Alginate/chitosan-based hydrogel loaded with gene vectors to deliver polydeoxyribonucleotide for effective wound healing

2021 ◽  
Author(s):  
Xiaodong Jing ◽  
Yanzhen Sun ◽  
Yang Liu ◽  
Xiaoli Ma ◽  
Hao Hu
Keyword(s):  
Wound Healing ◽  
Diabetic Foot ◽  
Chronic Wounds ◽  
Foot Ulcers ◽  
Pressure Sores ◽  
Leg Ulcers ◽  
Wound Treatment ◽  
Diabetic Foot Ulcers ◽  
Acute Bleeding ◽  
Gene Vectors

Timely and effective wound treatment is of great significance to acute bleeding caused by accidents and chronic wounds such as diabetic foot ulcers, venous leg ulcers, pressure sores. Hydrogel as...

scholarly journals THE EFFICACY OF HONEY AS AN ALTERNATIVE TO STANDARD ANTISEPTIC CARE IN THE TREATMENT OF CHRONIC PRESSURE ULCERS AND DIABETIC FOOT ULCERS IN ADULTS

2021 ◽  
pp. 37-47
Author(s):  
GF PEREIRA ◽  
M BALMITH ◽  
M NELL
Keyword(s):  
Wound Healing ◽  
Diabetic Foot ◽  
Bacterial Infections ◽  
Chronic Wounds ◽  
Pressure Ulcers ◽  
Keyword Search ◽  
Selection Process ◽  
Foot Ulcers ◽  
Published Data ◽  
Diabetic Foot Ulcers

Objective: A chronic wound fails to progress through the phases of wound healing in an orderly and appropriate process, and poses a major challenge to wound care professionals. Pressure ulcers (PUs) and diabetic foot ulcers (DFUs) are classified as chronic wounds. Antiseptics, such as povidone-iodine (PVP-I), are often used to treat bacterial infections in chronic wounds; however, their efficacy and ability to accelerate wound healing has come into question. As a result, current medical research is now focusing on alternative and natural antiseptic agents, such as honey, for the treatment of chronic wounds. The aim of this study was to analyze the wound healing effects of honey in PU and DFU treatment in comparison to standard antiseptic care. Methods: A systematic literature search of PubMed, ScienceDirect, and ClinicalKey was conducted to identify all published data of clinical trials and narrative reviews that investigated or reported the use of honey and standard antiseptics in the treatment of PUs and DFUs in adults. A keyword search was then performed using the following keywords: “PUs”, “DFUs”, “antiseptics”, “PVP-I”, “honey”, “Manuka honey (MH)”, and “wound healing”. Database restrictions were implemented based on the inclusion and exclusion criteria, notably the report’s availability, completion status and language, the sample populations’ age, as well as, the date of publication. A preferred reporting item for systematic review and meta-analysis (preferred reporting items for systematic reviews and meta-analyzes) diagram was constructed illustrating the study selection process. The eligibility of articles was assessed by the screening of titles, abstracts and full texts. A total of 12 articles were included in this study comprising of 775 patients with PUs, DFUs or a combination of PUs and DFUs. Results: Results indicated that honey reduced bacterial infection, reduced pain and edema experienced by patients, reduced the odor of the wound and promoted wound healing in the treatment of chronic ulcers. Honey was also found to be effective in the process of debridement and exudate removal. Conclusion: Honey was found to be highly effective in the treatment of PUs and DFUs and should be considered as an alternative to standard antiseptic care in the treatment of chronic wounds. However, the literature in this study is limited and so further research into honey and its antiseptic-promoting activity in wound healing is recommended.

scholarly journals A clinical study of platelet rich plasma versus conventional dressing in management of diabetic foot ulcers

2018 ◽  
Vol 5 (10) ◽  
pp. 3210 ◽  
Author(s):  
Nithyaraj Prakasam ◽  
Prabakar M.S. ◽  
Reshma S. ◽  
Loganathan K. ◽  
Senguttuvan K.
Keyword(s):  
Wound Healing ◽  
Tissue Regeneration ◽  
Diabetic Foot ◽  
Tamil Nadu ◽  
Chronic Wounds ◽  
Platelet Rich Plasma ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Group A ◽  
Group B

Background: Diabetic foot ulcers continue to pose significant global issue despite the advances made in the management of diabetes. It causes major foot complications if they are not addressed properly. It needs multidisciplinary approach for its care. While several advancements has taken place in wound care management, platelet rich plasma and stem cell therapy promises to offer a new hope in its management, aiding in cellular and tissue regeneration. The purpose of the present study was to compare Platelet-Rich Plasma versus conventional dressing in the management of diabetic foot ulcers.Methods: This prospective study was focused on 20 diabetic foot ulcers, carried out in a surgical unit of ACS Medical College and Hospital, Chennai, Tamil Nadu, from January 2018 to June 2018. Patients were divided into two groups; Group A received conventional ordinary dressing (N=10, 50%) and Group B received PRP dressing (N = 10, 50%). The mean follow-up period was 8 weeks.Results: The estimated time of wound healing was 8 weeks and healing was found to be more effective for patients in group B compared to patients in group A; the PRP group was found to be more effective in wound healing with fewer complications, less infection, exudates and pain.Conclusions: There have been considerable advances in the use of PRP in therapeutic processes in recent years in tissue regeneration therapy. PRP is a powerful tool for the treatment of chronic wounds and very promising for diabetic foot wounds; PRP enables healing, and reduces amputation rates, infection and exudates.

Recent Advances in the Development of Nitric Oxide-Releasing Biomaterials and Their Application Potentials in Chronic Wound Healing

2021 ◽  
Author(s):  
Min Wu ◽  
Zhihui Lu ◽  
Keke Wu ◽  
Changwoo Nam ◽  
Lin Zhang ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Wound Healing ◽  
Persistent Infection ◽  
Diabetic Foot ◽  
Chronic Wounds ◽  
Pressure Ulcers ◽  
Chronic Wound ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Nitric Oxide Releasing

Chronic wounds, such as pressure ulcers, vascular ulcers and diabetic foot ulcers (DFUs), often stays in a state of pathological inflammation and suffers from persistent infection, excess inflammation, and hypoxia,...

scholarly journals Use of Cellular and Tissue-based Product in the Treatment of Diabetic Foot Ulcers

2016 ◽  
Vol 3 (2) ◽  
pp. 92-96
Author(s):  
Thomas E Serena ◽  
Raphael A Yaakov ◽  
Eliot N Mostow
Keyword(s):  
Wound Healing ◽  
Diabetic Foot ◽  
Chronic Wounds ◽  
Relevant Literature ◽  
Cost Of Care ◽  
Asia Pacific ◽  
Cochrane Library ◽  
Foot Ulcers ◽  
Economic Evaluations ◽  
Diabetic Foot Ulcers

ABSTRACT Introduction The prevalence of diabetes has been rising sharply and the rise in chronic wounds parallels this trend. Lower extremity ulcers present a serious complication for people with diabetes. While debridement of necrotic tissue and off-loading plays an important role in wound healing, many patients with diabetic foot ulcers (DFUs) fail to heal with standard of care (SOC) alone. Unresolved ulcers can lead to complications, such as osteomyelitis and amputation. There continues to be a need for the evaluation of novel wound therapies that can accelerate wound healing and lower the cost of care associated with DFUs. This paper presents recent evidence for the use of cellular and/or tissue-based products (CTPs) and offers an approach for selecting an appropriate CTP. Materials and methods A systematic literature search was conducted using PubMed, Embase, Medline, Cochrane library, and NHS Economic Evaluation Database. Full-length articles in English were assessed for relevance to select studies on effectiveness and economic evaluations. Additionally, Google Scholar was used to gather relevant literature on commonly used CTPs, including Apligraf®, EpiFix®, and Dermagraft®. Findings Results from randomized controlled trials (RCTs) provided evidence for the superior efficacy of CTPs over SOC alone in treatment of chronic DFUs. In recent studies evaluating commonly used CTPs, significantly higher number of DFUs achieved complete closure with EpiFix® when compared to either Apligraf® or Dermagraft®. While cost-effectiveness studies continue to be limited, current literature suggests that CTPs can decrease the long-term costs associated with the care of DFUs by increasing the healing rate, reducing recovery time, and lowering the risk of infection and complications. Cellular and/or tissue-based products (CTPs) may result in higher average number of ulcer-free months and lower average number of amputations or resections compared to SOC alone. How to cite this article Serena TE, Yaakov RA, Mostow EN. Use of Cellular and Tissue-based Product in the Treatment of Diabetic Foot Ulcers. J Foot Ankle Surg (Asia-Pacific) 2016;3(2):92-96.

Photobiomodulation as an Adjunct Therapy in Wound Healing

2021 ◽  
pp. 153473462110041
Author(s):  
Harikrishna K. R. Nair ◽  
Sylvia S. Y. Chong ◽  
Daryl D. J. Selvaraj
Keyword(s):  
Wound Healing ◽  
Diabetic Foot ◽  
Chronic Wounds ◽  
Case Series ◽  
Stimulated Emission ◽  
Area Measurement ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Adjunct Therapy ◽  
Light Amplification

“Light amplification by stimulated emission of radiation” or more commonly known as Laser has become very popular in the field of dermatology and aesthetic medicine over the past decades. For the treatment of wound healing, a combination of different wavelengths for laser therapy has been introduced which includes 660, 800, and 970 nm. The aim of this study was to note wound healing utilizing photobiomodulation as an adjunct therapy by measuring the wound size in terms of length and width (area measurement). Study participants were selected randomly from a pool of patients who were attending for their routine follow-up visits in the Wound Care Unit in Hospital Kuala Lumpur. Eleven patients with chronic wounds of different etiologies, ie, diabetic foot ulcer and nonhealing ulcer, were recruited for this study . Wound assessment was done prior to cleansing using distilled water and followed by debridement if necessary. Subsequently, the laser technician and patients used protective goggles before applying a super intense continuous flow of laser with 3 wavelengths, ie, 660, 800, and 970 nm with 30 kJ of energy with the handpiece over a 3 min period whereby it is focused on the wound milieu and then rotated around the periwound area. There were 9 diabetic foot ulcers and 2 nonhealing ulcers treated with photobiomodulation as an adjunct therapy. All wounds were managed with the standard of care. Three wounds ie, 3 diabetic foot ulcers and 1 nonhealing ulcer were closed completely. Meanwhile, the other 7 ulcers are at 68.2% to 99% in terms of wound area reduction and new granulomatous tissue was present indicating high healing potential. Therefore, the photobiomodulation was effective as an adjunct in the management of diabetic foot and nonhealing ulcers in this case series. A larger sample size would be able to show the significance of this finding.

scholarly journals Topical Wound Oxygen Therapy in the Treatment of Chronic Diabetic Foot Ulcers

Medicina ◽  
2021 ◽  
Vol 57 (9) ◽  
pp. 917
Author(s):  
Robert G. Frykberg
Keyword(s):  
Wound Healing ◽  
Diabetic Foot ◽  
Clinical Studies ◽  
Oxygen Therapy ◽  
Chronic Wounds ◽  
Supplemental Oxygen ◽  
Foot Ulcers ◽  
Critical Threshold ◽  
Diabetic Foot Ulcers

Oxygen is a critical component of many biological processes and is essential for wound healing. Chronic wounds are typically characterized as being hypoxic in that the partial pressure of oxygen (pO2) in the center of the wound is often below a critical threshold necessary to fully support those enzymatic processes necessary for tissue repair. Providing supplemental oxygen can effectively raise pO2 levels to better optimize functioning of these essential enzymes. While hyperbaric oxygen therapy has been well studied in this regard, comparative clinical studies have fallen short of providing clear evidence in support of this modality for healing chronic diabetic foot ulcers (DFU). Topical oxygen therapy (TOT) has been in clinical use for over 50 years with encouraging pre-clinical and clinical studies that have shown improved healing rates when compared to standard care. Nonetheless, TOT has heretofore been discounted as an unproven wound healing modality without theoretical or clinical evidence to support its use. This review shall provide a brief summary of the role of oxygen in wound healing and, specifically, discuss the different types of topical oxygen devices and associated studies that have convincingly shown their efficacy in healing chronic DFUs. The time has come for topical oxygen therapy to be embraced as a proven adjunctive modality in this regard.

Electrospun nanofibers provide a good platform to treat chronic wounds like diabetic foot ulcers

2021 ◽  
Author(s):  
Moataz Dowaidar
Keyword(s):  
Drug Delivery ◽  
Wound Healing ◽  
Diabetic Foot ◽  
Wound Closure ◽  
Chronic Wounds ◽  
Electrospun Nanofibers ◽  
Wound Management ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers

Chronic foot ulceration is one of the major comorbid challenges associated with the manifestation of Type-2 Diabetic Mellitus and is responsible for high mortality rates, requiring the development of a localized drug delivery system (DDS) that can deliver the drug payload while also facilitating wound closure. Although nanofibers may be produced in many ways, electrospinning is one of the most versatile methods. Nanofiber-based DDSs show a substantial influence on targeted drug delivery, faster wound healing, and chronic wound closure. Electrospun nanofibers have evolved over time from simple nanofibers to new generations of nanofibers such as blend, composite, core-shell electrospun, and hybrid nanofibers, each with unique physicochemical and mechanochemical properties, giving distinct advantages to the respective nanofibers for better diabetic wound management. Optimizing the parameters involved in the preparation of nanofibers, which can be classified as static, processing and environmental parameters, is critical for process reproducibility, ensuring the desired properties of nanofibers, maintaining uniformity and maximizing the performance of electrospinning. Electrospun nanofibers are a suitable platform for treating chronic wounds such as diabetic foot ulcers. However, clinically using nanofiber-based DDSs as a localized wound therapy platform requires comprehensive physicochemical and mechanochemical characterization, as well as rigorous in-vitro and in-vivo drug release and wound healing efficacy testing.

Punch Grafting for the Management of Hard-to-Heal Diabetic Foot Ulcers: A Prospective Case Series

2021 ◽  
pp. 153473462110310
Author(s):  
Marta García-Madrid ◽  
Irene Sanz-Corbalán ◽  
Aroa Tardáguila-García ◽  
Raúl J. Molines-Barroso ◽  
Mateo López-Moral ◽  
...  
Keyword(s):  
Wound Healing ◽  
Clinical Outcomes ◽  
Diabetic Foot ◽  
Donor Site ◽  
Case Series ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Wound Debridement ◽  
Prospective Case Series

Punch grafting is an alternative treatment to enhance wound healing which has been associated with promising clinical outcomes in various leg and foot wound types. We aimed to evaluate the clinical outcomes of punch grafting as a treatment for hard-to-heal diabetic foot ulcers (DFUs). Six patients with chronic neuropathic or neuroischemic DFUs with more than 6 months of evolution not responding to conventional treatment were included in a prospective case series between May 2017 and December 2020. All patients were previously debrided using an ultrasound-assisted wound debridement and then, grafted with 4 to 6 mm punch from the donor site that was in all cases the anterolateral aspect of the thigh. All patients were followed up weekly until wound healing. Four (66.7%) DFUs were located in the heel, 1 (16.7%) in the dorsal aspect of the foot and 1 (16.7%) in the Achilles tendon. The median evolution time was 172 (interquartile range [IQR], 25th-75th; 44-276) weeks with a median area of 5.9 (IQR; 1.87-37.12) cm2 before grafting. Complete epithelization was achieved in 3 (50%) patients at 12 weeks follow-up period with a mean time of 5.67 ± 2.88 weeks. Two of the remaining patients achieved wound healing at 32 and 24 weeks, respectively, and 1 patient showed punch graft unsuccessful in adhering. The median time of wound healing of all patients included in the study was 9.00 (IQR; 4.00-28.00) weeks. The wound area reduction (WAR) at 4 weeks was 38.66% and WAR at 12 weeks was 88.56%. No adverse effects related to the ulcer were registered through the follow-up period. Autologous punch graft is an easy procedure that promotes healing, achieving wound closure in chronic DFUs representing an alternative of treatment for hard-to-heal DFUs in which conservative treatment has been unsuccessful.

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