1
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Olutoye OO, Eriksson E, Menchaca AD, Kirsner RS, Tanaka R, Schultz G, Weir D, Wagner T, Renata F, Naik-Mathuria B, Liu P, Ead KJ, Adedayo T, Armstrong DG, McMullin N, Balch Samora J, Akingba AG. Management of Acute Wounds - Expert Panel Consensus Statement. Adv Wound Care (New Rochelle) 2024. [PMID: 38618741 DOI: 10.1089/wound.2023.0059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2024] Open
Abstract
SIGNIFICANCE The Wound Healing Foundation recognized the need for consensus-based unbiased recommendations for the treatment of wounds. As a first step, a consensus on the treatment of chronic wounds was developed and published in 2022.(1) The current publication on acute wounds represents the second step in this process. Acute wounds may result from any number of conditions, including burns, military and combat operations, and trauma to specific areas of the body. The management of acute wounds requires timely and evidence-driven intervention to achieve optimal clinical outcomes. This consensus statement provides the clinician with the necessary foundational approaches to the causes, diagnosis and therapeutic management of acute wounds. Presented in a structured format, this is a useful guide for clinicians and learners in all patient care settings. RECENT ADVANCES Recent advances in the management of acute wounds have centered on stabilization and treatment in the military and combat environment, Specifically advancements in hemostasis, resuscitation, and the mitigation of infection risk through timely initiation of antibiotics and avoidance of high pressure irrigation in contaminated soft tissue injury. . CRITICAL ISSUES Critical issues include infection control, pain management and the unique considerations for the management of acute wounds in pediatric patients. FUTURE DIRECTIONS Future directions include new approaches to preventing the progression and conversion of burns through the use of the microcapillary gel, a topical gel embedded with the anti-inflammatory drug infliximab.(38) Additionally, the use of three-dimensional bioprinting and photo-modulation for skin reconstruction following burns is a promising area for continued discovery.
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Affiliation(s)
- Oluyinka O Olutoye
- Nationwide Children's Hospital, 2650, Surgery, 700 Children's Drive, T6 Administration, Columbus, Columbus, Ohio, United States, 43205
- The Ohio State University, 2647, Surgery, 700 Children's Drive, T6 Administration, Columbus, Ohio, United States, 43210-1132;
| | - Elof Eriksson
- Harvard Medical School, 1811, Plastic & Reconstructive Surgery, Boston, Massachusetts, United States;
| | - Alicia D Menchaca
- Nationwide Children's Hospital, 2650, Pediatric Surgery, 575 Children's Crossroad, Rm 4143, Columbus, Ohio, United States, 43205-2664;
| | - Robert S Kirsner
- University of Miami Miller School of Medicine, Department of Dermatology & Cutaneous Surgery, Miami, Florida, United States;
| | - Rica Tanaka
- Juntendo University School of Medicine Graduate School of Medicine, 73362, Regenerative Therapy, Department of Plastic & Reconstructive Surgery, Bunkyo-ku, Tokyo, Japan;
| | - Gregory Schultz
- Institute for Wound Research, Department of Obstetrics and Gynecology, University of Florida, Gainesville, Florida, United States, 32610-0294;
| | - Dot Weir
- Saratoga Hospital for Wound Healing and Hyperbaric Medicine, Saratoga Springs, United States;
| | - Tracey Wagner
- Nationwide Children's Hospital, 2650, Emergency Medicine, Columbus, Ohio, United States
- The Ohio State University College of Medicine, 12305, Columbus, Ohio, United States;
| | - Fabia Renata
- Nationwide Children's Hospital, 2650, Pediatric Surgery , Columbus, Ohio, United States
- The Ohio State University College of Medicine, 12305, Columbus, Ohio, United States;
| | - Bindi Naik-Mathuria
- The University of Texas Medical Branch at Galveston, 12338, Pediatric Surgery, Galveston, Texas, United States;
| | - Paul Liu
- Brown University/Rhode Island Hospital, Plastic Surgery, 225 Plain Street, Providence, Rhode Island, United States, 02905;
| | - Karim J Ead
- University of Southern California Keck School of Medicine, 12223, Los Angeles, California, United States;
| | - Temitope Adedayo
- Temple University School of Podiatric Medicine, 70068, Philadelphia, Pennsylvania, United States;
| | - David G Armstrong
- University of Southern California Keck School of Medicine, 12223, Los Angeles, California, United States;
| | - Neil McMullin
- Evans Army Community Hospital, 19909, Plastic Surgery, Fort Carson, Colorado, United States;
| | - Julie Balch Samora
- Nationwide Children's Hospital, 2650, Orthopedic Surgery, Columbus, Ohio, United States
- The Ohio State University College of Medicine, 12305, Columbus, Ohio, United States;
| | - Ajibola G Akingba
- VA, 8267, Vascular Surgery , Washington, District of Columbia, United States;
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Mazio C, Mavaro I, Palladino A, Casale C, Urciuolo F, Banfi A, D'Angelo L, Netti PA, de Girolamo P, Imparato G, Attanasio C. Rapid innervation and physiological epidermal regeneration by bioengineered dermis implanted in mouse. Mater Today Bio 2024; 25:100949. [PMID: 38298559 PMCID: PMC10827562 DOI: 10.1016/j.mtbio.2024.100949] [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: 09/25/2023] [Revised: 01/02/2024] [Accepted: 01/06/2024] [Indexed: 02/02/2024] Open
Abstract
Tissue-engineered skin substitutes are promising tools to cover large and deep skin defects. However, the lack of a synergic and fast regeneration of the vascular network, nerves, and skin appendages limits complete skin healing and impairs functional recovery. It has been highlighted that an ideal skin substitute should mimic the structure of the native tissue to enhance clinical effectiveness. Here, we produced a pre-vascularized dermis (PVD) comprised of fibroblasts embedded in their own extracellular matrix (ECM) and a capillary-like network. Upon implantation in a mouse full-thickness skin defect model, we observed a very early innervation of the graft in 2 weeks. In addition, mouse capillaries and complete epithelialization were detectable as early as 1 week after implantation and, skin appendages developed in 2 weeks. These anatomical features underlie the interaction with the skin nerves, thus providing a further cue for reinnervation guidance. Further, the graft displays mechanical properties, collagen density, and assembly features very similar to the host tissue. Taken together our data show that the pre-existing ECM components of the PVD, physiologically organized and assembled similarly to the native tissue, support a rapid regeneration of dermal tissue. Therefore, our results suggest a promising potential for PVD in skin regeneration.
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Affiliation(s)
- Claudia Mazio
- Istituto Italiano di Tecnologia, Center for Advanced Biomaterials for HealthCare@CRIB, Italy
| | - Isabella Mavaro
- Istituto Italiano di Tecnologia, Center for Advanced Biomaterials for HealthCare@CRIB, Italy
- University of Naples Federico II, Department of Veterinary Medicine and Animal Production, Italy
| | - Antonio Palladino
- University of Naples Federico II, Department of Agricultural Sciences, Italy
| | - Costantino Casale
- University of Naples Federico II, Interdisciplinary Research Centre on Biomaterials (CRIB), Italy
| | - Francesco Urciuolo
- University of Naples Federico II, Department of Chemical, Materials and Industrial Production Engineering, Italy
| | - Andrea Banfi
- Basel University Hospital and University of Basel, Department of Biomedicine, Switzerland
| | - Livia D'Angelo
- University of Naples Federico II, Department of Veterinary Medicine and Animal Production, Italy
| | - Paolo A. Netti
- Istituto Italiano di Tecnologia, Center for Advanced Biomaterials for HealthCare@CRIB, Italy
- University of Naples Federico II, Interdisciplinary Research Centre on Biomaterials (CRIB), Italy
- University of Naples Federico II, Department of Chemical, Materials and Industrial Production Engineering, Italy
| | - Paolo de Girolamo
- University of Naples Federico II, Department of Veterinary Medicine and Animal Production, Italy
| | - Giorgia Imparato
- Istituto Italiano di Tecnologia, Center for Advanced Biomaterials for HealthCare@CRIB, Italy
| | - Chiara Attanasio
- University of Naples Federico II, Department of Veterinary Medicine and Animal Production, Italy
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Gupta S, Moiemen N, Fischer JP, Attinger C, Jeschke MG, Taupin P, Orgill DP. Dermal Regeneration Template in the Management and Reconstruction of Burn Injuries and Complex Wounds: A Review. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2024; 12:e5674. [PMID: 38510326 PMCID: PMC10954069 DOI: 10.1097/gox.0000000000005674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 01/25/2024] [Indexed: 03/22/2024]
Abstract
Background Dermal scaffolds have created a paradigm shift for burn and wound management by providing improved healing and less scarring, while improving cosmesis and functionality. Dermal regeneration template (DRT) is a bilayer membrane for dermal regeneration developed by Yannas and Burke in the 1980s. The aim of this review is to summarize clinical evidence for dermal scaffolds focusing on DRT for the management and reconstruction of burn injuries and complex wounds. Methods A comprehensive search of PubMed was performed from the start of indexing through November 2022. Articles reporting on DRT use in patients with burns, limb salvage, and wound reconstruction were included with focus on high-level clinical evidence. Results DRT has become an established alternative option for the treatment of full-thickness and deep partial-thickness burns, with improved outcomes in areas where cosmesis and functionality are important. In the management of diabetic foot ulcers, use of DRT is associated with high rates of complete wound healing with a low risk of adverse outcomes. DRT has been successfully used in traumatic and surgical wounds, showing particular benefit in deep wounds and in the reconstruction of numerous anatomical sites. Conclusions Considerable clinical experience has accrued with the use of DRT beyond its original application for thermal injury. A growing body of evidence from clinical studies reports the successful use of DRT to improve clinical outcomes and quality of life across clinical indications at a number of anatomical sites.
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Affiliation(s)
| | | | | | | | - Marc G. Jeschke
- Hamilton Health Sciences, Hamilton, Ontario, Canada and McMaster University, Hamilton, Ontario, Canada
| | | | - Dennis P. Orgill
- Brigham and Women’s Hospital, Harvard Medical School, Boston, Mass
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Liu Y, Liu X, Guo H, Wang X, Li A, Qiu D, Gu Q. 3D bioprinting bioglass to construct vascularized full-thickness skin substitutes for wound healing. Mater Today Bio 2024; 24:100899. [PMID: 38188644 PMCID: PMC10770530 DOI: 10.1016/j.mtbio.2023.100899] [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: 06/21/2023] [Revised: 08/28/2023] [Accepted: 12/01/2023] [Indexed: 01/09/2024] Open
Abstract
Constructing three-dimensional (3D) bioprinted skin tissues that accurately replicate the mechanical properties of native skin and provide adequate oxygen and nutrient support remains a formidable challenge. In this study, we incorporated phosphosilicate calcium bioglasses (PSCs), a type of bioactive glass (BG), into the bioinks used for 3D bioprinting. The resulting bioink exhibited mechanical properties and biocompatibility that closely resembled those of natural skin. Utilizing 3D bioprinting technology, we successfully fabricated full-thickness skin substitutes, which underwent comprehensive evaluation to assess their regenerative potential in treating full-thickness skin injuries in rats. Remarkably, the skin substitutes loaded with PSCs exhibited exceptional angiogenic activity, as evidenced by the upregulation of angiogenesis-related genes in vitro and the observation of enhanced vascularization in wound tissue sections in vivo. These findings conclusively demonstrated the outstanding efficacy of PSCs in promoting angiogenesis and facilitating the repair of full-thickness skin wounds. The insights garnered from this study provide a valuable reference strategy for the development of skin tissue grafts with potent angiogenesis-inducing capabilities.
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Affiliation(s)
- Yanyan Liu
- State Key Laboratory of Membrane Biology, Institute of Zoology, Chinese Academy of Sciences, Chaoyang District, Beijing, 100101, PR China
- School of Materials Design and Engineering, Beijing Institute of Fashion Technology, Chaoyang District, Beijing, 100029, PR China
| | - Xin Liu
- State Key Laboratory of Membrane Biology, Institute of Zoology, Chinese Academy of Sciences, Chaoyang District, Beijing, 100101, PR China
- Beijing Institute for Stem Cell and Regenerative Medicine, Chaoyang District, Beijing, 100101, PR China
- Key Laboratory of Organ Regeneration and Transplantation of the Ministry of Education, Jilin University, Changchun 130061, PR China
| | - Haitao Guo
- State Key Laboratory of Membrane Biology, Institute of Zoology, Chinese Academy of Sciences, Chaoyang District, Beijing, 100101, PR China
- Beijing Institute for Stem Cell and Regenerative Medicine, Chaoyang District, Beijing, 100101, PR China
- University of Chinese Academy of Sciences, Huairou District, Beijing, 101449, PR China
| | - Xinhuan Wang
- State Key Laboratory of Membrane Biology, Institute of Zoology, Chinese Academy of Sciences, Chaoyang District, Beijing, 100101, PR China
- Beijing Institute for Stem Cell and Regenerative Medicine, Chaoyang District, Beijing, 100101, PR China
| | - Ailing Li
- Beijing National Laboratory for Molecular Sciences, State Key Laboratory of Polymer Physics and Chemistry, Institute of Chemistry, Chinese Academy of Sciences, Haidian District, Beijing, 100190, PR China
| | - Dong Qiu
- Beijing National Laboratory for Molecular Sciences, State Key Laboratory of Polymer Physics and Chemistry, Institute of Chemistry, Chinese Academy of Sciences, Haidian District, Beijing, 100190, PR China
- University of Chinese Academy of Sciences, Huairou District, Beijing, 101449, PR China
| | - Qi Gu
- State Key Laboratory of Membrane Biology, Institute of Zoology, Chinese Academy of Sciences, Chaoyang District, Beijing, 100101, PR China
- Beijing Institute for Stem Cell and Regenerative Medicine, Chaoyang District, Beijing, 100101, PR China
- University of Chinese Academy of Sciences, Huairou District, Beijing, 101449, PR China
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5
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Liao C, Zhu M, Ding H, Li Y, Sun Q, Li X. Comparing the traditional and emerging therapies for enhancing wound healing in diabetic patients: A pivotal examination. Int Wound J 2023; 21:e14488. [PMID: 37984812 PMCID: PMC10898383 DOI: 10.1111/iwj.14488] [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: 10/16/2023] [Revised: 10/22/2023] [Accepted: 10/23/2023] [Indexed: 11/22/2023] Open
Abstract
Chronic non-healing ulcers are common among diabetic patients, posing significant therapeutic challenges. This study compared traditional therapies (TT) and emerging therapies (ET) for enhancing diabetic patients' wound healing. A total of 150 diabetic patients with chronic ulcers, ages 30-65, were randomly assigned to one of two groups: TT (n = 75) or ET (n = 75). ET included growth factors, bioengineered skin substitutes, and hyperbaric oxygen therapy, while TT for wound healing predominantly included debridement, saline-moistened dressings, and off-loading techniques. The primary outcome was the percentage of lesions that healed within 12 weeks, which was assessed at intervals. Secondary outcomes included time to wound recovery, pain using Visual Analogue Scale (VAS), and life quality via Wound-QoL questionnaire. By the 12th week, the ET group had a repair rate of 81.33% compared to 57.33% in TT group (p < 0.05). ET exhibited superior pain reduction (VAS score: 4.7 ± 1.6 for ET vs. 6.2 ± 1.4 for TT, p < 0.05) and improved life quality (Wound-QoL score: 61.8 ± 9.1 for ET vs. 44.3 ± 10.3 for TT, p < 0.05). However, there were slightly more cases of cutaneous irritation and hematomas among ET patients. ET have demonstrated significant efficacy in accelerating wound healing in diabetic patients, surpassing traditional methods, with additional advantages in pain management and life quality. Due to the observed minor complications, however, caution is required.
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Affiliation(s)
- Chunfen Liao
- Department of Endocrinology, Renmin HospitalHubei University of MedicineShiyanChina
| | - Mingjie Zhu
- Department of Endocrinology, Renmin HospitalHubei University of MedicineShiyanChina
| | - Hongchen Ding
- Department of Endocrinology, Renmin HospitalHubei University of MedicineShiyanChina
| | - Yanli Li
- Department of Endocrinology, Renmin HospitalHubei University of MedicineShiyanChina
| | - Qianshu Sun
- Department of Endocrinology, Renmin HospitalHubei University of MedicineShiyanChina
| | - Xueqin Li
- Department of Endocrinology, Renmin HospitalHubei University of MedicineShiyanChina
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6
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Amin D, Marwan H, Rowan B, Abramowicz S, Zaid W. The Use of Urinary Bladder Matrix for Reconstructing Avulsed Traumatic Soft Tissue Injuries to the Maxillofacial Region. J Craniofac Surg 2023; 34:2317-2320. [PMID: 37665070 DOI: 10.1097/scs.0000000000009699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 06/05/2023] [Indexed: 09/05/2023] Open
Abstract
INTRODUCTION The purpose of the study was to provide an overview of our initial experience utilizing urinary bladder matrix (UBM) for reconstructing avulsed injuries resulting from trauma. MATERIALS AND METHODS This retrospective case series evaluated patients presented with avulsed soft tissue injuries to the head and neck who underwent reconstruction with UBM. Patients were treated by Oral and Maxillofacial Surgery Service in Louisiana State University Health Sciences Center (Baton Rouge, LA). Descriptive variables were collected. Descriptive statistics were calculated. RESULTS Eight patients (mean age 55.8 y) met our inclusion criteria. Wounds were located in the scalp (n=2, 25%), mandible (n=2, 25%), upper eyelid (n=1, 12.5%), cheek (n=1, 12.5%), nose (n=1, 12.5%), or neck (n=1, 12.5%). The depth of the wound extended from the skin to the subcutaneous tissue (n=1, 12.5%), muscle (n=2, 25%), bone (n=3, 37.5%), and/or cartilage (n=1, 12.5%). The mean wound diameter was 47.9 cm 2 (range 17-85 cm 2 ). Wounds were classified as acute (n=6, 75%) or chronic wounds (n=2, 25%). At 6 months, all patients had achieved complete healing with no need for additional surgical procedures (n=8, 100%) with a mean healing time of 36.5 days (range 14-90 d). CONCLUSION Urinary bladder matrix minimize donor-side morbidity, eliminates contraction, and offers a wide range of product sizes to cover a wide range of maxillofacial soft tissue defects in a single-stage manner.
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Affiliation(s)
- Dina Amin
- Associate Professor, Residency Program Director, Department of Oral and Maxillofacial Surgery, University of Rochester, Rochester, NY
| | - Hisham Marwan
- Department of Surgery, University of Texas Medical Branch, Galveston, Texas; Faculty, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Brian Rowan
- Department of Oral and Maxillofacial Surgery, School of Dentistry Louisiana State University Health Science Center, New Orleans, LA
| | - Shelly Abramowicz
- Department of Surgery, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA
| | - Waleed Zaid
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Louisiana State University Health Science Center, New Orleans, LA
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7
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di Summa PG, Di Marzio N, Jafari P, Jaconi ME, Nesic D. FastSkin ® Concept: A Novel Treatment for Complex Acute and Chronic Wound Management. J Clin Med 2023; 12:6564. [PMID: 37892702 PMCID: PMC10607178 DOI: 10.3390/jcm12206564] [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: 08/15/2023] [Revised: 09/26/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023] Open
Abstract
Successful treatments for acute and chronic skin wounds remain challenging. The goal of this proof-of-concept study was to assess the technical feasibility and safety of a novel wound treatment solution, FastSkin®, in a pig model. FastSkin® was prepared from skin micrografts patterned in blood using acoustic waves. Upon coagulation, the graft was transferred on a silicone sheet and placed on wounds. Six full-thickness wounds were created at the back of two pigs and treated with either FastSkin®, split-thickness skin graft (positive control), a gauze coverage (negative control, NC1), or blood patterned without micrografts (negative control, NC2). Silicone sheets were removed after 7, 14, and 21 days. Wound healing was monitored for six weeks and evaluated macroscopically for re-epithelialization and morphometrically for residual wound area and wound contraction. Tissue regeneration was assessed with histology after six weeks. Re-epithelialization was faster in wounds covered with FastSkin® treatments compared to NC2 and in NC2 compared to NC1. Importantly, an enhanced collagen organization was observed in FastSkin® in contrast to NC treatments. In summary, two clinically approved skin wound treatments, namely micrografting and blood clot graft, were successfully merged with sound-induced patterning of micrografts to produce an autologous, simple, and biologically active wound treatment concept.
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Affiliation(s)
- Pietro G. di Summa
- Department of Plastic and Hand Surgery, University Hospital of Lausanne (CHUV), University of Lausanne (UNIL), 1015 Lausanne, Switzerland;
| | - Nicola Di Marzio
- AO Research Institute Davos, 7270 Davos, Switzerland;
- Department of Health Sciences, Università del Piemonte Orientale (UPO), 28100 Novara, Italy
| | - Paris Jafari
- Center for Integrative Genomics, University of Lausanne, 1015 Lausanne, Switzerland;
| | - Marisa E. Jaconi
- Department of Basic Neurosciences, University of Geneva, 1211 Geneva, Switzerland;
| | - Dobrila Nesic
- Division of Fixed Prosthodontics and Biomaterials, University Clinic of Dental Medicine, University of Geneva, Rue Michel-Servet 1, 1211 Geneva, Switzerland
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8
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Hu Y, Xiong Y, Zhu Y, Zhou F, Liu X, Chen S, Li Z, Qi S, Chen L. Copper-Epigallocatechin Gallate Enhances Therapeutic Effects of 3D-Printed Dermal Scaffolds in Mitigating Diabetic Wound Scarring. ACS APPLIED MATERIALS & INTERFACES 2023; 15:38230-38246. [PMID: 37535406 PMCID: PMC10436249 DOI: 10.1021/acsami.3c04733] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 07/10/2023] [Indexed: 08/04/2023]
Abstract
Morbid dermal templates, microangiopathy, and abnormal inflammation are the three most critical reasons for the scarred healing and the high recurrence rate of diabetic wounds. In this present study, a combination of a methacrylated decellularized extracellular matrix (ECMMA, aka EM)-based hydrogel system loaded with copper-epigallocatechin gallate (Cu-EGCG) capsules is proposed to fabricate bio-printed dermal scaffolds for diabetic wound treatment. Copper ions act as a bioactive element for promoting angiogenesis, and EGCG can inhibit inflammation on the wound site. In addition to the above activities, EM/Cu-EGCG (E/C) dermal scaffolds can also provide optimized templates and nutrient exchange space for guiding the orderly deposition and remodeling of ECM. In vitro experiments have shown that the E/C hydrogel can promote angiogenesis and inhibit the polarization of macrophages to the M1 pro-inflammatory phenotype. In the full-thickness skin defect model of diabetic rats, the E/C dermal scaffold combined with split-thickness skin graft transplantation can alleviate pathological scarring via promoting angiogenesis and driving macrophage polarization to the anti-inflammatory M2 phenotype. These may be attributed to the scaffold-actuated expression of angiogenesis-related genes in the HIF-1α/vascular endothelial growth factor pathway and decreased expression of inflammation-related genes in the TNF-α/NF-κB/MMP9 pathway. The results of this study show that the E/C dermal scaffold could serve as a promising artificial dermal analogue for solving the problems of delayed wound healing and reulceration of diabetic wounds.
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Affiliation(s)
- Yanke Hu
- Department
of Burn, Wound Repair & Reconstruction, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong 510080, China
- Guangdong
Provincial Engineering Technology Research Center of Burn and Wound
Accurate Diagnosis and Treatment Key Technology and Series of Products, Sun Yat-Sen University, Guangzhou, Guangdong 510080, China
- Institute
of Precision Medicine, The First Affiliated
Hospital, Sun Yat-Sen University, Guangzhou, Guangdong 510080, China
| | - Yahui Xiong
- Department
of Burn, Wound Repair & Reconstruction, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong 510080, China
- Guangdong
Provincial Engineering Technology Research Center of Burn and Wound
Accurate Diagnosis and Treatment Key Technology and Series of Products, Sun Yat-Sen University, Guangzhou, Guangdong 510080, China
- Institute
of Precision Medicine, The First Affiliated
Hospital, Sun Yat-Sen University, Guangzhou, Guangdong 510080, China
| | - Yongkang Zhu
- Department
of Burn, Wound Repair & Reconstruction, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong 510080, China
- Guangdong
Provincial Engineering Technology Research Center of Burn and Wound
Accurate Diagnosis and Treatment Key Technology and Series of Products, Sun Yat-Sen University, Guangzhou, Guangdong 510080, China
- Institute
of Precision Medicine, The First Affiliated
Hospital, Sun Yat-Sen University, Guangzhou, Guangdong 510080, China
| | - Fei Zhou
- Department
of Burn, Wound Repair & Reconstruction, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong 510080, China
- Guangdong
Provincial Engineering Technology Research Center of Burn and Wound
Accurate Diagnosis and Treatment Key Technology and Series of Products, Sun Yat-Sen University, Guangzhou, Guangdong 510080, China
- Institute
of Precision Medicine, The First Affiliated
Hospital, Sun Yat-Sen University, Guangzhou, Guangdong 510080, China
| | - Xiaogang Liu
- Department
of Burn, Wound Repair & Reconstruction, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong 510080, China
- Guangdong
Provincial Engineering Technology Research Center of Burn and Wound
Accurate Diagnosis and Treatment Key Technology and Series of Products, Sun Yat-Sen University, Guangzhou, Guangdong 510080, China
- Institute
of Precision Medicine, The First Affiliated
Hospital, Sun Yat-Sen University, Guangzhou, Guangdong 510080, China
| | - Shuying Chen
- Department
of Burn, Wound Repair & Reconstruction, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong 510080, China
- Guangdong
Provincial Engineering Technology Research Center of Burn and Wound
Accurate Diagnosis and Treatment Key Technology and Series of Products, Sun Yat-Sen University, Guangzhou, Guangdong 510080, China
- Institute
of Precision Medicine, The First Affiliated
Hospital, Sun Yat-Sen University, Guangzhou, Guangdong 510080, China
| | - Zhanpeng Li
- Department
of Burn, Wound Repair & Reconstruction, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong 510080, China
- Guangdong
Provincial Engineering Technology Research Center of Burn and Wound
Accurate Diagnosis and Treatment Key Technology and Series of Products, Sun Yat-Sen University, Guangzhou, Guangdong 510080, China
- Institute
of Precision Medicine, The First Affiliated
Hospital, Sun Yat-Sen University, Guangzhou, Guangdong 510080, China
| | - Shaohai Qi
- Department
of Burn, Wound Repair & Reconstruction, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong 510080, China
- Guangdong
Provincial Engineering Technology Research Center of Burn and Wound
Accurate Diagnosis and Treatment Key Technology and Series of Products, Sun Yat-Sen University, Guangzhou, Guangdong 510080, China
- Institute
of Precision Medicine, The First Affiliated
Hospital, Sun Yat-Sen University, Guangzhou, Guangdong 510080, China
| | - Lei Chen
- Department
of Burn, Wound Repair & Reconstruction, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong 510080, China
- Guangdong
Provincial Engineering Technology Research Center of Burn and Wound
Accurate Diagnosis and Treatment Key Technology and Series of Products, Sun Yat-Sen University, Guangzhou, Guangdong 510080, China
- Institute
of Precision Medicine, The First Affiliated
Hospital, Sun Yat-Sen University, Guangzhou, Guangdong 510080, China
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9
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Segni AD, BenShoshan M, Harats M, Melnikov N, Barzilay CM, Dothan D, Liaani A, Kornhaber R, Haik J. Personalised burn treatment: bedside electrospun nanofibre scaffold with cultured autologous keratinocytes: a case study. J Wound Care 2023; 32:428-436. [PMID: 37405944 DOI: 10.12968/jowc.2023.32.7.428] [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: 07/07/2023]
Abstract
Nearly four decades after cultured epidermal autografts (CEA) were first used for the treatment of extensive burn wounds, the current gold standard treatment remains grafting healthy autologous skin from a donor site to the damaged areas, with current skin substitutes limited in their clinical use. We propose a novel treatment approach, using an electrospun polymer nanofibrous matrix (EPNM) applied on-site directly on the CEA-grafted areas. In addition, we propose a personalised treatment on hard-to-heal areas, in which we spray suspended autologous keratinocytes integrated with 3D EPNM applied on-site, directly onto the wound bed. This method enables the coverage of larger wound areas than possible with CEA. We present the case of a 26-year-old male patient with full-thickness burns covering 98% of his total body surface area (TBSA). We were able to show that this treatment approach resulted in good re-epithelialisation, seen as early as seven days post CEA grafting, with complete wound closure within three weeks, and to a lesser extent in areas treated with cell spraying. Moreover, in vitro experiments confirmed the feasibility of using keratinocytes embedded within the EPNM: cell and culture viability, identity, purity and potency were determined. These experiments show that the skin cells are viable and can proliferate within the EPNM. The results presented are of a promising novel strategy for the development of personalised wound treatment, integrating on-the-spot 'printed' EPNM with autologous skin cells, which will be applied at the bedside, over deep dermal wounds, to accelerate healing time and wound closure.
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Affiliation(s)
- Ayelet Di Segni
- The Green Skin Engineering Center, National Burn Center, Sheba Medical Center, Tel Hashomer, Israel
| | - Marina BenShoshan
- The Green Skin Engineering Center, National Burn Center, Sheba Medical Center, Tel Hashomer, Israel
| | - Moti Harats
- National Burn Center, Sheba Medical Center, Tel Hashomer, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- University of Notre Dame Australia, Fremantle, Western Australia, Australia
- Talpiot Leadership Program, Sheba Medical Center, Tel Hashomer, Israel
| | - Nir Melnikov
- The Green Skin Engineering Center, National Burn Center, Sheba Medical Center, Tel Hashomer, Israel
| | | | - Daniel Dothan
- The Green Skin Engineering Center, National Burn Center, Sheba Medical Center, Tel Hashomer, Israel
| | - Adi Liaani
- The Green Skin Engineering Center, National Burn Center, Sheba Medical Center, Tel Hashomer, Israel
| | - Rachel Kornhaber
- National Burn Center, Sheba Medical Center, Tel Hashomer, Israel
- School of Nursing, Paramedicine and Healthcare Sciences, Charles Sturt University, NSW, Australia
| | - Josef Haik
- The Green Skin Engineering Center, National Burn Center, Sheba Medical Center, Tel Hashomer, Israel
- National Burn Center, Sheba Medical Center, Tel Hashomer, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- University of Notre Dame Australia, Fremantle, Western Australia, Australia
- Talpiot Leadership Program, Sheba Medical Center, Tel Hashomer, Israel
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10
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Chintalapudi N, Rice OM, Hsu JR. The use of xenogenic dermal matrices in the context of open extremity wounds: where and when to consider? OTA Int 2023; 6:e237. [PMID: 37448569 PMCID: PMC10337846 DOI: 10.1097/oi9.0000000000000237] [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: 11/29/2022] [Accepted: 12/14/2022] [Indexed: 07/15/2023]
Abstract
Optimal treatment of orthopaedic extremity trauma includes meticulous care of both bony and soft tissue injuries. Historically, clinical scenarios involving soft tissue defects necessitated the assistance of a plastic surgeon. While their expertise in coverage options and microvascular repair is invaluable, barriers preventing collaboration are common. Acellular dermal matrices represent a promising and versatile tool for orthopaedic trauma surgeons to keep in their toolbox. These biological scaffolds are each unique in how they are used and promote healing. This review explores some commercial products and offers guidance for selection in different clinical scenarios involving traumatic wounds.
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Affiliation(s)
- Nainisha Chintalapudi
- Corresponding author. Address: Nainisha Chintalapudi, MD, Atrium Health Mercy, 2001 Vail Ave, Charlotte, NC 28207. E-mail:
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11
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Boukani LM, Khosroshahi RF, Kh SA, Rashtbar M, Khosroshahi AF. Statistical study of clinical trials with stem cells and their function in skin wound. Cell Tissue Res 2023:10.1007/s00441-023-03793-3. [PMID: 37266728 DOI: 10.1007/s00441-023-03793-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 05/23/2023] [Indexed: 06/03/2023]
Abstract
Mesenchymal stem cells (MSCs) have been known as a reliable and effective source to repair damaged tissues. The differentiation and self-renewal ability, easy access, immune system modulation capability, and important role in the process of repairing wounds have caused using these cells extensively in wound healing. In this review study, the role of MSCs is debated about different diseases especially in repairing skin wounds. This review article was obtained from 75 basic and trial articles on the PubMed, Google Scholar, and Clinical Trials databases between 2000 and 2022. MSCs are capable of migrating to the wound site and are effective in all stages of wound healing. These cells differentiate into skin cells and also inhibit inflammatory responses, proliferation, and differentiation cells through paracrine messages. They stimulate locally resident precursors, leading to angiogenesis, epithelial regeneration, and granular tissue formation. During maturation stages, these cells decrease fibrosis tissue formation and wound contraction and increase collagen expression and wound tensile strength. The molecular factors of the lesion site change function of these cells and cause MSCs to create a wound healing microenvironment instead of a fibrotic microenvironment. Currently, significant advances have been achieved in the delivery of MSCs to wound sites. These cells are injected intravenously or intradermally, with or without a scaffold. They are also used in the form of spray or hydrogels. Furthermore, the extracellular vesicles and the synergistic environment of these cells alone are effective. Forthcoming studies could lead to more effective treatment strategies for the use of MSCs in wound healing.
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Affiliation(s)
| | | | | | - Morteza Rashtbar
- Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ahad Ferdowsi Khosroshahi
- Imam Reza General Hospital & Stem Cell Research, Tabriz University of Medical Sciences, Tabriz, Iran.
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12
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Fadilah NIM, Riha SM, Mazlan Z, Wen APY, Hao LQ, Joseph B, Maarof M, Thomas S, Motta A, Fauzi MB. Functionalised-biomatrix for wound healing and cutaneous regeneration: future impactful medical products in clinical translation and precision medicine. Front Bioeng Biotechnol 2023; 11:1160577. [PMID: 37292094 PMCID: PMC10245056 DOI: 10.3389/fbioe.2023.1160577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 05/08/2023] [Indexed: 06/10/2023] Open
Abstract
Skin tissue engineering possesses great promise in providing successful wound injury and tissue loss treatments that current methods cannot treat or achieve a satisfactory clinical outcome. A major field direction is exploring bioscaffolds with multifunctional properties to enhance biological performance and expedite complex skin tissue regeneration. Multifunctional bioscaffolds are three-dimensional (3D) constructs manufactured from natural and synthetic biomaterials using cutting-edge tissue fabrication techniques incorporated with cells, growth factors, secretomes, antibacterial compounds, and bioactive molecules. It offers a physical, chemical, and biological environment with a biomimetic framework to direct cells toward higher-order tissue regeneration during wound healing. Multifunctional bioscaffolds are a promising possibility for skin regeneration because of the variety of structures they provide and the capacity to customise the chemistry of their surfaces, which allows for the regulated distribution of bioactive chemicals or cells. Meanwhile, the current gap is through advanced fabrication techniques such as computational designing, electrospinning, and 3D bioprinting to fabricate multifunctional scaffolds with long-term safety. This review stipulates the wound healing processes used by commercially available engineered skin replacements (ESS), highlighting the demand for a multifunctional, and next-generation ESS replacement as the goals and significance study in tissue engineering and regenerative medicine (TERM). This work also scrutinise the use of multifunctional bioscaffolds in wound healing applications, demonstrating successful biological performance in the in vitro and in vivo animal models. Further, we also provided a comprehensive review in requiring new viewpoints and technological innovations for the clinical application of multifunctional bioscaffolds for wound healing that have been found in the literature in the last 5 years.
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Affiliation(s)
- Nur Izzah Md Fadilah
- Centre for Tissue Engineering and Regenerative Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Shaima Maliha Riha
- Centre for Tissue Engineering and Regenerative Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Zawani Mazlan
- Centre for Tissue Engineering and Regenerative Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Adzim Poh Yuen Wen
- Department of Surgery, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Looi Qi Hao
- My Cytohealth Sdn Bhd Kuala Lumpur, Kuala Lumpur, Malaysia
| | - Blessy Joseph
- Business Innovation and Incubation Centre, Mahatma Gandhi University, Kottayam, Kerala, India
| | - Manira Maarof
- Centre for Tissue Engineering and Regenerative Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Sabu Thomas
- International and Inter University Centre for Nanosciences and Nanotechnology, Mahatma Gandhi University, Kottayam, Kerala, India
| | - Antonella Motta
- Department of Industrial Engineering, University of Trento, Trento, Italy
| | - Mh Busra Fauzi
- Centre for Tissue Engineering and Regenerative Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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13
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Wang Z, Xu H, Yang H, Zhang Y, Wang X, Wang P, Xu Z, Lv D, Rong Y, Dong Y, Tang B, Hu Z, Deng W, Zhu J. Single-stage transplantation combined with epidermal stem cells promotes the survival of tissue-engineered skin by inducing early angiogenesis. Stem Cell Res Ther 2023; 14:51. [PMID: 36959609 PMCID: PMC10035248 DOI: 10.1186/s13287-023-03281-z] [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: 08/13/2022] [Accepted: 03/13/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND The composite transplantation of a split-thickness skin graft (STSG) combined with an acellular dermal matrix (ADM) is a promising repair method for full-thickness skin defects. Due to delayed vascularization of the ADM, no currently available engineered skin tissue is able to permanently cover full-thickness skin defects via a single-stage procedure. Epidermal stem cells (EpSCs) have been found to promote angiogenesis in the wound bed. Whether EpSCs can induce early angiogenesis of dermal substitutes and promote the survival of single-stage tissue-engineered skin transplantation needs to be further studied. METHODS In vitro, rat vascular endothelial cells (RVECs) were treated with the supernatant of EpSCs cultured in ADM and stimulated for 48 h. RVECs were analysed by RNA sequencing and tube formation assays. For the in vivo experiment, 75 rats were randomly divided into five groups: ADM, ADM + EpSCs (AE), STSG, ADM + STSG (AS), and ADM + STSG + EpSCs (ASE) groups. The quality of wound healing was estimated by general observation and H&E and Masson staining. The blood perfusion volume was evaluated using the LDPI system, and the expression of vascular markers was determined by immunohistochemistry (IHC). RESULTS The active substances secreted by EpSCs cultured in ADM promoted angiogenesis, as shown by tube formation experiments and RNA-seq. EpSCs promoted epithelialization of the ADM and vascularization of the ADM implant. The ASE group showed significantly increased skin graft survival, reduced skin contraction, and an improved cosmetic appearance compared with the AS group and the STSG control group. CONCLUSIONS In summary, our findings suggest that EpSCs promote the formation of new blood vessels in dermal substitutes and support one-step transplantation of tissue-engineered skin, and thereby provide new ideas for clinical application.
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Affiliation(s)
- Zhiyong Wang
- Department of Burn and Wound Repair Surgery, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Hailin Xu
- Department of Burn and Wound Repair Surgery, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Hao Yang
- Department of Burn and Wound Repair Surgery, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Yi Zhang
- Department of Burn and Plastic Surgery, Affiliated Hospital of Nantong University, Nantong, China
| | - Xiaoyan Wang
- Department of Burn and Wound Repair Surgery, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Peng Wang
- Department of Burn and Wound Repair Surgery, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Zhongye Xu
- Department of Burn and Wound Repair Surgery, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Dongming Lv
- Department of Burn and Wound Repair Surgery, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Yanchao Rong
- Department of Burn and Wound Repair Surgery, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Yunxian Dong
- Department of Plastic Surgery, Guangdong Second Provincial General Hospital, Southern Medical University, Guangzhou, China
| | - Bing Tang
- Department of Burn and Wound Repair Surgery, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Zhicheng Hu
- Department of Burn and Wound Repair Surgery, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
| | - Wuguo Deng
- Collaborative Innovation Center of Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangzhou, China.
| | - Jiayuan Zhu
- Department of Burn and Wound Repair Surgery, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
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14
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Song H, Gao K, Hao D, Li A, Liu R, Anggito B, Yin B, Jin Q, Dartora V, Lam KS, Smith LR, Panitch A, Zhou J, Farmer DL, Wang A. Engineered multi-functional, pro-angiogenic collagen-based scaffolds loaded with endothelial cells promote large deep burn wound healing. Front Pharmacol 2023; 14:1125209. [PMID: 36937891 PMCID: PMC10014525 DOI: 10.3389/fphar.2023.1125209] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 02/17/2023] [Indexed: 03/06/2023] Open
Abstract
The lack of vascularization associated with deep burns delays the construction of wound beds, increases the risks of infection, and leads to the formation of hypertrophic scars or disfigurement. To address this challenge, we have fabricated a multi-functional pro-angiogenic molecule by grafting integrin αvβ3 ligand LXW7 and collagen-binding peptide (SILY) to a dermatan sulfate (DS) glycosaminoglycan backbone, named LXW7-DS-SILY (LDS), and further employed this to functionalize collagen-based Integra scaffolds. Using a large deep burn wound model in C57/BLK6 mice (8-10 weeks old, 26-32g, n = 39), we demonstrated that LDS-modified collagen-based Integra scaffolds loaded with endothelial cells (ECs) accelerate wound healing rate, re-epithelialization, vascularization, and collagen deposition. Specifically, a 2 cm × 3 cm full-thickness skin burn wound was created 48 h after the burn, and then wounds were treated with four groups of different dressing scaffolds, including Integra + ECs, Integra + LDS, and Integra + LDS + ECs with Integra-only as the control. Digital photos were taken for wound healing measurement on post-treatment days 1, 7, 14, 21, 28, and 35. Post-treatment photos revealed that treatment with the Intgera + LDS + ECs scaffold exhibited a higher wound healing rate in the proliferation phase. Histology results showed significantly increased re-epithelialization, increased collagen deposition, increased thin and mixed collagen fiber content, increased angiogenesis, and shorter wound length within the Integra + LDS + ECs group at Day 35. On Day 14, the Integra + LDS + ECs group showed the same trend. The relative proportions of collagen changed from Day 14 to Day 35 in the Integra + LDS + ECs and Integra + ECs groups demonstrated decreased thick collagen fiber deposition and greater thin and mixed collagen fiber deposition. LDS-modified Integra scaffolds represent a promising novel treatment to accelerate deep burn wound healing, thereby potentially reducing the morbidity associated with open burn wounds. These scaffolds can also potentially reduce the need for autografting and morbidity in patients with already limited areas of harvestable skin.
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Affiliation(s)
- Hengyue Song
- Center for Surgical Bioengineering, Department of Surgery, UC Davis Medical Center, Sacramento, CA, United States
- Department of Burns and Plastic Surgery, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China
- Institute for Pediatric Regenerative Medicine, Shriners Hospitals for Children, Sacramento, CA, United States
| | - Kewa Gao
- Center for Surgical Bioengineering, Department of Surgery, UC Davis Medical Center, Sacramento, CA, United States
- Institute for Pediatric Regenerative Medicine, Shriners Hospitals for Children, Sacramento, CA, United States
| | - Dake Hao
- Center for Surgical Bioengineering, Department of Surgery, UC Davis Medical Center, Sacramento, CA, United States
- Institute for Pediatric Regenerative Medicine, Shriners Hospitals for Children, Sacramento, CA, United States
| | - Andrew Li
- Center for Surgical Bioengineering, Department of Surgery, UC Davis Medical Center, Sacramento, CA, United States
- Division of Plastic Surgery, Department of Surgery, UC Davis Medical Center, Sacramento, CA, United States
| | - Ruiwu Liu
- Department of Biochemistry and Molecular Medicine, UC Davis Medical Center, Sacramento, CA, United States
| | - Bryan Anggito
- Center for Surgical Bioengineering, Department of Surgery, UC Davis Medical Center, Sacramento, CA, United States
- Department of Biomedical Engineering, University of California Davis, Davis, CA, United States
| | - Boyan Yin
- Center for Surgical Bioengineering, Department of Surgery, UC Davis Medical Center, Sacramento, CA, United States
| | - Qianyu Jin
- Center for Surgical Bioengineering, Department of Surgery, UC Davis Medical Center, Sacramento, CA, United States
- College of Biological Sciences, University of California Davis, Davis, CA, United States
| | - Vanessa Dartora
- Department of Biomedical Engineering, University of California Davis, Davis, CA, United States
| | - Kit S. Lam
- Department of Biochemistry and Molecular Medicine, UC Davis Medical Center, Sacramento, CA, United States
| | - Lucas R. Smith
- Department of Neurobiology, Physiology and Behavior, University of California Davis, Davis, CA, United States
- Department of Physical Medicine and Rehabilitation, UC Davis Medical Center, Sacramento, CA, United States
| | - Alyssa Panitch
- Center for Surgical Bioengineering, Department of Surgery, UC Davis Medical Center, Sacramento, CA, United States
- Department of Biomedical Engineering, University of California Davis, Davis, CA, United States
| | - Jianda Zhou
- Department of Burns and Plastic Surgery, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Diana L. Farmer
- Center for Surgical Bioengineering, Department of Surgery, UC Davis Medical Center, Sacramento, CA, United States
- Institute for Pediatric Regenerative Medicine, Shriners Hospitals for Children, Sacramento, CA, United States
| | - Aijun Wang
- Center for Surgical Bioengineering, Department of Surgery, UC Davis Medical Center, Sacramento, CA, United States
- Institute for Pediatric Regenerative Medicine, Shriners Hospitals for Children, Sacramento, CA, United States
- Department of Biomedical Engineering, University of California Davis, Davis, CA, United States
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15
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Chiu A, Sharma D, Zhao F. Tissue Engineering-Based Strategies for Diabetic Foot Ulcer Management. Adv Wound Care (New Rochelle) 2023; 12:145-167. [PMID: 34939837 PMCID: PMC9810358 DOI: 10.1089/wound.2021.0081] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 10/26/2021] [Indexed: 01/13/2023] Open
Abstract
Significance: Diabetic foot ulcers (DFU) are a mounting problem with the increasingly frail population. Injuries that would otherwise heal are kept open by risk factors such as diabetes, obesity, and age-related conditions, which interferes with the natural wound healing processes. Recent Advances: This review summarizes recent advancements in the field of tissue engineering for the treatment of DFUs. FDA-approved approaches, including signaling-based therapies, stem cell therapies, and skin substitutes are summarized and cutting-edge experimental technologies that have the potential to manage chronic wounds, such as skin printing, skin organogenesis, skin self-assembly, and prevascularization, are discussed. Critical Issues: The standard of care for chronic wounds involves wound debridement, wound dressings, and resolving the underlying cause such as lowering the glycemic index and reducing wound pressure. Current DFU treatments are limited by low wound closure rates and poor regrown skin quality. New adjuvant therapies that facilitate wound closure in place of or in conjunction with standard care are critically needed. Future Directions: Tissue engineering strategies are limited by the plasticity of adult human cells. In addition to traditional techniques, genetic modification, although currently an emerging technology, has the potential to unlock human regeneration and can be incorporated in future therapeutics.
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Affiliation(s)
- Alvis Chiu
- Department of Biomedical Engineering, Texas A&M University, College Station, Texas, USA
| | - Dhavan Sharma
- Department of Biomedical Engineering, Texas A&M University, College Station, Texas, USA
| | - Feng Zhao
- Department of Biomedical Engineering, Texas A&M University, College Station, Texas, USA
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16
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Xia W, Lin C, Tu Z, Li Y, Shen G. Preparation of laser microporous porcine acellular dermal matrix and observation of wound transplantation. Cell Tissue Bank 2023; 24:191-202. [PMID: 35804250 PMCID: PMC10006019 DOI: 10.1007/s10561-022-10023-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 06/20/2022] [Indexed: 11/02/2022]
Abstract
To prepare a new type of porcine acellular dermis matrix (PADM) with the new laser microporous technique and verify its safety and feasibility. A novel porcine acellular dermis matrix (ADM) was prepared by using sequential combined decellularization of trypsin, neutral protease and SDS solution method and fully rinsed with ultrasonic wave. Specific laser microporous technology was used to prepare the laser micropore porcine acellular dermal matrix (LPADM). SD rats were chose as the animal models and autologous skin was transplanted by one-step method to observe and detect the graft activity, immunogenicity and vascularization degree of the novel PADM. A porcelain white, shiny, soft and elastic dermal matrix was prepared in this study, the results showed low DNA residue and low cytotoxicity. HE staining and SEM observation revealed that the PADM had neither residual cells nor cell fragments, while the collagen bundles were intact and orderly arranged. All the SD rats survived. No infection or skin allergy was found after surgery. None of the animals lost weight. Histological examination showed that the LPADM was fully vascularized with little tissue destruction in the experiment group. Immunohistochemical staining for CD31 showed ideal vascularization in the experiment group, and immunohistochemical staining for TNF-α showed there were no statistical significance of inflammatory reaction in both groups. This study demonstrated that the novel PADM prepared by sequential combined decellularization of trypsin, neutral protease and SDS solution method and new laser microporous technique was effective and safe in animal transplantation.
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Affiliation(s)
- Weidong Xia
- The Burn Plastic Surgery, The First Affiliated Hospital of Soochow University, Soochow University, Suzhou, 215006, China
| | - Cai Lin
- Department of Burn, The First Affiliated Hospital of Wenzhou Medical University, Nan Bai Xiang, Wenzhou, 325000, Zhejiang, China
| | - Zhuolong Tu
- Department of Burn, The First Affiliated Hospital of Wenzhou Medical University, Nan Bai Xiang, Wenzhou, 325000, Zhejiang, China
| | - Yuan Li
- Department of Burn, The First Affiliated Hospital of Wenzhou Medical University, Nan Bai Xiang, Wenzhou, 325000, Zhejiang, China
| | - Guoliang Shen
- The Burn Plastic Surgery, The First Affiliated Hospital of Soochow University, Soochow University, Suzhou, 215006, China.
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17
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Biomaterials Based on Chitosan and Polyvinyl Alcohol as a Drug Delivery System with Wound-Healing Effects. Gels 2023; 9:gels9020122. [PMID: 36826292 PMCID: PMC9957424 DOI: 10.3390/gels9020122] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/22/2023] [Accepted: 01/26/2023] [Indexed: 02/04/2023] Open
Abstract
The excellent biological properties of chitosan (CS) together with the increased oxygen permeability of polyvinyl alcohol (PVA) were the prerequisites for the creation of a wound healing dressing that would also function as a system for L-arginine (L-arg) and caffeine (Caff) delivery. Using the freezing/thawing method, 12 hydrogels were obtained in PVA:CS polymer ratios of 90:10, 75:25, and 60:40, and all were loaded with L-arg, Caff, and the mixture of L-arg and Caff, respectively. Afterwards, an inorganic material (zeolite-Z) was added to the best polymeric ratio (75:25) and loaded with active substances. The interactions between the constituents of the hydrogels were analyzed by FTIR spectroscopy, the uniformity of the network was highlighted by the SEM technique, and the dynamic water vapor sorption capacity was evaluated. In the presence of the inorganic material, the release profile of the active substances is delayed, and in vitro permeation kinetics proves that the equilibrium state is not reached even after four hours. The synergy of the constituents in the polymer network recommends that they be used in medical applications, such as wound healing dressings.
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18
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Veale RWF, Kollmetz T, Taghavi N, Duston-Fursman CG, Beeson MT, Asefi D, Chittock HD, Vikranth AS, Dowling SG, Dempsey SG, Rose HJ, Mason ITT, May BCH. Influence of advanced wound matrices on observed vacuum pressure during simulated negative pressure wound therapy. J Mech Behav Biomed Mater 2023; 138:105620. [PMID: 36543083 DOI: 10.1016/j.jmbbm.2022.105620] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/24/2022] [Accepted: 12/11/2022] [Indexed: 12/23/2022]
Abstract
Biomaterials and negative pressure wound therapy (NPWT) are treatment modalities regularly used together to accelerate soft-tissue regeneration. This study evaluated the impact of the design and composition of commercially available collagen-based matrices on the observed vacuum pressure delivered under NPWT using a custom test apparatus. Specifically, testing compared the effect of the commercial products; ovine forestomach matrix (OFM), collagen/oxidized regenerated cellulose (collagen/ORC) and a collagen-based dressing (CWD) on the observed vacuum pressure. OFM resulted in an ∼50% reduction in the observed target vacuum pressure at 75 mmHg and 125 mmHg, however, this effect was mitigated to a ∼0% reduction when fenestrations were introduced into the matrix. Both collagen/ORC and CWD reduced the observed vacuum pressure at 125 mmHg (∼15% and ∼50%, respectively), and this was more dramatic when a lower vacuum pressure of 75 mmHg was delivered (∼20% and ∼75%, respectively). The reduced performance of the reconstituted collagen products is thought to result from the gelling properties of these products that may cause occlusion of the delivered vacuum to the wound bed. These findings highlight the importance of in vitro testing to establish the impact of adjunctive therapies on NPWT, where effective delivery of vacuum pressure is paramount to the efficacy of this therapy.
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Affiliation(s)
- Robert W F Veale
- Aroa Biosurgery Limited, Airport Oaks, Auckland, 2022, New Zealand
| | - Tarek Kollmetz
- Aroa Biosurgery Limited, Airport Oaks, Auckland, 2022, New Zealand
| | - Navid Taghavi
- Aroa Biosurgery Limited, Airport Oaks, Auckland, 2022, New Zealand
| | | | - Matthew T Beeson
- Aroa Biosurgery Limited, Airport Oaks, Auckland, 2022, New Zealand
| | - Dorrin Asefi
- Aroa Biosurgery Limited, Airport Oaks, Auckland, 2022, New Zealand
| | - Henry D Chittock
- Aroa Biosurgery Limited, Airport Oaks, Auckland, 2022, New Zealand
| | | | - Shane G Dowling
- Aroa Biosurgery Limited, Airport Oaks, Auckland, 2022, New Zealand
| | - Sandi G Dempsey
- Aroa Biosurgery Limited, Airport Oaks, Auckland, 2022, New Zealand
| | - Hamish J Rose
- Aroa Biosurgery Limited, Airport Oaks, Auckland, 2022, New Zealand
| | - Isaac T T Mason
- Aroa Biosurgery Limited, Airport Oaks, Auckland, 2022, New Zealand
| | - Barnaby C H May
- Aroa Biosurgery Limited, Airport Oaks, Auckland, 2022, New Zealand.
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19
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A Comprehensive Review on Bio-Based Materials for Chronic Diabetic Wounds. MOLECULES (BASEL, SWITZERLAND) 2023; 28:molecules28020604. [PMID: 36677658 PMCID: PMC9861360 DOI: 10.3390/molecules28020604] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 12/26/2022] [Accepted: 12/27/2022] [Indexed: 01/11/2023]
Abstract
Globally, millions of people suffer from poor wound healing, which is associated with higher mortality rates and higher healthcare costs. There are several factors that can complicate the healing process of wounds, including inadequate conditions for cell migration, proliferation, and angiogenesis, microbial infections, and prolonged inflammatory responses. Current therapeutic methods have not yet been able to resolve several primary problems; therefore, their effectiveness is limited. As a result of their remarkable properties, bio-based materials have been demonstrated to have a significant impact on wound healing in recent years. In the wound microenvironment, bio-based materials can stimulate numerous cellular and molecular processes that may enhance healing by inhibiting the growth of pathogens, preventing inflammation, and stimulating angiogenesis, potentially converting a non-healing environment to an appropriately healing one. The aim of this present review article is to provide an overview of the mechanisms underlying wound healing and its pathophysiology. The development of bio-based nanomaterials for chronic diabetic wounds as well as novel methodologies for stimulating wound healing mechanisms are also discussed.
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20
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Wong She RB, Gibran NS. Burn Wound Bed Management. J Burn Care Res 2023; 44:S13-S18. [PMID: 36048573 DOI: 10.1093/jbcr/irac128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Indexed: 12/27/2022]
Abstract
Critical to the success of modern burn care is the management of the burn wound. Timely and complete removal of nonviable tissue is complicated by the irreplaceable nature of the tissue lost either through the burn injury or as "collateral damage" as part of the treatment. Challenges in distinguishing between viable and nonviable tissue and "replacing the irreplaceable" are discussed alongside potential disruptive technologies which could fundamentally change how burn care is delivered. Advances in burn wound bed management forms the foundation on which the goal of zero preventable death and disability after burn injury can be achieved.
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Affiliation(s)
- Richard B Wong She
- National Burn Centre of New Zealand, Middlemore Hospital, Auckland, New Zealand
| | - Nicole S Gibran
- UW Department of Surgery, Harborview Medical Center, Seattle, Washington, USA
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21
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Palanisamy CP, Cui B, Zhang H, Gunasekaran VP, Ariyo AL, Jayaraman S, Rajagopal P, Long Q. A critical review on starch-based electrospun nanofibrous scaffolds for wound healing application. Int J Biol Macromol 2022; 222:1852-1860. [PMID: 36195229 DOI: 10.1016/j.ijbiomac.2022.09.274] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 09/18/2022] [Accepted: 09/28/2022] [Indexed: 11/05/2022]
Abstract
Starch-based nanofibrous scaffolds exhibit a potential wound healing processes as they are cost-effective, flexible, and biocompatible. Recently, natural polymers have received greater importance in regenerative medicine, mainly in the process of healing wounds and burns due to their unique properties which also include safety, biocompatibility, and biodegradability. In this respect, starch is considered to be one of the reliable natural polymers to promote the process of wound healing at a significantly faster rate. Starch and starch-based electrospun nanofibrous scaffolds have been used for the wound healing process which includes the process of adhesion, proliferation, differentiation, and regeneration of cells. It also possesses significant activity to encapsulate and deliver biomaterials at a specific site which persuades the wound healing process at an increased rate. As the aforementioned scaffolds mimic the native extracellular matrix more closely, may help in the acceleration of wound closure, which in turn may lead to the promotion of tissue reorganization and remodeling. In-depth knowledge in understanding the properties of nanofibrous scaffolds paves a way to unfold novel methods and therapies, also to overcome challenges associated with wound healing. This review is intended to provide comprehensive information and recent advances in starch-based electrospun nanofibrous scaffolds for wound healing.
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Affiliation(s)
- Chella Perumal Palanisamy
- Mini-invasive Neurosurgery and Translational Medical Center, Xi'an Central Hospital, Xi'an Jiaotong University, No. 161, West 5th Road, Xincheng District, Xi'an 710003, China
| | - Bo Cui
- State Key Laboratory of Biobased Material and Green Papermaking, College of Food Science and Engineering, Qilu University of Technology, Shandong Academy of Science, Jinan 250353, China.
| | - Hongxia Zhang
- State Key Laboratory of Biobased Material and Green Papermaking, College of Food Science and Engineering, Qilu University of Technology, Shandong Academy of Science, Jinan 250353, China
| | | | - Adeniran Lateef Ariyo
- Department of Physiology and Biochemistry, Faculty of Veterinary Medicine, University of Abuja, FCT, Abuja, Nigeria
| | - Selvaraj Jayaraman
- Department of Biochemistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 600 077, India
| | - Ponnulakshmi Rajagopal
- Central Research Laboratory, Meenakhsi Academy of Higher Education and Research, West K.K. Nagar, Chennai 600 078, India
| | - Qianfa Long
- Mini-invasive Neurosurgery and Translational Medical Center, Xi'an Central Hospital, Xi'an Jiaotong University, No. 161, West 5th Road, Xincheng District, Xi'an 710003, China.
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22
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Tan SH, Chua DAC, Tang JRJ, Bonnard C, Leavesley D, Liang K. Design of Hydrogel-based Scaffolds for in vitro Three-dimensional Human Skin Model Reconstruction. Acta Biomater 2022; 153:13-37. [DOI: 10.1016/j.actbio.2022.09.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 09/01/2022] [Accepted: 09/26/2022] [Indexed: 11/01/2022]
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23
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Ramachandran V, Mohanasundaram T, Tiwari R, Tiwari G, Vijayakumar P, Bhongiri B, Xavier RM. Nrf2 Mediated Heme Oxygenase-1 Activation Contributes to Diabetic Wound Healing - an Overview. Drug Res (Stuttg) 2022; 72:487-495. [PMID: 35931068 DOI: 10.1055/a-1899-8233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Diabetic wound healing is a complicated procedure because hyperglycemia changes the various stages of wound healing. In type 2 diabetes mellitus (T2DM), oxidative stress is proven to be a critical factor in causing non-healing wounds and aggravating the inflammatory phase, resulting in the amputation of lower limbs in T2DM patients. This makes scientists figure out how to control oxidative stress and chronic inflammation at the molecular level. Nuclear factor erythroid 2- related factor 2 (Nrf2) releases antioxidant proteins to suppress reactive oxygen species (ROS) activation and inflammation. The current review discusses the role of Nrf2 in improving diabetic wound healing by reducing the production of ROS and thus reducing oxidative stress, as well as inhibiting nuclear factor kappa B (NF-kB) dissociation and nuclear translocation, which prevents the release of inflammatory mediators and increases antioxidant protein levels, thereby improving diabetic wound healing. As a result, the researcher will be able to find a more effective diabetic wound healing therapy.
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Affiliation(s)
- Vadivelan Ramachandran
- Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Ooty, The Nilgiris, Tamilnadu, India
| | - Tharani Mohanasundaram
- Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Ooty, The Nilgiris, Tamilnadu, India
| | - Ruchi Tiwari
- Pranveer Singh institute of Technology (Pharmacy), Kanpur - Agra - Delhi, NH2, Bhauti, Kanpur, Uttar Pradesh, India
| | - Gaurav Tiwari
- Pranveer Singh institute of Technology (Pharmacy), Kanpur - Agra - Delhi, NH2, Bhauti, Kanpur, Uttar Pradesh, India
| | - Putta Vijayakumar
- Department of Pharmacy Practice, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Ooty, The Nilgiris, Tamilnadu, India
| | - Bhargav Bhongiri
- Department of Pharmacy Practice, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Ooty, The Nilgiris, Tamilnadu, India
| | - Rinu Mary Xavier
- Department of Pharmacy Practice, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Ooty, The Nilgiris, Tamilnadu, India
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24
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Subramaniam T, Shaiful Hadi N, Sulaiman S, Fauzi MB, Hj Idrus RB, Chowdhury SR, Law JX, Maarof M. Comparison of three different skin substitutes in promoting wound healing in an ovine model. Burns 2022; 48:1198-1208. [PMID: 34893370 DOI: 10.1016/j.burns.2021.08.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 07/23/2021] [Accepted: 08/16/2021] [Indexed: 12/15/2022]
Abstract
Skin substitutes are designed dressings intended to promote wound closure. In previous in vitro and in vivo studies on small animal, an acellular skin patch made of collagen hydrogel with dermal fibroblast conditioned medium (Col-DFCM), a collagen sponge scaffold with freshly harvested skin cells (OTC), and a platelet-rich-plasma gel with freshly harvested skin cells (PRP) have been developed and tested for immediate treatment of full-thickness wound. However, to determine the safety and efficacy of these skin patches for clinical applications, further study in a large animal model is needed. The aim of this study is to evaluate the potential of Col-DFCM, OTC and PRP in treating full-thickness wound in an ovine model via histological analysis and immunohistochemistry staining were performed, with the untreated (NT) group serving as the control. Gross examination was conducted on day 7, 14 and 21 to determine the wound closure rate. The findings of percentage of wound size reduction showed that the wound healed fastest in the presence of Col-DFCM (91.34 ± 23.35%) followed by OTC (84.49 ± 23.13%), PRP (77.73 ± 20.9%) and NT group (73.94 ± 23.71%). Histological evaluation with Hematoxylin & Eosin (H & E) and Masson's trichrome staining was used to study the structure of the wound area. The results showed that OTC treated wound was more mature as indicated by the presence of a thinner epidermis followed by the Col-DFCM, PRP and NT group. Immunohistochemistry analysis also confirmed the integrity and maturity of the regenerated skin, with positive expression of cytokeratin 10 (CK10) and involucrin in the epidermal layer. In conclusion, Col-DFCM, OTC and PRP treatments promote healing of full-thickness wound and have the potential to be used clinically for rapid treatment of full-thickness wound.
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Affiliation(s)
- Thayaalini Subramaniam
- Center for Tissue Engineering and Regenerative Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Cheras 56000, Kuala Lumpur, Malaysia
| | - Nursharafana Shaiful Hadi
- Center for Tissue Engineering and Regenerative Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Cheras 56000, Kuala Lumpur, Malaysia
| | - Shamsul Sulaiman
- Center for Tissue Engineering and Regenerative Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Cheras 56000, Kuala Lumpur, Malaysia
| | - Mh Busra Fauzi
- Center for Tissue Engineering and Regenerative Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Cheras 56000, Kuala Lumpur, Malaysia
| | - Ruszymah Bt Hj Idrus
- Center for Tissue Engineering and Regenerative Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Cheras 56000, Kuala Lumpur, Malaysia; Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Cheras 56000, Kuala Lumpur, Malaysia
| | - Shiplu Roy Chowdhury
- Center for Tissue Engineering and Regenerative Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Cheras 56000, Kuala Lumpur, Malaysia
| | - Jia Xian Law
- Center for Tissue Engineering and Regenerative Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Cheras 56000, Kuala Lumpur, Malaysia
| | - Manira Maarof
- Center for Tissue Engineering and Regenerative Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Cheras 56000, Kuala Lumpur, Malaysia.
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25
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Boucard E, Vidal L, Coulon F, Mota C, Hascoët JY, Halary F. The degradation of gelatin/alginate/fibrin hydrogels is cell type dependent and can be modulated by targeting fibrinolysis. Front Bioeng Biotechnol 2022; 10:920929. [PMID: 35935486 PMCID: PMC9355319 DOI: 10.3389/fbioe.2022.920929] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 06/29/2022] [Indexed: 11/29/2022] Open
Abstract
In tissue engineering, cell origin is important to ensure outcome quality. However, the impact of the cell type chosen for seeding in a biocompatible matrix has been less investigated. Here, we investigated the capacity of primary and immortalized fibroblasts of distinct origins to degrade a gelatin/alginate/fibrin (GAF)-based biomaterial. We further established that fibrin was targeted by degradative fibroblasts through the secretion of fibrinolytic matrix-metalloproteinases (MMPs) and urokinase, two types of serine protease. Finally, we demonstrated that besides aprotinin, specific targeting of fibrinolytic MMPs and urokinase led to cell-laden GAF stability for at least forty-eight hours. These results support the use of specific strategies to tune fibrin-based biomaterials degradation over time. It emphasizes the need to choose the right cell type and further bring targeted solutions to avoid the degradation of fibrin-containing hydrogels or bioinks.
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Affiliation(s)
- Elea Boucard
- Nantes Université, INSERM, Center for Research in Transplantation and Translational Immunology, UMR 1064, Nantes, France
| | - Luciano Vidal
- Rapid Manufacturing Platform, Institut de Recherche en Génie Civil et Mécanique (GeM), UMR 7 CNRS 6183 Ecole Centrale de Nantes, Nantes, France
| | - Flora Coulon
- Nantes Université, INSERM, Center for Research in Transplantation and Translational Immunology, UMR 1064, Nantes, France
| | - Carlos Mota
- Department of Complex Tissue Regeneration, MERLN Institute for Technology-inspired Regenerative Medicine, Maastricht University, Maastricht, Netherlands
| | - Jean-Yves Hascoët
- Rapid Manufacturing Platform, Institut de Recherche en Génie Civil et Mécanique (GeM), UMR 7 CNRS 6183 Ecole Centrale de Nantes, Nantes, France
| | - Franck Halary
- Nantes Université, INSERM, Center for Research in Transplantation and Translational Immunology, UMR 1064, Nantes, France
- *Correspondence: Franck Halary,
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26
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Design of 3D Hybrid Plant Extract/Marine and Bovine Collagen Matrixes as Potential Dermal Scaffolds for Skin Wound Healing. ScientificWorldJournal 2022; 2022:8788061. [PMID: 35812001 PMCID: PMC9262554 DOI: 10.1155/2022/8788061] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 05/29/2022] [Accepted: 06/06/2022] [Indexed: 11/23/2022] Open
Abstract
Tissue engineering involves the use of smart biomimetic hybrid matrices to reinforce the cellular interaction with the matrix and restore native properties after regeneration. In this study, we highlight the potential of 3D collagen sponges soaked with bioactive extract, to enhance the wound healing process in vivo. Acid-soluble collagen from two sources, marine and bovine, were extracted and characterized physiochemically using Fourier transform infrared spectroscopy (FTIR) and SDS-PAGE. Our results confirmed that the extracted collagens were mainly composed of collagen type I with slight molecular structure differences. Both collagens present two different α chains (α1 and α2) and one β chain. Highly interconnected 3D scaffolds from collagen from the skin are designed and added by the widely known healing plants Pistacia lentiscus and Calendula officinalis. The resulting 3D collagen matrices possess fine biocompatibility with skin cells, Hacat (keratinocytes), and 3T3-L1 (fibroblasts) cells. To evaluate the potential wound healing effect, a collagen sponge soaked with the bioactive extract was tested on BALB/c mice. Our findings confirmed that sponges significantly improve animal re-epithelialization by increasing wound closure. Consequently, spongy collagen scaffolds loaded with Pistacia lentiscus and Calendula officinalis could be used as potential wound dressing material.
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27
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Fabricating a Novel Three-Dimensional Skin Model Using Silica Nonwoven Fabrics (SNF). APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12136537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Silica nonwoven fabrics (SNF) prepared using electrospinning have high biocompatibility, thermal stability, and porosity that allows growing three-dimensional culture of cells. In this study, we used SNF to construct a three-dimensional artificial skin model consisting of epidermal and dermal layers with immortalized and primary human cell lines, creating a novel model that minimizes tissue shrinkage. As a result, SNF dermal/epidermal models have enhanced functions in the basement membrane, whereas Collagen dermal/epidermal models have advantages in keratinization and barrier functions. The SNF dermal/epidermal model with mechanical strength formed a basement membrane mimicking structure, suggesting the construction of a stable skin model. Next, we constructed three-dimensional skin models consisting of SNF and collagen. In the combination models, the expression of genes in the basement membrane was significantly increased compared with that in the Collagen dermal/epidermal model, and the gene for keratinization was increased compared with that in the SNF dermal/epidermal model. We believe that the combination model can be a biomimetic model that takes advantage of both SNF and collagen and can be applied to various basic research. Our new skin model is expected to be an alternative method for skin testing to improve the shrinkage of the collagen matrix gel.
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28
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Urciuolo F, Passariello R, Imparato G, Casale C, Netti PA. Bioengineered Wound Healing Skin Models: The Role of Immune Response and Endogenous ECM to Fully Replicate the Dynamic of Scar Tissue Formation In Vitro. Bioengineering (Basel) 2022; 9:bioengineering9060233. [PMID: 35735476 PMCID: PMC9219817 DOI: 10.3390/bioengineering9060233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/24/2022] [Accepted: 05/25/2022] [Indexed: 12/27/2022] Open
Abstract
The healing of deep skin wounds is a complex phenomenon evolving according with a fine spatiotemporal regulation of different biological events (hemostasis, inflammation, proliferation, remodeling). Due to the spontaneous evolution of damaged human dermis toward a fibrotic scar, the treatment of deep wounds still represents a clinical concern. Bioengineered full-thickness skin models may play a crucial role in this direction by providing a deep understanding of the process that leads to the formation of fibrotic scars. This will allow (i) to identify new drugs and targets/biomarkers, (ii) to test new therapeutic approaches, and (iii) to develop more accurate in silico models, with the final aim to guide the closure process toward a scar-free closure and, in a more general sense, (iv) to understand the mechanisms involved in the intrinsic and extrinsic aging of the skin. In this work, the complex dynamic of events underlaying the closure of deep skin wound is presented and the engineered models that aim at replicating such complex phenomenon are reviewed. Despite the complexity of the cellular and extracellular events occurring during the skin wound healing the gold standard assay used to replicate such a process is still represented by planar in vitro models that have been largely used to identify the key factors regulating the involved cellular processes. However, the lack of the main constituents of the extracellular matrix (ECM) makes these over-simplistic 2D models unable to predict the complexity of the closure process. Three-dimensional bioengineered models, which aim at recreating the closure dynamics of the human dermis by using exogenous biomaterials, have been developed to fill such a gap. Although interesting mechanistic effects have been figured out, the effect of the inflammatory response on the ECM remodelling is not replicated yet. We discuss how more faithful wound healing models can be obtained by creating immunocompetent 3D dermis models featuring an endogenous ECM.
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Affiliation(s)
- Francesco Urciuolo
- Interdisciplinary Research Centre on Biomaterials (CRIB), University of Naples Federico II, P.le Tecchio 80, 80125 Naples, Italy; (C.C.); (P.A.N.)
- Department of Chemical, Materials and Industrial Production Engineering (DICMAPI), University of Naples Federico II, P.le Tecchio 80, 80125 Naples, Italy;
- Correspondence:
| | - Roberta Passariello
- Department of Chemical, Materials and Industrial Production Engineering (DICMAPI), University of Naples Federico II, P.le Tecchio 80, 80125 Naples, Italy;
- Center for Advanced Biomaterials for HealthCare@CRIB Istituto Italiano di Tecnologia, Largo Barsanti e Matteucci 53, 80125 Naples, Italy;
| | - Giorgia Imparato
- Center for Advanced Biomaterials for HealthCare@CRIB Istituto Italiano di Tecnologia, Largo Barsanti e Matteucci 53, 80125 Naples, Italy;
| | - Costantino Casale
- Interdisciplinary Research Centre on Biomaterials (CRIB), University of Naples Federico II, P.le Tecchio 80, 80125 Naples, Italy; (C.C.); (P.A.N.)
| | - Paolo Antonio Netti
- Interdisciplinary Research Centre on Biomaterials (CRIB), University of Naples Federico II, P.le Tecchio 80, 80125 Naples, Italy; (C.C.); (P.A.N.)
- Department of Chemical, Materials and Industrial Production Engineering (DICMAPI), University of Naples Federico II, P.le Tecchio 80, 80125 Naples, Italy;
- Center for Advanced Biomaterials for HealthCare@CRIB Istituto Italiano di Tecnologia, Largo Barsanti e Matteucci 53, 80125 Naples, Italy;
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29
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Chen L, Ma J, Chen Y, Huang C, Zheng Z, Gao Y, Jiang Z, Wei X, Peng Y, Yu S, Yang L. Polydopamine modified acellular dermal matrix sponge scaffold loaded with a-FGF: Promoting wound healing of autologous skin grafts. BIOMATERIALS ADVANCES 2022; 136:212790. [PMID: 35929322 DOI: 10.1016/j.bioadv.2022.212790] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 03/20/2022] [Accepted: 04/01/2022] [Indexed: 06/15/2023]
Abstract
Despite increasing potentials as a skin regeneration template (DRT) to guide tissue healing, acellular dermal matrix (ADM) is still challenged by issues (like dense architecture, low cellular adhesion and poor vascularization), contributing to necrosis and shedding of upper transplanted skins. Modified with polydopamine (PDA), a novel and porous DRT capable of drug delivery was designed using porcine-derived ADM (PADMS) gels, termed PDA-PADMS. However, it was unclear whether it could efficiently deliver human acidic fibroblast growth factor (a-FGF) and regenerate skin defects. Herein, after being fabricated and optimized with PADMS gels in different ratios (1:6, 1:7, 1:8), PDA-PADMS loading a-FGF (PDA-PADMS-FGF) was evaluated by the morphology, physical& chemical properties, drug release and in-vitro biological evaluations, followed by full-thickness skin defects implanted with PDA-PADMS-FGF covered by transplanted skins. Apart from containing abundant collagen and elastin, porous PADMS (with a loose and uniform structure) was demonstrated to possess controlled release of a-FGF and biocompatibility attributed to PDA coating. Consistent with augmented cellular migration and proliferation in vitro, PDA-PADMS-FGF also accelerated wound healing and reduced scarring, improving collagen arrangement and neovascularization. In conclusion, PDA-PADMS-FGF has a good potential and application prospect as a matrix material for wound repair.
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Affiliation(s)
- Lianglong Chen
- Department of Burns, Nanfang Hospital, Southern Medical University, Jingxi Street, Baiyun District, Guangzhou 510515, PR China
| | - Jun Ma
- Department of Burns, Nanfang Hospital, Southern Medical University, Jingxi Street, Baiyun District, Guangzhou 510515, PR China
| | - Yujia Chen
- Department of Burns, Nanfang Hospital, Southern Medical University, Jingxi Street, Baiyun District, Guangzhou 510515, PR China
| | - Chaoyang Huang
- Department of Burns, Nanfang Hospital, Southern Medical University, Jingxi Street, Baiyun District, Guangzhou 510515, PR China
| | - Zijun Zheng
- Department of Burns, Nanfang Hospital, Southern Medical University, Jingxi Street, Baiyun District, Guangzhou 510515, PR China
| | - Yanbin Gao
- Department of Burns, Nanfang Hospital, Southern Medical University, Jingxi Street, Baiyun District, Guangzhou 510515, PR China
| | - Ziwei Jiang
- Department of Burns, Nanfang Hospital, Southern Medical University, Jingxi Street, Baiyun District, Guangzhou 510515, PR China
| | - Xuerong Wei
- Department of Burns, Nanfang Hospital, Southern Medical University, Jingxi Street, Baiyun District, Guangzhou 510515, PR China
| | - Yujie Peng
- Department of Burns, Nanfang Hospital, Southern Medical University, Jingxi Street, Baiyun District, Guangzhou 510515, PR China
| | - Shengxiang Yu
- Department of Burns, Nanfang Hospital, Southern Medical University, Jingxi Street, Baiyun District, Guangzhou 510515, PR China
| | - Lei Yang
- Department of Burns, Nanfang Hospital, Southern Medical University, Jingxi Street, Baiyun District, Guangzhou 510515, PR China.
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30
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Managing Wound Healing with a High-Risk Patient: A Case Report. COSMETICS 2022. [DOI: 10.3390/cosmetics9020028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Wound healing is a complex, multi-step process. This process begins immediately after skin damage. The outcome of wound healing depends on the quality of each stage of this process: a normal or pathological scar. Violation of wound healing entails a decrease in the function of scar tissue as well as aesthetic dissatisfaction with the patient. This problem is especially important in aesthetic surgery. Patients who have come for beauty feel frustration, obtaining pathological scars. We have been dealing with the problem of wound healing after plastic surgery for about 10 years. Our approach includes the assessment of the risk of pathological wound healing and the treatment of high-risk patients. The risk assessment includes historical data on wound healing, signs of connective tissue dysfunction (especially patients with connective tissue dysplasia), and genetic polymorphisms of genes responsible for the structure of the components of the extracellular matrix of the skin. In the future, patients with a high risk of pathological scarring can be prescribed treatment after surgery. This article presents a clinical case in which we demonstrate our approach.
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31
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Petrie K, Cox CT, Becker BC, MacKay BJ. Clinical applications of acellular dermal matrices: A review. Scars Burn Heal 2022; 8:20595131211038313. [PMID: 35083065 PMCID: PMC8785275 DOI: 10.1177/20595131211038313] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION The extracellular matrix (ECM) plays an integral role in wound healing. It provides both structure and growth factors that allow for the organised cell proliferation. Large or complex tissue defects may compromise host ECM, creating an environment that is unfavourable for the recovery of anatomical function and appearance. Acellular dermal matrices (ADMs) have been developed from a variety of sources, including human (HADM), porcine (PADM) and bovine (BADM), with multiple different processing protocols. The objective of this report is to provide an overview of current literature assessing the clinical utility of ADMs across a broad spectrum of applications. METHODS PubMed, MEDLINE, EMBASE, Scopus, Cochrane and Web of Science were searched using keywords 'acellular dermal matrix', 'acellular dermal matrices' and brand names for commercially available ADMs. Our search was limited to English language articles published from 1999 to 2020 and focused on clinical data. RESULTS A total of 2443 records underwent screening. After removing non-clinical studies and correspondence, 222 were assessed for eligibility. Of these, 170 were included in our synthesis of the literature. While the earliest ADMs were used in severe burn injuries, usage has expanded to a number of surgical subspecialties and procedures, including orthopaedic surgery (e.g. tendon and ligament reconstructions), otolaryngology, oral surgery (e.g. treating gingival recession), abdominal wall surgery (e.g. hernia repair), plastic surgery (e.g. breast reconstruction and penile augmentation), and chronic wounds (e.g. diabetic ulcers). CONCLUSION Our understanding of ADM's clinical utility continues to evolve. More research is needed to determine which ADM has the best outcomes for each clinical scenario. LAY SUMMARY Large or complex wounds present unique reconstructive and healing challenges. In normal healing, the extracellular matrix (ECM) provides both structural and growth factors that allow tissue to regenerate in an organised fashion to close the wound. In difficult or large soft-tissue defects, however, the ECM is often compromised. Acellular dermal matrix (ADM) products have been developed to mimic the benefits of host ECM, allowing for improved outcomes in a variety of clinical scenarios. This review summarises the current clinical evidence regarding commercially available ADMs in a wide variety of clinical contexts.
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Affiliation(s)
- Kyla Petrie
- Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Cameron T Cox
- Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | | | - Brendan J MacKay
- Texas Tech University Health Sciences Center, Lubbock, TX, USA.,University Medical Center, Lubbock, TX, USA
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Potekaev NN, Borzykh OB, Medvedev GV, Pushkin DV, Petrova MM, Petrov AV, Dmitrenko DV, Karpova EI, Demina OM, Shnayder NA. The Role of Extracellular Matrix in Skin Wound Healing. J Clin Med 2021; 10:jcm10245947. [PMID: 34945243 PMCID: PMC8706213 DOI: 10.3390/jcm10245947] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 12/15/2021] [Accepted: 12/17/2021] [Indexed: 12/30/2022] Open
Abstract
Impaired wound healing is one of the unsolved problems of modern medicine, affecting patients’ quality of life and causing serious economic losses. Impaired wound healing can manifest itself in the form of chronic skin wounds or hypertrophic scars. Research on the biology and physiology of skin wound healing disorders is actively continuing, but, unfortunately, a single understanding has not been developed. The attention of clinicians to the biological and physiological aspects of wound healing in the skin is necessary for the search for new and effective methods of prevention and treatment of its consequences. In addition, it is important to update knowledge about genetic and non-genetic factors predisposing to impaired wound healing in order to identify risk levels and develop personalized strategies for managing such patients. Wound healing is a very complex process involving several overlapping stages and involving many factors. This thematic review focuses on the extracellular matrix of the skin, in particular its role in wound healing. The authors analyzed the results of fundamental research in recent years, finding promising potential for their transition into real clinical practice.
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Affiliation(s)
- Nikolai N. Potekaev
- Department of Skin Disease and Cosmetology, Pirogov Russian National Research Medical University, 117997 Moscow, Russia; (N.N.P.); (E.I.K.); (O.M.D.)
| | - Olga B. Borzykh
- Shared Core Facilities “Molecular and Cell Technologies”, V. F. Voino-Yasenetsky Krasnoyarsk State Medical University, 660022 Krasnoyarsk, Russia; (M.M.P.); (A.V.P.); (D.V.D.)
- Correspondence: (O.B.B.); (N.A.S.); Tel.: +7-(812)-670-02-20-78-14 (N.A.S.)
| | - German V. Medvedev
- Department of Hand Surgery with Microsurgical Equipment, R. R. Vreden National Medical Research Centre for Traumatology and Orthopedics, 195427 Saint Petersburg, Russia;
| | - Denis V. Pushkin
- Medical Faculty, Saint Petersburg State University, 199034 Saint Petersburg, Russia;
| | - Marina M. Petrova
- Shared Core Facilities “Molecular and Cell Technologies”, V. F. Voino-Yasenetsky Krasnoyarsk State Medical University, 660022 Krasnoyarsk, Russia; (M.M.P.); (A.V.P.); (D.V.D.)
| | - Artem V. Petrov
- Shared Core Facilities “Molecular and Cell Technologies”, V. F. Voino-Yasenetsky Krasnoyarsk State Medical University, 660022 Krasnoyarsk, Russia; (M.M.P.); (A.V.P.); (D.V.D.)
| | - Diana V. Dmitrenko
- Shared Core Facilities “Molecular and Cell Technologies”, V. F. Voino-Yasenetsky Krasnoyarsk State Medical University, 660022 Krasnoyarsk, Russia; (M.M.P.); (A.V.P.); (D.V.D.)
| | - Elena I. Karpova
- Department of Skin Disease and Cosmetology, Pirogov Russian National Research Medical University, 117997 Moscow, Russia; (N.N.P.); (E.I.K.); (O.M.D.)
| | - Olga M. Demina
- Department of Skin Disease and Cosmetology, Pirogov Russian National Research Medical University, 117997 Moscow, Russia; (N.N.P.); (E.I.K.); (O.M.D.)
| | - Natalia A. Shnayder
- Shared Core Facilities “Molecular and Cell Technologies”, V. F. Voino-Yasenetsky Krasnoyarsk State Medical University, 660022 Krasnoyarsk, Russia; (M.M.P.); (A.V.P.); (D.V.D.)
- Institute of Personalized Psychiatry and Neurology, Shared Core Facilities, V. M. Bekhterev National Medical Research Centre for Psychiatry and Neurology, 192019 Saint Petersburg, Russia
- Correspondence: (O.B.B.); (N.A.S.); Tel.: +7-(812)-670-02-20-78-14 (N.A.S.)
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Rios-Galacho M, Martinez-Moreno D, López-Ruiz E, Galvez-Martin P, Marchal JA. An overview on the manufacturing of functional and mature cellular skin substitutes. TISSUE ENGINEERING PART B-REVIEWS 2021; 28:1035-1052. [PMID: 34652978 DOI: 10.1089/ten.teb.2021.0131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
There are different types of skin diseases due to chronic injuries that impede the natural healing process of the skin. Tissue engineering (TE) has focused on the development of bioengineered skin or skin substitutes that cover the wound, providing the necessary care to restore the functionality of injured skin. There are two types of substitutes: acellular skin substitutes (ASSs), which offer a low response of the body, and cellular skin substitutes (CSSs), which incorporate living cells and appear as a great alternative in the treatment of skin injuries due to them presenting a greater interaction and integration with the rest of the body. For the development of a CSS, it is necessary to select the most suitable biomaterials, cell components, and methodology of biofabrication for the wound to be treated. Moreover, these CSSs are immature substitutes that must undergo a maturing process in specific bioreactors, guaranteeing their functionality. The bioreactor simulates the natural state of maturation of the skin by controlling parameters such as temperature, pressure, or humidity, allowing a homogeneous maturation of the CSSs in an aseptic environment. The use of bioreactors not only contributes to the maturation of the CSSs, but also offers a new way of obtaining large sections of skin substitutes or natural skin from small portions acquired from the patient, donor, or substitute. Based on the innovation of this technology and the need to develop efficient CSSs, this work offers an update on bioreactor technology in the field of skin regeneration.
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Affiliation(s)
| | | | - Elena López-Ruiz
- Universidad de Jaen, 16747, Department of Health Sciences, Jaen, Andalucía, Spain;
| | | | - Juan Antonio Marchal
- University of Granada, humqn Anatomy and embriology, avd del conocimiento nº 11, Granada, Granada, Spain, 18016;
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Wound dressings: curbing inflammation in chronic wound healing. Emerg Top Life Sci 2021; 5:523-537. [PMID: 34196717 PMCID: PMC8589427 DOI: 10.1042/etls20200346] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 05/07/2021] [Accepted: 06/10/2021] [Indexed: 12/15/2022]
Abstract
Chronic wounds represent an economic burden to healthcare systems worldwide and a societal burden to patients, deeply impacting their quality of life. The incidence of recalcitrant wounds has been steadily increasing since the population more susceptible, the elderly and diabetic, are rapidly growing. Chronic wounds are characterised by a delayed wound healing process that takes longer to heal under standard of care than acute (i.e. healthy) wounds. Two of the most common problems associated with chronic wounds are inflammation and infection, with the latter usually exacerbating the former. With this in mind, researchers and wound care companies have developed and marketed a wide variety of wound dressings presenting different compositions but all aimed at promoting healing. This makes it harder for physicians to choose the correct therapy, especially given a lack of public quantitative data to support the manufacturers’ claims. This review aims at giving a brief introduction to the clinical need for chronic wound dressings, focusing on inflammation and evaluating how bio-derived and synthetic dressings may control excess inflammation and promote healing.
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Li D, Sun WQ, Wang T, Gao Y, Wu J, Xie Z, Zhao J, He C, Zhu M, Zhang S, Wang P, Mo X. Evaluation of a novel tilapia-skin acellular dermis matrix rationally processed for enhanced wound healing. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 127:112202. [PMID: 34225854 DOI: 10.1016/j.msec.2021.112202] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 04/21/2021] [Accepted: 05/16/2021] [Indexed: 12/14/2022]
Abstract
Acellular Dermal Matrix (ADM) is mainly made with human or porcine skins and has the risk of zoonotic virus transmission. The fish skin-derived ADM could overcome the shortcoming. Fish skin acellular matrix has been used as wound dressing, but there is few systematic studies on tilapia-skin acellular dermal matrix (TS-ADM). In the present study, a novel TS-ADM was made by an alkaline decellularization process and γ-irradiation. The physical properties, biocompatibility, pre-clinical safety and wound healing activity of TS-ADM were systematically evaluated for its value as a functionally bioactive wound dressing. Histopathological analysis (hematoxylin and eosin staining, 4,6-diamidino-2-phenylindole (DAPI) staining) and DNA quantification both proved that the nuclear components of tilapia skin were removed sufficiently in TS-ADM. Compared to the commercial porcine acellular dermal matrix (DC-ADM), TS-ADM has distinctive features in morphology, thermal stability, degradability and water vapor transmission. TS-ADM was more readily degradable than DC-ADM in vitro and in vivo. In both rat and mini-pig skin wound healing experiments, TS-ADM was shown to significantly promote granulation growth, collagen deposition, angiogenesis and re-epithelialization, which may be attributed to the high expression of transforming growth factor-beta 1 (TGF-β1), alpha-smooth muscle actin (α-SMA) and CD31. Herein, the novel TS-ADM, used as a low-cost bioactive dressing, could form a microenvironment conducive to wound healing.
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Affiliation(s)
- Dongsheng Li
- Shanghai Engineering Research Center of Nano-Biomaterials and Regenerative Medicine, College of Chemistry, Chemical Engineering and Biotechnology, Donghua University, Shanghai 201620, PR China
| | - Wendell Q Sun
- Institute of Biothermal Science and Technology, School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai 200093, PR China
| | - Tong Wang
- School of Life Sciences, Yantai University, Yantai 264005, PR China
| | - Yonglin Gao
- School of Life Sciences, Yantai University, Yantai 264005, PR China
| | - Jinglei Wu
- Shanghai Engineering Research Center of Nano-Biomaterials and Regenerative Medicine, College of Chemistry, Chemical Engineering and Biotechnology, Donghua University, Shanghai 201620, PR China
| | - Zeping Xie
- School of Pharmaceutical Sciences, Binzhou Medical University, Yantai 264003, PR China
| | - Juanjuan Zhao
- School of Pharmaceutical Sciences, Binzhou Medical University, Yantai 264003, PR China
| | - Chuanglong He
- Shanghai Engineering Research Center of Nano-Biomaterials and Regenerative Medicine, College of Chemistry, Chemical Engineering and Biotechnology, Donghua University, Shanghai 201620, PR China
| | - Meifang Zhu
- State Key Lab of Chemical Fibers & Polymer Materials, College of Materials Science & Engineering, Donghua University, Shanghai 201620, PR China
| | - Shumin Zhang
- School of Pharmaceutical Sciences, Binzhou Medical University, Yantai 264003, PR China
| | - Peng Wang
- Department of Plastic and Aesthetic Center, Yantai Yuhuangding Hospital, Yantai 264000, PR China.
| | - Xiumei Mo
- Shanghai Engineering Research Center of Nano-Biomaterials and Regenerative Medicine, College of Chemistry, Chemical Engineering and Biotechnology, Donghua University, Shanghai 201620, PR China.
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Melotti L, Martinello T, Perazzi A, Iacopetti I, Ferrario C, Sugni M, Sacchetto R, Patruno M. A Prototype Skin Substitute, Made of Recycled Marine Collagen, Improves the Skin Regeneration of Sheep. Animals (Basel) 2021; 11:ani11051219. [PMID: 33922557 PMCID: PMC8145883 DOI: 10.3390/ani11051219] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/19/2021] [Accepted: 04/21/2021] [Indexed: 12/14/2022] Open
Abstract
Simple Summary Marine ecosystems are a huge source of unexplored “blue” materials for different applications. The edible part of sea urchin is limited, and the vast majority of the product ends up as waste. Our studies intend to fully recycle wastes from the food industry and reconvert them in high added-value products, as innovative biocompatible skin substitutes for tissue regeneration. The aim of the present work is to apply the pioneering skin substitute in in vivo experimental wounds to test its regenerative potential and compare it, in a future study, to the available commercial membranes produced with collagen of bovine, porcine, and equine origin. Results are encouraging since the skin substitute made with marine collagen reduced inflammation, promoted the deposition of granulation tissue, and enhanced a proper re-epithelialization with the adequate development of skin appendages. In summary, our findings might be of great interest for processing industries and biotech companies which transform waste materials in high-valuable and innovative products for Veterinary advanced applications. Abstract Skin wound healing is a complex and dynamic process that aims to restore lesioned tissues. Collagen-based skin substitutes are a promising treatment to promote wound healing by mimicking the native skin structure. Recently, collagen from marine organisms has gained interest as a source for producing biomaterials for skin regenerative strategies. This preliminary study aimed to describe the application of a collagen-based skin-like scaffold (CBSS), manufactured with collagen extracted from sea urchin food waste, to treat experimental skin wounds in a large animal. The wound-healing process was assessed over different time points by the means of clinical, histopathological, and molecular analysis. The CBSS treatment improved wound re-epithelialization along with cell proliferation, gene expression of growth factors (VEGF-A), and development of skin adnexa throughout the healing process. Furthermore, it regulated the gene expression of collagen type I and III, thus enhancing the maturation of the granulation tissue into a mature dermis without any signs of scarring as observed in untreated wounds. The observed results (reduced inflammation, better re-epithelialization, proper development of mature dermis and skin adnexa) suggest that sea urchin-derived CBSS is a promising biomaterial for skin wound healing in a “blue biotechnologies” perspective for animals of Veterinary interest.
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Affiliation(s)
- Luca Melotti
- Department of Comparative Biomedicine and Food Science, University of Padova, Viale dell’Università 16, Legnaro, 35020 Padova, Italy; (L.M.); (R.S.)
| | - Tiziana Martinello
- Department of Veterinary Medicine, University of Bari, SP. Casamassima Km.3, Valenzano, 70010 Bari, Italy;
| | - Anna Perazzi
- Department of Animal Medicine, Production and Health, University of Padova, Viale dell’Università 16, Legnaro, 35020 Padova, Italy;
| | - Ilaria Iacopetti
- Department of Animal Medicine, Production and Health, University of Padova, Viale dell’Università 16, Legnaro, 35020 Padova, Italy;
- Correspondence: (I.I.); (M.S.); (M.P.)
| | - Cinzia Ferrario
- Department of Environmental Science and Policy, University of Milan, Via Celoria, 2, 20133 Milan, Italy;
- Center for Complexity and Biosystems, Department of Physics, University of Milan, Via Celoria, 16, 20133 Milan, Italy
| | - Michela Sugni
- Department of Environmental Science and Policy, University of Milan, Via Celoria, 2, 20133 Milan, Italy;
- Center for Complexity and Biosystems, Department of Physics, University of Milan, Via Celoria, 16, 20133 Milan, Italy
- Correspondence: (I.I.); (M.S.); (M.P.)
| | - Roberta Sacchetto
- Department of Comparative Biomedicine and Food Science, University of Padova, Viale dell’Università 16, Legnaro, 35020 Padova, Italy; (L.M.); (R.S.)
| | - Marco Patruno
- Department of Comparative Biomedicine and Food Science, University of Padova, Viale dell’Università 16, Legnaro, 35020 Padova, Italy; (L.M.); (R.S.)
- Correspondence: (I.I.); (M.S.); (M.P.)
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Tan SH, Ngo ZH, Leavesley D, Liang K. Recent Advances in the Design of Three-Dimensional and Bioprinted Scaffolds for Full-Thickness Wound Healing. TISSUE ENGINEERING PART B-REVIEWS 2021; 28:160-181. [PMID: 33446047 DOI: 10.1089/ten.teb.2020.0339] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Three-dimensional (3D) printed scaffolds have recently emerged as an innovative treatment option for patients with critical-sized skin wounds. Current approaches to managing life-threatening wounds include skin grafting and application of commercially sourced skin substitutes. However, these approaches are not without several challenges. Limited donor tissue and donor site morbidity remain a concern for tissue grafting, while engineered skin substitutes fail to fully recapitulate the complex native environment required for wound healing. The implementation of 3D printed dermal scaffolds offers a potential solution for these shortcomings. Spatial control over scaffold structure, the ability to incorporate multiple materials and bioactive ingredients, enables the creation of conditions specifically optimized for wound healing. Three-dimensional bioprinting, a subset of 3D printing, allows for the replacement of lost cell populations and secreted active compounds that contribute to tissue repair and recovery. The replacement of damaged and lost cells delivers beneficial effects directly, or synergistically, supporting injured tissue to recover its native state. Despite encouraging results, the promise of 3D printed scaffolds has yet to be realized. Further improvements to current material formulations and scaffold designs are required to achieve the goal of clinical adoption. Herein, we provide an overview of 3D printing techniques and discuss several strategies for healing of full-thickness wounds by using 3D printed acellular scaffolds or bioprinted cellular scaffolds, aimed at translating this technology to the clinical management of skin lesions. We identify the challenges associated with designing and optimizing printed tissue replacements, and discuss the future perspectives of this emerging option for managing patients who present with critical-sized life-threatening cutaneous wounds.
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Affiliation(s)
- Shi Hua Tan
- Skin Research Institute of Singapore (SRIS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Zong Heng Ngo
- Skin Research Institute of Singapore (SRIS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - David Leavesley
- Skin Research Institute of Singapore (SRIS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Kun Liang
- Skin Research Institute of Singapore (SRIS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
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Martínez-Santamaría L, Cárcamo C, García-Pardo L, García-Arranz M, Melen G, Guerrero-Aspizua S, Llanos L, Río MD, García-Olmo D, Escámez MJ. Combined adipose mesenchymal stromal cell advanced therapy resolved a recalcitrant leg ulcer in an 85-year-old patient. Regen Med 2020; 15:2053-2065. [PMID: 33245008 DOI: 10.2217/rme-2020-0139] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Venous leg ulcers (VLU) represent an uphill economic, health and social burden, aggravated in the elderly. Best-practice care interventions are often insufficient and alternative therapies need to be explored. Herein, we have treated for the first time a chronic VLU in an elderly patient by combining cell therapy and tissue engineering in the context of a compassionate use. The administration of allogeneic adipose-derived mesenchymal stromal cells (MSCs) embedded in a plasma-based bioengineered dermis covering the ulcer bed and also injected into the ulcer margins led to the complete closure of a 10-year recalcitrant VLU in an 85-year-old patient. Regenerative properties of MSCs might be boosted by the use of bioengineered matrices for their delivery.
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Affiliation(s)
- Lucía Martínez-Santamaría
- Department of Bioengineering, Carlos III University (UC3M). Avda. Universidad, 30. 28911. Leganés, Madrid, Spain.,Centre for Biomedical Network Research on Rare Diseases (CIBERER), U714. C/ Monforte de Lemos 3-5. 28029 Madrid, Spain.,Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz. Avda. de los Reyes Católicos, 2, 28040 Madrid, Spain.,Centre for Energy, Environment & Technology Research (CIEMAT). Avda. Complutense, 40, 28040 Madrid, Spain
| | - Carmen Cárcamo
- Plastic & Reconstructive Surgery Department, Hospital Universitario Fundación Jiménez Díaz. Avda. de los Reyes Católicos, 2, 28040 Madrid, Spain
| | - Lourdes García-Pardo
- Plastic & Reconstructive Surgery Department, Hospital Universitario Fundación Jiménez Díaz. Avda. de los Reyes Católicos, 2, 28040 Madrid, Spain
| | - Mariano García-Arranz
- New Therapy Unit, Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz & Universidad Autónoma de Madrid. Avda. de los Reyes Católicos, 2, 28040 Madrid, Spain.,Department of Surgery, Medicine School, Universidad Autónoma de Madrid. C/ Arzobispo Morcillo, 4, 28029 Madrid, Spain
| | - Gustavo Melen
- Production Unit of Advanced Therapies Medicines, Fundación para la Investigación Biomédica del Hospital Infantil Universitario Niño Jesús. Avda. de Menéndez Pelayo,65, 28009 Madrid, Spain
| | - Sara Guerrero-Aspizua
- Department of Bioengineering, Carlos III University (UC3M). Avda. Universidad, 30. 28911. Leganés, Madrid, Spain.,Centre for Biomedical Network Research on Rare Diseases (CIBERER), U714. C/ Monforte de Lemos 3-5. 28029 Madrid, Spain.,Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz. Avda. de los Reyes Católicos, 2, 28040 Madrid, Spain.,Centre for Energy, Environment & Technology Research (CIEMAT). Avda. Complutense, 40, 28040 Madrid, Spain
| | - Lucía Llanos
- Clinical Research Unit, Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz. Avda. de los Reyes Católicos, 2, 28040 Madrid, Spain
| | - Marcela Del Río
- Department of Bioengineering, Carlos III University (UC3M). Avda. Universidad, 30. 28911. Leganés, Madrid, Spain.,Centre for Biomedical Network Research on Rare Diseases (CIBERER), U714. C/ Monforte de Lemos 3-5. 28029 Madrid, Spain.,Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz. Avda. de los Reyes Católicos, 2, 28040 Madrid, Spain.,Centre for Energy, Environment & Technology Research (CIEMAT). Avda. Complutense, 40, 28040 Madrid, Spain
| | - Damián García-Olmo
- New Therapy Unit, Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz & Universidad Autónoma de Madrid. Avda. de los Reyes Católicos, 2, 28040 Madrid, Spain.,Department of Surgery, Medicine School, Universidad Autónoma de Madrid. C/ Arzobispo Morcillo, 4, 28029 Madrid, Spain
| | - María-José Escámez
- Department of Bioengineering, Carlos III University (UC3M). Avda. Universidad, 30. 28911. Leganés, Madrid, Spain.,Centre for Biomedical Network Research on Rare Diseases (CIBERER), U714. C/ Monforte de Lemos 3-5. 28029 Madrid, Spain.,Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz. Avda. de los Reyes Católicos, 2, 28040 Madrid, Spain.,Centre for Energy, Environment & Technology Research (CIEMAT). Avda. Complutense, 40, 28040 Madrid, Spain
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Stoica AE, Grumezescu AM, Hermenean AO, Andronescu E, Vasile BS. Scar-Free Healing: Current Concepts and Future Perspectives. NANOMATERIALS (BASEL, SWITZERLAND) 2020; 10:E2179. [PMID: 33142891 PMCID: PMC7693882 DOI: 10.3390/nano10112179] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 10/15/2020] [Accepted: 10/27/2020] [Indexed: 02/07/2023]
Abstract
Every year, millions of people develop scars due to skin injuries after trauma, surgery, or skin burns. From the beginning of wound healing development, scar hyperplasia, and prolonged healing time in wound healing have been severe problems. Based on the difference between adult and fetal wound healing processes, many promising therapies have been developed to decrease scar formation in skin wounds. Currently, there is no good or reliable therapy to cure or prevent scar formation. This work briefly reviews the engineering methods of scarless wound healing, focusing on regenerative biomaterials and different cytokines, growth factors, and extracellular components in regenerative wound healing to minimize skin damage cell types, and scar formation.
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Affiliation(s)
- Alexandra Elena Stoica
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest, 1–7 Gheorghe Polizu Street, 011061 Bucharest, Romania; (A.E.S.); (A.M.G.); (E.A.)
- National Research Center for Micro and Nanomaterials, Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest, 060042 Bucharest, Romania
| | - Alexandru Mihai Grumezescu
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest, 1–7 Gheorghe Polizu Street, 011061 Bucharest, Romania; (A.E.S.); (A.M.G.); (E.A.)
| | - Anca Oana Hermenean
- Institute of Life Sciences, Vasile Goldiş Western University of Arad, 310025 Arad, Romania;
| | - Ecaterina Andronescu
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest, 1–7 Gheorghe Polizu Street, 011061 Bucharest, Romania; (A.E.S.); (A.M.G.); (E.A.)
| | - Bogdan Stefan Vasile
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest, 1–7 Gheorghe Polizu Street, 011061 Bucharest, Romania; (A.E.S.); (A.M.G.); (E.A.)
- National Research Center for Micro and Nanomaterials, Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest, 060042 Bucharest, Romania
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Magden GK, Vural C, Bayrak BY, Ozdogan CY, Kenar H. Composite sponges from sheep decellularized small intestinal submucosa for treatment of diabetic wounds. J Biomater Appl 2020; 36:113-127. [PMID: 33023379 DOI: 10.1177/0885328220963897] [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: 12/25/2022]
Abstract
Despite the fast development of technology in the world, diabetic foot wounds cause deaths and massive economical losses. Diabetes comes first among the reasons of non traumatic foot amputations. To reduce the healing time of these fast progressing wounds, effective wound dressings are in high demand. In our study, sheep small intestinal submucosa (SIS) based biocompatible sponges were prepared after SIS decellularization and their wound healing potential was investigated on full thickness skin defects in a diabetic rat model. The decellularized SIS membranes had no cytotoxic effects on human fibroblasts and supported capillary formation by HUVECs in a fibroblast-HUVEC co-culture. Glutaraldehyde crosslinked sponges of three different compositions were prepared to test in a diabetic rat model: gelatin (GS), gelatin: hyaluronic acid (GS:HA) and gelatin: hyaluronic acid: SIS (GS:HA:SIS). The GS:HA:SIS sponges underwent a 24.8 ± 5.4% weight loss in a 7-day in vitro erosion test. All sponges had a similar Young's modulus under compression but GS:HA:SIS had the highest (5.00 ± 0.04 kPa). Statistical analyses of histopathological results of a 12-day in vivo experiment revealed no significant difference among the control, GS, GS:HA, and GS:HA:SIS transplanted groups in terms of granulation tissue thickness, collagen deposition, capillary vessel formation, and foreign body reaction (P > 0.05). On the other hand, in the GS:HA:SIS transplanted group 80% of the animals had a complete epidermal regeneration and this was significantly different than the control group (30%, P < 0.05). Preclinical studies revealed that the ECM of sheep small intestinal submucosa can be used as an effective biomaterial in diabetic wound healing.
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Affiliation(s)
- Gamze Kara Magden
- Polymer Science and Technology Dept., Graduate School of Natural and Applied Sciences, Kocaeli University, Turkey
| | - Cigdem Vural
- Polymer Science and Technology Dept., Graduate School of Natural and Applied Sciences, Kocaeli University, Turkey
| | - Busra Yaprak Bayrak
- Polymer Science and Technology Dept., Graduate School of Natural and Applied Sciences, Kocaeli University, Turkey
| | - Candan Yilmaz Ozdogan
- Polymer Science and Technology Dept., Graduate School of Natural and Applied Sciences, Kocaeli University, Turkey
| | - Halime Kenar
- Experimental and Clinical Research Center, Diabetes and Obesity Research Laboratory, Kocaeli University, Turkey
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Clinical Translational Potential in Skin Wound Regeneration for Adipose-Derived, Blood-Derived, and Cellulose Materials: Cells, Exosomes, and Hydrogels. Biomolecules 2020; 10:biom10101373. [PMID: 32992554 PMCID: PMC7650547 DOI: 10.3390/biom10101373] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 09/22/2020] [Accepted: 09/24/2020] [Indexed: 12/13/2022] Open
Abstract
Acute and chronic skin wounds due to burns, pressure injuries, and trauma represent a substantial challenge to healthcare delivery with particular impacts on geriatric, paraplegic, and quadriplegic demographics worldwide. Nevertheless, the current standard of care relies extensively on preventive measures to mitigate pressure injury, surgical debridement, skin flap procedures, and negative pressure wound vacuum measures. This article highlights the potential of adipose-, blood-, and cellulose-derived products (cells, decellularized matrices and scaffolds, and exosome and secretome factors) as a means to address this unmet medical need. The current status of this research area is evaluated and discussed in the context of promising avenues for future discovery.
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Norris EG, Dalecki D, Hocking DC. Using Acoustic Fields to Fabricate ECM-Based Biomaterials for Regenerative Medicine Applications. RECENT PROGRESS IN MATERIALS 2020; 2:1-24. [PMID: 33604591 PMCID: PMC7889011 DOI: 10.21926/rpm.2003018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Ultrasound is emerging as a promising tool for both characterizing and fabricating engineered biomaterials. Ultrasound-based technologies offer a diverse toolbox with outstanding capacity for optimization and customization within a variety of therapeutic contexts, including improved extracellular matrix-based materials for regenerative medicine applications. Non-invasive ultrasound fabrication tools include the use of thermal and mechanical effects of acoustic waves to modify the structure and function of extracellular matrix scaffolds both directly, and indirectly via biochemical and cellular mediators. Materials derived from components of native extracellular matrix are an essential component of engineered biomaterials designed to stimulate cell and tissue functions and repair or replace injured tissues. Thus, continued investigations into biological and acoustic mechanisms by which ultrasound can be used to manipulate extracellular matrix components within three-dimensional hydrogels hold much potential to enable the production of improved biomaterials for clinical and research applications.
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Affiliation(s)
- Emma G Norris
- Department of Pharmacology and Physiology, University of Rochester, Rochester, New York, USA
| | - Diane Dalecki
- Department of Biomedical Engineering, University of Rochester, Rochester, New York, USA
| | - Denise C Hocking
- Department of Pharmacology and Physiology, University of Rochester, Rochester, New York, USA
- Department of Biomedical Engineering, University of Rochester, Rochester, New York, USA
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Przekora A. A Concise Review on Tissue Engineered Artificial Skin Grafts for Chronic Wound Treatment: Can We Reconstruct Functional Skin Tissue In Vitro? Cells 2020; 9:cells9071622. [PMID: 32640572 PMCID: PMC7407512 DOI: 10.3390/cells9071622] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 06/17/2020] [Accepted: 06/21/2020] [Indexed: 12/12/2022] Open
Abstract
Chronic wounds occur as a consequence of a prolonged inflammatory phase during the healing process, which precludes skin regeneration. Typical treatment for chronic wounds includes application of autografts, allografts collected from cadaver, and topical delivery of antioxidant, anti-inflammatory, and antibacterial agents. Nevertheless, the mentioned therapies are not sufficient for extensive or deep wounds. Moreover, application of allogeneic skin grafts carries high risk of rejection and treatment failure. Advanced therapies for chronic wounds involve application of bioengineered artificial skin substitutes to overcome graft rejection as well as topical delivery of mesenchymal stem cells to reduce inflammation and accelerate the healing process. This review focuses on the concept of skin tissue engineering, which is a modern approach to chronic wound treatment. The aim of the article is to summarize common therapies for chronic wounds and recent achievements in the development of bioengineered artificial skin constructs, including analysis of biomaterials and cells widely used for skin graft production. This review also presents attempts to reconstruct nerves, pigmentation, and skin appendages (hair follicles, sweat glands) using artificial skin grafts as well as recent trends in the engineering of biomaterials, aiming to produce nanocomposite skin substitutes (nanofilled polymer composites) with controlled antibacterial activity. Finally, the article describes the composition, advantages, and limitations of both newly developed and commercially available bioengineered skin substitutes.
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Affiliation(s)
- Agata Przekora
- Department of Biochemistry and Biotechnology, Medical University of Lublin, Chodzki 1 Street, 20-093 Lublin, Poland
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Dill V, Mörgelin M. Biological dermal templates with native collagen scaffolds provide guiding ridges for invading cells and may promote structured dermal wound healing. Int Wound J 2020; 17:618-630. [PMID: 32045112 PMCID: PMC7949003 DOI: 10.1111/iwj.13314] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 12/20/2019] [Accepted: 01/10/2020] [Indexed: 01/14/2023] Open
Abstract
Dermal substitutes are of major importance in treating full thickness skin defects. They come in a variety of materials manufactured into various forms, such as films, hydrocolloids, hydrogels, sponges, membranes, and electrospun micro- and nanofibers. Bioactive dermal substitutes act in wound healing either by delivery of bioactive compounds or by being constructed from materials having endogenous activity. The healing success rate is highly determined by cellular and physiological processes at the host-biomaterial interface during crucial wound healing steps. Hence, it is important to design appropriate wound treatment strategies with the ability to work actively with tissues and cells to enhance healing. Therefore, in this study, we investigated biological dermal templates and their potential to stimulate natural cell adherence, guidance, and morphology. The most pronounced effect was observed in biomaterials with the highest content of native collagen networks. Cell attachment and proliferation were significantly enhanced on native collagen scaffolds. Cell morphology was more asymmetrical on such scaffolds, resembling native in vivo structures. Importantly, considerably lower expression of myofibroblast phenotype was observed on native collagen scaffolds. Our data suggest that this treatment strategy might be beneficial for the wound environment, with the potential to promote improved tissue regeneration and reduce abnormal scar formation.
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Affiliation(s)
- Veronika Dill
- Department of Clinical Sciences, Division of Infection MedicineLund UniversityLundSweden
| | - Matthias Mörgelin
- Department of Clinical Sciences, Division of Infection MedicineLund UniversityLundSweden
- Colzyx ABLundSweden
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Abstract
The skin is the largest organ in the body, fulfilling a variety of functions and acting as a barrier for internal organs against external insults. As for extensive or irreversible damage, skin autografts are often considered the gold standard, however inherent limitations highlight the need for alternative strategies. Engineering of human-compatible tissues is an interdisciplinary and active field of research, leading to the production of scaffolds and skin substitutes to guide repair and regeneration. However, faithful reproduction of extracellular matrix (ECM) architecture and bioactive content capable of cell-instructive and cell-responsive properties remains challenging. ECM is a heterogeneous, connective network composed of collagens, glycoproteins, proteoglycans, and small molecules. It is highly coordinated to provide the physical scaffolding, mechanical stability, and biochemical cues necessary for tissue morphogenesis and homeostasis. Decellularization processes have made it possible to isolate the ECM in its native and three-dimensional form from a cell-populated tissue for use in skin regeneration. In this review, we present recent knowledge about these decellularized biomaterials with the potential to be used as dermal or skin substitutes in clinical applications. We detail tissue sources and clinical indications with success rates and report the most effective decellularization methods compatible with clinical use.
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Preclinical Models: Boosting Synergies for Improved Translation. J Clin Med 2020; 9:jcm9041011. [PMID: 32260102 PMCID: PMC7230432 DOI: 10.3390/jcm9041011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 04/01/2020] [Indexed: 11/17/2022] Open
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Cell-free scaffold from jellyfish Cassiopea andromeda (Cnidaria; Scyphozoa) for skin tissue engineering. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2020; 111:110748. [PMID: 32279751 DOI: 10.1016/j.msec.2020.110748] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 01/31/2020] [Accepted: 02/15/2020] [Indexed: 12/17/2022]
Abstract
Disruption of the continuous cutaneous membrane in the integumentary system is considered a health problem of high cost for any nation. Several attempts have been made for developing skin substitutes in order to restore injured tissue including autologous implants and the use of scaffolds based on synthetic and natural materials. Current biomaterials used for skin tissue repair include several scaffold matrices types, synthetic or natural, absorbable, degradable or non-degradable polymers, porous or dense scaffolds, and cells capsulated in hydrogels or spheroids systems so forth. These materials have advantages and disadvantages and its use will depend on the desired application. Recently, marine organisms such as jellyfish have attracted renewed interest, because both its composition and structure resemble the architecture of human dermic tissue. In this context, the present study aims to generate scaffolds from Cassiopea andromeda (C. andromeda), with application in skin tissue engineering, using a decellularization process. The obtained scaffold was studied by infrared spectroscopy (FT-IR), thermogravimetric analysis (TGA), differential scanning calorimetry analysis (DSC), and scanning electron microscopy (SEM). Crystal violet staining and DNA quantification assessed decellularization effectiveness while the biocompatibility of scaffold was determined with human dermic fibroblasts. Results indicated that the decellularization process reduce native cell population leading to 70% reduction in DNA content. In addition, SEM showed that the macro and microstructure of the collagen I-based scaffold were preserved allowing good adhesion and proliferation of human dermic fibroblasts. The C. andromeda scaffold mimics human skin and therefore represents great potential for skin tissue engineering.
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