 03/16/2022] [Revised: 04/12/2022] [Accepted: 04/13/2022] [Indexed: 01/07/2023] Open
Abstract
Chronic wounds adversely affect patient quality of life, increase the risk of mortality, and impose high costs on healthcare systems. Since protein-energy malnutrition or specific nutrient deficiencies can delay wound healing, nutritionally focused care is a key strategy to help prevent or treat the occurrence of non-healing wounds. The objective of our study of inpatients in a rehabilitation hospital was to quantify the effect of daily wound-specific oral nutritional supplementation (WS-ONS) on healing chronic wounds. Using electronic medical records, we conducted a retrospective analysis of patients with chronic wounds. We identified records for (a) a treatment group who received standard wound care + usual hospital diet + daily WS-ONS for ≥14 days, and (b) a control group who received standard wound care + a usual hospital diet. We collected data for demographics, nutritional status, and wound-relevant health characteristics. We examined weekly measurements of wound number and sizes (surface area for superficial wounds or volume for non-superficial wounds). There were 341 patients identified, 114 with 322 wounds in the treatment group and 227 patients with 420 wounds in the control group. We found that rehabilitation inpatients who were given nutritional support had larger wounds and lower functional independence on admission. At discharge, wound area reduction (percent) was nearly two-fold better in patients who were given daily WS-ONS + usual hospital diet compared to those who consumed usual diet only (61.1% vs 34.5%). Overall, weekly wound improvement (lowered wound area or wound volume) was more likely in the WS-ONS group than in the Control group, particularly from the start of care to week 2. Inpatients with largest wounds and lowest functional independence on admission were most likely to be given WS-ONS, an indication that caregivers recognised the need for supplementation. Week-to-week improvement in wound size was more likely in patients who received WS-ONS than in those who did not. Specifically, wound areas and wound volumes were significantly lower at discharge among patients who were given specialised nutritional support. More research in this field is needed to improve care and reduce healthcare costs.
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Affiliation(s)
- Rya K. Clark
- Clinical NutritionTIRR Memorial Hermann HospitalHoustonTexasUSA
| | - Argyrios Stampas
- Spinal Cord Injury Medicine ResearchTIRR Memorial Hermann HospitalHoustonTexasUSA
| | - Kirk W. Kerr
- Scientific and Medical AffairsAbbott LaboratoriesColumbusOhioUSA
| | | | - Suela Sulo
- Scientific and Medical AffairsAbbott LaboratoriesColumbusOhioUSA
| | - Luis Leon‐Novelo
- School of Public HealthUniversity of Texas Health Science Center at HoustonHoustonTexasUSA
| | - Esther Ngan
- School of Public HealthUniversity of Texas Health Science Center at HoustonHoustonTexasUSA
| | - Dehuti Pandya
- Department of PharmacyTIRR Memorial Hermann HospitalHoustonTexasUSA
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15
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Malone M, Schultz G. Challenges in the diagnosis and management of wound infection. Br J Dermatol 2022; 187:159-166. [PMID: 35587707 DOI: 10.1111/bjd.21612] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2022] [Indexed: 12/16/2022]
Abstract
Human epithelia are constantly exposed to microorganisms present in the environment or residing as part of commensal flora. Despite this exposure, infections involving the skin and subcutaneous tissue in healthy individuals are, fortunately, quite rare. Many of the wounds that afflict the human body occur in individuals of ill health and/or where the mechanism of wounding is impeded by host immunological, physiological or regenerative dysfunction. The interplay between microorganisms and host immunity is complex and remains ill defined; however, the interpretation of downstream manifestations of the host response to invading microorganisms is still based largely on the clinical signs and symptoms of an active infectious process. In this review article we will provide a brief overview of the current challenges clinicians face in diagnosing wound infections, how chronic infections caused by biofilms are a major challenge, and how there have been minimal advancements in developing new diagnostics or therapeutics in the identification and management of wound infections.
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Affiliation(s)
- Matthew Malone
- South West Sydney Limb Preservation and Wound Research, South Western Sydney LHD, Sydney, NSW, Australia.,Infectious Diseases and Microbiology, School of Medicine, Western Sydney University, Sydney, NSW, Australia
| | - Gregory Schultz
- Institute for Wound Research, University of Florida, Gainesville, FL, USA
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Zhang M, Feng T, Wu H, Ma W, Wang Z, Wang C, Wang Y, Wang S, Lin HL. An injectable thermosensitive hydrogel with self-assembled peptide coupled with antimicrobial peptide for enhanced wound healing. J Mater Chem B 2022; 10:6143-6157. [DOI: 10.1039/d2tb00644h] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Wound dressing based on thermosensitive hydrogel shows advantages over performed traditional dressings such as rapid reversible sol-gel-sol transition property and the capacity of filling the irregular wound area. Herein, RA-Amps...
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