scholarly journals Advances in Wound Healing: A Review of Current Wound Healing Products

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Patrick S. Murphy ◽  
Gregory R. D. Evans
Keyword(s):  
Wound Healing ◽  
Growth Factor ◽  
Side Effects ◽  
Hyperbaric Oxygen ◽  
Negative Pressure ◽  
State Of The Art ◽  
Wound Care ◽  
Skin Substitutes ◽  
Healing Environment ◽  
Current State

Successful wound care involves optimizing patient local and systemic conditions in conjunction with an ideal wound healing environment. Many different products have been developed to influence this wound environment to provide a pathogen-free, protected, and moist area for healing to occur. Newer products are currently being used to replace or augment various substrates in the wound healing cascade. This review of the current state of the art in wound-healing products looks at the latest applications of silver in microbial prophylaxis and treatment, including issues involving resistance and side effects, the latest uses of negative pressure wound devices, advanced dressings and skin substitutes, biologic wound products including growth factor applications, and hyperbaric oxygen as an adjunct in wound healing. With the abundance of available products, the goal is to find the most appropriate modality or combination of modalities to optimize healing.

Experience of negative pressure wound therapy over sternal wound healing: A retrospective review

WCET Journal ◽  
2019 ◽  
Vol 39 (2) ◽  
pp. 9-18
Author(s):  
Wai Sze Ho ◽  
Wai Kuen Lee ◽  
Ka Kay Chan ◽  
Choi Ching Fong
Keyword(s):  
Wound Healing ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Assessment Tool ◽  
Wound Care ◽  
Wound Therapy ◽  
Treatment Pathways ◽  
Wound Assessment ◽  
One Year

Objectives The aim of this study was to retrospectively review the effectiveness of negative pressure wound therapy (NPWT) in sternal wound healing with the use of the validated Bates-Jensen Wound Assessment Tool (BWAT), and explore the role of NPWT over sternal wounds and future treatment pathways. Methods Data was gathered from patients' medical records and the institution's database clinical management system. Seventeen subjects, who had undergone cardiothoracic surgeries and subsequently consulted the wound care team in one year were reviewed. Fourteen of them were included in the analysis. Healing improvement of each sternal wound under continuous NPWT and continuous conventional dressings was studied. In total, 23 continuous NPWT and 13 conventional dressing episodes were analysed with the BWAT. Results Among conventional dressing episodes, sternal wound improvement was 2.5–3% over 10 days to 3.5 weeks, whereas 4–5% sternal healing was achieved in 5 days to 2 weeks with sternal wire presence. Better healing at 11% in 1 week by conventional dressing was attained after sternal wire removal. In NPWT episodes, 8–29%, 13–24%, and 15–46% of healing was observed in 2 weeks, 3.5 to 5 weeks and 6 to 7 weeks, respectively. Only 39% wound healing was acquired at the 13th week of NPWT in one subject. With sternal wire present, 6%–29% wound healing progress was achieved by NPWT in 1–4 weeks, and 16–23% wound improvement in 2 to 4.5 weeks by NWPT after further surgical debridement. After sternal wire removal, 6–34% sternal wound healing occurred by continuous NPWT for 1–2 weeks, and maximum healing at 46% after 2.5 weeks of NPWT were observed. Conclusions Better wound healing was achieved in the NPWT group in comparison to conventional dressings alone. However, suboptimal sternal wound healing by NPWT alone was observed. Removal of sternal wire may improve the effectiveness of NPWT. Successful tertiary closure after NPWT among subjects supports the important bridging role of NPWT in sternal wound healing. Factors causing stagnant sternal wound healing by NPWT alone are discussed.

scholarly journals Effects of Hyperbaric Oxygen on Inflammatory Response to Wound and Trauma: Possible Mechanism of Action

2006 ◽  
Vol 6 ◽  
pp. 425-441 ◽  
Author(s):  
Noori S. Al-Waili ◽  
Glenn J. Butler
Keyword(s):  
Wound Healing ◽  
Growth Factor ◽  
Inflammatory Response ◽  
Hyperbaric Oxygen ◽  
Mechanism Of Action ◽  
Chronic Wounds ◽  
Carbon Monoxide Poisoning ◽  
Clinical Applications ◽  
No Production ◽  
Mediators Of Inflammation

There is growing interest in expanding the clinical applications for HBO2(hyperbaric oxygen therapy) into new medical and surgical fields. The pathophysiology of response towards wounds, infection, trauma, or surgery involves various chemical mediators that include cytokines, prostaglandins (PGs), and nitric oxide (NO). The beneficial role played by HBO2in wound healing, carbon monoxide poisoning, decompression sickness, and other indications is well documented. However, the exact mechanism of action is still poorly understood. This review addresses the effects of HBO2on PGs, NO, and cytokines involved in wound pathophysiology and inflammation in particular. The results of this review indicate that HBO2has important effects on the biology of cytokines and other mediators of inflammation. HBO2causes cytokine down-regulation and growth factor up-regulation. HBO2transiently suppresses stimulus-induced proinflammatory cytokine production and affects the liberation of TNFα (tumor necrosis factor alpha) and endothelins. VEGF (vascular endothelial growth factor) levels are significantly increased with HBO2, whereas the value of PGE2 and COX-2 mRNA are markedly reduced. The effect of HBO2on NO production is not well established and more studies are required. In conclusion, cytokines, PGs, and NO may play a major role in the mechanism of action of HBO2 and further research could pave the way for new clinical applications for HBO2to be established. It could be proposed that chronic wounds persist due to an uncontrolled pathological inflammatory response in the wound bed and that HBO2enhances wound healing by damping pathological inflammation (anti-inflammatory effects); this hypothetical proposal remains to be substantiated with experimental results.

scholarly journals Invasive Techniques in Scar Management: Skin Substitutes

2020 ◽  
pp. 317-323
Author(s):  
F. W. Timmermans ◽  
E. Middelkoop
Keyword(s):  
Wound Healing ◽  
Scar Formation ◽  
Wound Management ◽  
Skin Substitutes ◽  
Current State ◽  
Scar Management ◽  
Scar Quality ◽  
Engineered Skin Substitutes ◽  
Invasive Techniques

AbstractIn the last decades, skin substitutes have emerged as an important innovation in improving scar quality. They can be applied during the initial wound management but also during scar reconstruction procedures. This chapter provides an overview on the development, current state, and future of cell-seeded and tissue-engineered skin substitutes. We will discuss some of the most important varieties of skin substitutes in the context of scar formation and wound healing.

The effect of hyperbaric oxygen therapy on gene expression: microarray analysis on wound healing

2020 ◽  
pp. 31-37
Author(s):  
Jakub Tlapák ◽  
◽  
Petr Chmátal ◽  
Boris Oniščenko ◽  
Vojtěch Pavlík ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Gene Expression ◽  
Extracellular Matrix ◽  
Wound Healing ◽  
Hyperbaric Oxygen ◽  
Wound Care ◽  
Genomic Analysis ◽  
Live Animal ◽  
Elevated Expression ◽  
Hbo2 Therapy

Background: Hyperbaric oxygen (HBO2) therapy canhave a positive effect on wound healing, angiogenesis and blood flow. No prior study has described the effects of HBO2 therapy and gene expression of this process. The goal of our research was to show the effects of HBO2 and its impact at the molecular level on angiogenesis, proliferation, differentiation, oxidative stress, inflammation, and extracellular matrix formation. Live animal subjects were used for simulating the process of wound healing under standard conditions and under the influence of HBO2. Methods: Two experimental groups were created using injured rabbits (N=24), one group (N=12) treated with hyperbaric therapy twice a day and one (N=12) with standard wound care management. Wounds were surgical, uninfected, and in healthy animal test subjects. We compared the whole genomic analysis of the transcriptome with the use of microarray technology at three intervals during treatment. Results: The induction of the wounds in rabbit skin increased expression of hundreds of genes in both treatment groups. The numbers of elevated and decreased genes gradually reduced as the wound healed. Gene expression analysis showed elevated expression of several genes associated with inflammation in both groups of injured animals. Genes connected to the process of angiogenesis, proliferation, differentiation, oxidative stress and extracellular matrix formation were without statistically significant changes. Conclusion: The evidence did not support that HBO2 had any significant effect on gene expression during wound healing. Additionally, there was no evidence to support that there were changes in gene expression in either treatment group.

Role of Topical Biological Therapies and Dressings in Healing Ischemic Wounds

2018 ◽  
Vol 17 (4) ◽  
pp. 236-246
Author(s):  
Saritphat Orrapin ◽  
Kittipan Rekasem
Keyword(s):  
Wound Healing ◽  
Growth Factor ◽  
Platelet Rich Plasma ◽  
Wound Care ◽  
Healing Process ◽  
Platelet Derived Growth Factor ◽  
Wound Healing Process ◽  
Biological Therapies ◽  
Biological Dressing ◽  
Epidermal Growth

Ischemic wounds are the most severe expression of critical limb ischemia (CLI), and they have been defined clinically as an end stage of peripheral arterial disease. Urgent revascularization is a fundamental part for limb salvage in patients with CLI. However, the risk of revascularization should be weighed against the likelihood of success given a patient’s life-threatening comorbidities. Once the condition of arterial insufficiency is revascularized, wound care is an important aspect to promote the wound healing process and infection control. MOIST concept for wound care is a modern systematic treatment for enhanced wound healing process. Currently, advanced biological therapies are emerging in ischemic wound therapies to restore the wound healing process and involve active biological agents to support the wound healing process. We studied and summarized the different types of available topical biological therapies and their mechanisms on the healing process including platelet-derived growth factor, epidermal growth factor, fibroblast growth factor, and vascular endothelial growth factor, platelet-rich plasma, and honey for local wound care of patient with CLI. Our review suggests that topical platelet-derived growth factor, epidermal growth factor, platelet-rich plasma, and honey are available as well as considered in the ischemic wound healing process enhancement through the MOIST concept. In conclusion, biologic wound dressing or topical agent therapy may improve the wound healing process, increase limb salvage, is inexpensive, and provides potential safety with nontoxic low-risk therapy in patients with an ischemic wound. Thus, local wound care by biological dressing should be added in adjuvant treatment for ischemic wound patients. However, further randomized studies are needed to support efficacy and long-term outcomes of these biological dressing in patients with ischemic wound.

scholarly journals Effects of Strong Acidic Electrolyzed Water in Wound Healing via Inflammatory and Oxidative Stress Response

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Ailyn Fadriquela ◽  
Ma Easter Joy Sajo ◽  
Johny Bajgai ◽  
Dong-Heui Kim ◽  
Cheol-Su Kim ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Wound Healing ◽  
Growth Factor ◽  
Inflammatory Responses ◽  
Wound Care ◽  
Antioxidant Responses ◽  
Electrolyzed Water ◽  
Cutaneous Wounds ◽  
Wound Healing Effect ◽  
Factor Α

Strong acidic electrolyzed water (StAEW) is known to inactivate microorganisms but is not fully explored in the medical field. This study is aimed at exploring StAEW as a potential wound care agent and its mechanism. StAEW (pH: 2.65, ORP: 1159 mV, ACC: 32.1 ppm) was sprayed three times a day to the cutaneous wounds of hairless mice for seven days. Wound morphological and histological features and immune-redox markers were compared with saline- (Sal-) and alcohol- (Alc-) treated groups. Results showed that the StAEW group showed a significantly higher wound healing percentage than the Sal group on days 2, 4, 5, and 6 and the Alc group on day 4. The StAEW group also showed earlier mediation on proinflammatory cytokines such as tumor necrosis factor-α, interleukin- (IL-) 6, IL-1β, and keratinocyte chemoattractant. In addition, basic fibroblast growth factor and platelet-derived growth factor were found to be significantly changed in favor of the fibroblast synthesis and angiogenesis. In line, the StAEW group showed a controlled amount of ROS and significantly decreased compared to the Alc group. The StAEW group also favored oxidative stress balance through antioxidant responses. Additionally, matrix metalloproteinases (MMP) 9 and MMP1 were also modulated for keratinocyte and cell migration. Taken together, this study has proven the wound healing effect of StAEW and its earlier mediation through oxidative and inflammatory responses.

scholarly journals Recombinant human epidermal growth factor combined with vacuum sealing drainage for wound healing in Bama pigs

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Shuai Wei ◽  
Wei Wang ◽  
Li Li ◽  
Hao-Ye Meng ◽  
Chun-Zhen Feng ◽  
...  
Keyword(s):  
Wound Healing ◽  
Growth Factor ◽  
Epidermal Growth Factor ◽  
Negative Pressure ◽  
Human Epidermal Growth Factor ◽  
Epidermal Growth ◽  
And Migration ◽  
Vacuum Sealing Drainage ◽  
Better Than ◽  
Proliferation And Migration

Abstract Background Vacuum sealing drainage (VSD) and epidermal growth factor (EGF) both play an important role in the treatment of wounds. This study aims to explore the effects of the combination of VSD and EGF on wound healing and the optimal concentration and time of EGF. Methods We tested the proliferation and migration capacity of HaCaT and L929 cells at different EGF concentrations (0, 1, 5, 10, and 100 ng/ml) and different EGF action times (2, 10, and 30 min). A full-thickness skin defect model was established using male, 30-week-old Bama pigs. The experiment included groups as follows: routine dressing change after covering with sterile auxiliary material (Control), continuous negative pressure drainage of the wound (VSD), continuous negative pressure drainage of the wound and injection of EGF 10 min followed by removal by continuous lavage (V + E 10 min), and continuous negative pressure drainage of the wound and injection of EGF 30 min followed by removal by continuous lavage (V + E 30 min). The wound healing rate, histological repair effect and collagen deposition were compared among the four groups. Results An EGF concentration of 10 ng/ml and an action time of 10 min had optimal effects on the proliferation and migration capacities of HaCaT and L929 cells. The drug dispersion effect was better than drug infusion after bolus injection effect, and the contact surface was wider. Compared with other groups, the V + E 10 min group promoted wound healing to the greatest extent and obtained the best histological score. Conclusions A recombinant human epidermal growth factor (rhEGF) concentration of 10 ng/ml can promote the proliferation and migration of epithelial cells and fibroblasts to the greatest extent in vitro. VSD combined with rhEGF kept in place for 10 min and then washed, can promote wound healing better than the other treatments in vivo.

scholarly journals Instillation-TIME (iTIME) as a rationale amendment for TIME conception. Is there enough evidence for the efficiency of negative pressure wound therapy with instillation (iNPWT) to announce a breakthrough idea for wound treatment?

2019 ◽  
Vol 6 (2) ◽  
pp. 7-8
Author(s):  
Adam Bobkiewicz ◽  
Adam Studniarek ◽  
Łukasz Krokowicz ◽  
Michał Drews ◽  
Tomasz Banasiewicz
Keyword(s):  
Wound Healing ◽  
Negative Pressure ◽  
Care Management ◽  
Negative Pressure Wound Therapy ◽  
Chronic Wound ◽  
Wound Care ◽  
Wound Treatment ◽  
Wound Therapy ◽  
Number Of Patients ◽  
Moisture Balance

An increased number of patients developing difficult-to-heal wounds results in billions spending for chronic wound care management. Introduction of TIME conception has been a breakthrough idea for wound healing based on phase-adapted wound therapy that interacts and influence each other and included: T – tissue management, I - infection control, M - moisture balance, E - edge of the wound. Negative pressure wound therapy (NPWT) revolutionized the management of wound healing. Moreover, recently NPWT with instillation (iNPWT) has gained the popularity of optimizing wound healing. In the context of acceleration of wound healing, iNPWT meets the criteria of the TIME conception. All individual components of TIME strategy are found in iNPWT providing “all in one” conception. Such management is easy to apply, monitor and it is well- tolerated by patients. Based on the current studies, iNPWT is found to be an important alternative for other methods of wound healing. It is believed that iNPWT will evolve and gain popularity as an innovative treatment for TIME conception.

scholarly journals Recombinant Human Epidermal Growth Factor Combined with Vacuum Sealing Drainage for Wound Healing in Bama Pigs

2020 ◽  
Author(s):  
Shuai Wei ◽  
Wei Wang ◽  
Li Li ◽  
Haoye Meng ◽  
Chunzhen Feng ◽  
...  
Keyword(s):  
Wound Healing ◽  
Growth Factor ◽  
Epidermal Growth Factor ◽  
Negative Pressure ◽  
L929 Cells ◽  
Epidermal Growth ◽  
And Migration ◽  
Vacuum Sealing Drainage ◽  
Better Than ◽  
Proliferation And Migration

Abstract Background: Both vacuum sealing drainage (VSD) and epidermal growth factor (EGF) play important roles in the treatment of wounds. This study aims to explore the effect of the combination of VSD and EGF on wound healing and the optimal concentration and time of EGF.Methods: In this study, we tested the proliferation and migration capacity of HaCaT and L929 cells at different EGF concentrations (0, 1, 5, 10, and 100 ng/ml) and different EGF action times (2, 10, and 30min). A full-thickness skin defect model was established using male, 30-week-old Bama pigs. The skin defects were randomly divided follows: routine dressing change after covering with sterile auxiliary material (Control), continuous negative pressure drainage of the wound (VSD), continuous negative pressure drainage of the wound and injection of epidermal growth factor 10 minutes followed by removal by continuous lavage (V+E 10 min), and continuous negative pressure drainage of the wound and injection of epidermal growth factor 30 minutes followed by removal by continuous lavage (V+E 30 min). The wound healing rate, histological repair effect and collagen deposition were compared among the four groups.Results: An EGF concentration of 10 ng/ml and an action time of 10 minutes had optimal effects on the proliferation and migration capacities of HaCaT and L929 cells. The drug dispersion effect was better than drug infusion after bolus injection effect, and the contact surface was wider. Compared with other groups, the V+E 10min group promoted wound healing to the greatest extent and obtained the best histological score. Conclusions: A rhEGF concentration of 10 ng/ml can promote the proliferation and migration of epithelial cells and fibroblasts to the greatest extent in vitro. VSD combined with rhEGF kept in place for 10 minutes and then washed, can promote wound healing better than the other treatments in vivo.

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