scholarly journals Surgical Strategies to Promote Cutaneous Healing

2021 ◽  
Vol 9 (2) ◽  
pp. 45
Author(s):  
Ines Maria Niederstätter ◽  
Jennifer Lynn Schiefer ◽  
Paul Christian Fuchs
Keyword(s):  
Wound Healing ◽  
Wound Closure ◽  
Chronic Wounds ◽  
Treatment Algorithm ◽  
Surgical Site Infections ◽  
Repair Process ◽  
Suture Technique ◽  
The Body ◽  
Wound Debridement ◽  
Reconstructive Ladder

Usually, cutaneous wound healing does not get impeded and processes uneventfully, reaching wound closure easily. The goal of this repair process is to restore the integrity of the body surface by creating a resilient and stable scar. Surgical practice and strategies have an impact on the course of wound healing and the later appearance of the scar. By considering elementary surgical principles, such as the appropriate suture material, suture technique, and timing, optimal conditions for wound healing can be created. Wounds can be differentiated into clean wounds, clean–contaminated wounds, contaminated, and infected/dirty wounds, based on the degree of colonization or infection. Furthermore, a distinction is made between acute and chronic wounds. The latter are wounds that persist for longer than 4–6 weeks. Care should be taken to avoid surgical site infections in the management of wounds by maintaining sterile working conditions, using antimicrobial working techniques, and implementing the principles of preoperative antibiotics. Successful wound closure is influenced by wound debridement. Wound debridement removes necrotic tissue, senescent and non-migratory cells, bacteria, and foreign bodies that impede wound healing. Additionally, the reconstructive ladder is a viable and partially overlapping treatment algorithm in plastic surgery to achieve successful wound closure.

scholarly journals Induced pluripotent stem cell-derived endothelial cells promote angiogenesis and accelerate wound closure in a murine excisional wound healing model

2018 ◽  
Vol 38 (4) ◽  
Author(s):  
Zoë E. Clayton ◽  
Richard P. Tan ◽  
Maria M. Miravet ◽  
Katarina Lennartsson ◽  
John P. Cooke ◽  
...  
Keyword(s):  
Stem Cells ◽  
Wound Healing ◽  
Endothelial Cells ◽  
Endothelial Cell ◽  
Adult Stem Cells ◽  
Wound Closure ◽  
Chronic Wounds ◽  
Control Treatment ◽  
Excisional Wound ◽  
Induced Pluripotent

Chronic wounds are a major complication in patients with cardiovascular diseases. Cell therapies have shown potential to stimulate wound healing, but clinical trials using adult stem cells have been tempered by limited numbers of cells and invasive procurement procedures. Induced pluripotent stem cells (iPSCs) have several advantages of other cell types, for example they can be generated in abundance from patients’ somatic cells (autologous) or those from a matched donor. iPSCs can be efficiently differentiated to functional endothelial cells (iPSC-ECs). Here, we used a murine excisional wound model to test the pro-angiogenic properties of iPSC-ECs in wound healing. Two full-thickness wounds were made on the dorsum of NOD-SCID mice and splinted. iPSC-ECs (5 × 105) were topically applied to one wound, with the other serving as a control. Treatment with iPSC-ECs significantly increased wound perfusion and accelerated wound closure. Expression of endothelial cell (EC) surface marker, platelet endothelial cell adhesion molecule (PECAM-1) (CD31), and pro-angiogenic EC receptor, Tie1, mRNA was up-regulated in iPSC-EC treated wounds at 7 days post-wounding. Histological analysis of wound sections showed increased capillary density in iPSC-EC wounds at days 7 and 14 post-wounding, and increased collagen content at day 14. Anti-GFP fluorescence confirmed presence of iPSC-ECs in the wounds. Bioluminescent imaging (BLI) showed progressive decline of iPSC-ECs over time, suggesting that iPSC-ECs are acting primarily through short-term paracrine effects. These results highlight the pro-regenerative effects of iPSC-ECs and demonstrate that they are a promising potential therapy for intractable wounds.

scholarly journals Redox for Repair: Cold Physical Plasmas and Nrf2 Signaling Promoting Wound Healing

Antioxidants ◽  
2018 ◽  
Vol 7 (10) ◽  
pp. 146 ◽  
Author(s):  
Anke Schmidt ◽  
Sander Bekeschus
Keyword(s):  
Wound Healing ◽  
Wound Closure ◽  
Chronic Wounds ◽  
Health Care Systems ◽  
Molecular Switches ◽  
Dermal Fibroblasts ◽  
Tissue Response ◽  
Related Factor ◽  
Plasma Effects ◽  
Care Systems

Chronic wounds and ulcers are major public health threats. Being a substantial burden for patients and health care systems alike, better understanding of wound pathophysiology and new avenues in the therapy of chronic wounds are urgently needed. Cold physical plasmas are particularly effective in promoting wound closure, irrespective of its etiology. These partially ionized gases deliver a therapeutic cocktail of reactive oxygen and nitrogen species safely at body temperature and without genotoxic side effects. This field of plasma medicine reanimates the idea of redox repair in physiological healing. This review compiles previous findings of plasma effects in wound healing. It discusses new links between plasma treatment of cells and tissues, and the perception and intracellular translation of plasma-derived reactive species via redox signaling pathways. Specifically, (i) molecular switches governing redox-mediated tissue response; (ii) the activation of the nuclear E2-related factor (Nrf2) signaling, together with antioxidative and immunomodulatory responses; and (iii) the stabilization of the scaffolding function and actin network in dermal fibroblasts are emphasized in the light of wound healing.

scholarly journals Hydrogels for management of chronic wound healing

2021 ◽  
Vol 5 (3) ◽  
pp. 095-104
Author(s):  
IM Cardoso-Daodu ◽  
CP Azubuike ◽  
MO Ilomuanya
Keyword(s):  
Wound Healing ◽  
Chronic Wounds ◽  
Healing Process ◽  
Three Dimensional ◽  
Scar Tissue ◽  
The Body ◽  
Polymer Chains ◽  
Wound Healing Process ◽  
Dimensional Network ◽  
Healing Wound

Chronic wounds occur when one wound healing process or a sequence of wound healing events are affected resulting in slow healing of the wound thereby placing the patient in deep pain. Various diseases and conditions can delay the process of wound healing. Wound healing can be classified into four main stages: hemostasis, inflammation, remodeling, and scar tissue formation with each phase overlapping one another. The skin is the largest organ in the body. It protects the entire external surface of the human body and is the primary site of interaction with the outside environment. There is therefore a need to fabricate an ideal dressing through scientific research and investigations. Hydrogels are a three-dimensional network of hydrophilic polymers that can swell in water and absorb copious amounts of water while maintaining their structure because of their chemical or physical crosslinking of individual polymer chains. A hydrogel must be composed of at least 10% water. Hydrogels possess the flexibility and water percentage which is remarkably like tissues. They are biocompatible and biodegradable which makes them ideal for dermal wound healing.

scholarly journals Biological Mechanisms of Chronic Wound and Diabetic Foot Healing: The Role of Collagen

2018 ◽  
Vol 19 (4) ◽  
pp. 373-382 ◽  
Author(s):  
Victor Alexandrovich Stupin ◽  
Ruslan Borisovich Gabitov ◽  
Tatiana Georgievna Sinelnikova ◽  
Ekaterina Vladimirovna Silina
Keyword(s):  
Wound Healing ◽  
Diabetic Foot ◽  
World Literature ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Treatment Algorithm ◽  
Diabetic Foot Syndrome ◽  
Results Of Treatment ◽  
Native Collagen ◽  
Chronic Ulcers

Abstract The treatment of chronic wounds is a continuously developing research focus. The problems of excessive mechanical forces, infection, inflammation, reduced production of growth factors, and lack of collagen will affect the results of treatment. The purpose of this study was to analysse the elements that lead to long-term non-healing of chronic wounds and trophic ulcers, including diabetic foot syndrome, by determining the optimal treatment algorithm. The paper presents an analysis of the world literature on the etiopathogenesis and principles of chronic wound treatment in diabetic foot syndrome. The epidemiology of chronic wounds of different genesis is presented. The issues of physiological and metabolic disorders in chronic ulcers affecting the process of wound healing are discussed. Particular attention is paid to collagen, which is a protein that forms the basis of connective tissue; collagen ensures the strength and elasticity of the skin, which confirms the importance of its role not only in aesthetics but also in the process of wound healing. Different types of collagen and their roles in the mechanisms of chronic wound healing in diabetic foot syndrome are described. The results of clinical studies evaluating the effectiveness of medical products and preparations, consisting of collagen with preserved (native collagen) and fractionated structures, in treating chronic wounds of diabetic foot syndrome are analysed. It has been shown that the use of native collagen preparations is a promising treatment for chronic ulcers and wounds, including diabetic foot syndrome, which makes it possible to increase the effectiveness of treatment and reduce the economic costs of managing these patients.

scholarly journals Antibacterial Test of Binahong Leaf Extract Ointment (Anredera cordifolia) Against Staphylococcus aureus Bacteria from Diabetic Wounds

2020 ◽  
Vol 5 (01) ◽  
pp. 1-10
Author(s):  
Risa Umami ◽  
Riwayati Malika
Keyword(s):  
Staphylococcus Aureus ◽  
Wound Healing ◽  
Leaf Extract ◽  
Wound Closure ◽  
Healing Process ◽  
The Body ◽  
Wound Healing Process ◽  
Antibacterial Test ◽  
Glucose Levels ◽  
Diabetic Wounds

Diabetes mellitus (DM) is characterized by an increase in glucose levels in the blood due to disorders of glucose metabolism in the body. The pancreas organ of people with DM has a weakness in producing the hormone insulin. As a result, the distribution of blood glucose to other organs of the body is inhibited so that glucose levels in the blood increase which causes DM sufferers to experience longer wound healing than normal humans. Binahong leaves contain alkaloids, saponins and flavonoids which have antibacterial activity which can accelerate the wound healing process. The purpose of this study was to determine the antibacterial effect of binahong leaf extract ointment (Anredera cordifolia) against Staphylococcus aureus bacteria from diabetic wounds. This research includes antibacterial test for binahong leaf extract ointment (Anredera cordifolia) with variations in the concentration of 10%, 20%, and 30% of the concentration of binahong leaf extract of 25% which resulted in a wound coverage percentage of up to 100%, namely at 30% ointment concentration. The conclusion of this study is that there was no wound closure for negative control and positive control in the form of oxytetracycline, the percentage of wound closure was 85%.

scholarly journals Improved Wound Closure Rates and Mechanical Properties Resembling Native Skin in Murine Diabetic Wounds Treated with a Tropoelastin and Collagen Wound Healing Device

2020 ◽  
Author(s):  
Robert S. Kellar ◽  
Robert B. Diller ◽  
Aaron J. Tabor ◽  
Dominic D. Dominguez ◽  
Robert G. Audet ◽  
...  
Keyword(s):  
Mechanical Properties ◽  
Wound Healing ◽  
Wound Closure ◽  
Chronic Wounds ◽  
Critical Role ◽  
Recovery Process ◽  
Health Concern ◽  
Full Thickness ◽  
Healthy Human ◽  
Wound Matrix

AbstractChronic wounds in patients suffering from type II diabetes mellitus (DMII) where wounds remain open with a complicated pathophysiology, healing, and recovery process is a public health concern. Normal wound healing plays a critical role in wound closure, restoration of mechanical properties, and the biochemical characteristics of the remodeled tissue. Biological scaffolds provide a tissue substitute to help facilitate wound healing by mimicking the extracellular matrix (ECM) of the dermis. In the current study an electrospun biomimetic scaffold, wound healing device (WHD), containing tropoelastin (TE) and collagen was synthesized to mimic the biochemical and mechanical characteristics of healthy human skin. The WHD was compared to a commercially available porcine small intestinal submucosa (SIS) matrix that has been used in both partial and full-thickness wounds, Oasis® Wound Matrix. Wound closure rates, histochemistry, qPCR, and mechanical testing of treated wound sites were evaluated. The WHD in a splinted, full-thickness, diabetic murine wound healing model demonstrated an enhanced rate of wound closure, decreased tissue inflammation, skin organ regeneration, and a stronger and more durable remodeled tissue that more closely mimics native unwounded skin compared to the control device.

scholarly journals Flax Fiber Hydrophobic Extract Inhibits Human Skin Cells Inflammation and Causes Remodeling of Extracellular Matrix and Wound Closure Activation

2015 ◽  
Vol 2015 ◽  
pp. 1-15 ◽  
Author(s):  
Monika Styrczewska ◽  
Anna Kostyn ◽  
Anna Kulma ◽  
Grazyna Majkowska-Skrobek ◽  
Daria Augustyniak ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Extracellular Matrix ◽  
Wound Healing ◽  
Wound Closure ◽  
Chronic Wounds ◽  
Flax Fiber ◽  
Great Promise ◽  
Dependent Manner ◽  
Skin Cells ◽  
Anti Inflammatory

Inflammation is the basis of many diseases, with chronic wounds amongst them, limiting cell proliferation and tissue regeneration. Our previous preclinical study of flax fiber applied as a wound dressing and analysis of its components impact on the fibroblast transcriptome suggested flax fiber hydrophobic extract use as an anti-inflammatory and wound healing preparation. The extract contains cannabidiol (CBD), phytosterols, and unsaturated fatty acids, showing great promise in wound healing. Inin vitroproliferation and wound closure tests the extract activated cell migration and proliferation. The activity of matrix metalloproteinases in skin cells was increased, suggesting activation of extracellular components remodeling. The expression of cytokines was diminished by the extract in a cannabidiol-dependent manner, butβ-sitosterol can act synergistically with CBD in inflammation inhibition. Extracellular matrix related genes were also analyzed, considering their importance in further stages of wound healing. The extract activated skin cell matrix remodeling, but the changes were only partially cannabidiol- andβ-sitosterol-dependent. The possible role of fatty acids also present in the extract is suggested. The study shows the hydrophobic flax fiber components as wound healing activators, with anti-inflammatory cannabidiol acting in synergy with sterols, and migration and proliferation promoting agents, some of which still require experimental identification.

scholarly journals Wound Healing: A Cellular Perspective

2019 ◽  
Vol 99 (1) ◽  
pp. 665-706 ◽  
Author(s):  
Melanie Rodrigues ◽  
Nina Kosaric ◽  
Clark A. Bonham ◽  
Geoffrey C. Gurtner
Keyword(s):  
Wound Healing ◽  
Single Cell ◽  
Wound Closure ◽  
Chronic Wounds ◽  
Cell Types ◽  
Skin Injury ◽  
Complex Processes ◽  
Cell Technologies ◽  
Cellular Recruitment ◽  
Healing Wounds

Wound healing is one of the most complex processes in the human body. It involves the spatial and temporal synchronization of a variety of cell types with distinct roles in the phases of hemostasis, inflammation, growth, re-epithelialization, and remodeling. With the evolution of single cell technologies, it has been possible to uncover phenotypic and functional heterogeneity within several of these cell types. There have also been discoveries of rare, stem cell subsets within the skin, which are unipotent in the uninjured state, but become multipotent following skin injury. Unraveling the roles of each of these cell types and their interactions with each other is important in understanding the mechanisms of normal wound closure. Changes in the microenvironment including alterations in mechanical forces, oxygen levels, chemokines, extracellular matrix and growth factor synthesis directly impact cellular recruitment and activation, leading to impaired states of wound healing. Single cell technologies can be used to decipher these cellular alterations in diseased states such as in chronic wounds and hypertrophic scarring so that effective therapeutic solutions for healing wounds can be developed.

scholarly journals Fibrin Glue Enhances Adipose-Derived Stromal Cell Cytokine Secretion and Survival Conferring Accelerated Diabetic Wound Healing

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Ursula Hopfner ◽  
Matthias M. Aitzetmueller ◽  
Philipp Neßbach ◽  
Michael S. Hu ◽  
Hans-Guenther Machens ◽  
...  
Keyword(s):  
Wound Healing ◽  
Fibrin Glue ◽  
Stromal Cell ◽  
Wound Closure ◽  
Chronic Wounds ◽  
Imaging System ◽  
Diabetic Wound ◽  
Diabetic Wound Healing

Introduction. Although chronic wounds are a major personal and economic burden, treatment options are still limited. Among those options, adipose-derived stromal cell- (ASC-) based therapies rank as a promising approach but are restricted by the harsh wound environment. Here we use a commercially available fibrin glue to provide a deliverable niche for ASCs in chronic wounds. Material and Methods. To investigate the in vitro effect of fibrin glue, cultivation experiments were performed and key cytokines for regeneration were quantified. By using an established murine chronic diabetic wound-healing model, we evaluated the influence of fibrin glue spray seeding on cell survival (In Vivo Imaging System, IVIS), wound healing (wound closure kinetics), and neovascularization of healed wounds (CD31 immunohistochemistry). Results. Fibrin glue seeding leads to a significantly enhanced secretion of key cytokines (SDF-1, bFGF, and MMP-2) of human ASCs in vitro. IVIS imaging showed a significantly prolonged murine ASC survival in diabetic wounds and significantly accelerated complete wound closure in the fibrin glue seeded group. CD31 immunohistochemistry revealed significantly more neovascularization in healed wounds treated with ASCs spray seeded in fibrin glue vs. ASC injected into the wound bed. Conclusion. Although several vehicles have shown to successfully act as cell carrier systems in preclinical trials, regulatory issues have prohibited clinical usage for chronic wounds. By demonstrating the ability of fibrin glue to act as a carrier vehicle for ASCs, while simultaneously enhancing cellular regenerative function and viability, this study is a proponent of clinical translation for ASC-based therapies.

Unique closure of Gustilo IIIA fracture with a hard-to-heal lower extremity wound

2021 ◽  
Vol 30 (Sup2) ◽  
pp. S24-S27
Author(s):  
Caroline E Clarke ◽  
William H Tettelbach
Keyword(s):  
Wound Healing ◽  
Lower Extremity ◽  
Wound Closure ◽  
Interdisciplinary Approach ◽  
Wound Management ◽  
Reconstructive Ladder ◽  
Creative Solutions ◽  
Lower Extremity Wound ◽  
Complex Wound ◽  
Wound Bed Preparation

Consistently achieving wound closure requires a broad understanding of wound physiology, anatomy and wound healing phases. The multifaceted principles of wound closure are comprised of: perfusion evaluation; diabetes control; nutritional optimisation; infection control; mechanical stress avoidance; oedema management; wound bed preparation; and community care. Optimisation of each element is crucial to timely and durable resolution of acute and hard-to-heal wounds. This objective is realisable only through an interdisciplinary approach to wound healing. The reconstructive ladder represents the graduation of complex wound management as applied by the specialty of plastic surgery. The approach to reconstruction typically begins with the least invasive option, which is considered reliable. However, there are instances when the most reliable option on the reconstructive ladder is not a viable option and creative solutions for wound closure are required. The following case report demonstrates a unique approach to lower extremity salvage in a subacute compound fracture surgical site infection using a limited reconstructive ladder.

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