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Advances in Wound Care

Lyn M Wise, Gabriella S Stuart, Nicola C Real, Stephen B Fleming, Andrew A Mercer
Objective: Vascular endothelial growth factor (VEGF) family members are critical regulators of tissue repair and depending on their distinct pattern of receptor specificity can also promote inflammation and scarring. This study utilized a receptor-selective VEGF to examine the role of VEGF receptor (VEGFR)-2 in scar tissue (ST) formation. Approach: Cutaneous skin wounds were created in mice using a 4 mm biopsy punch and then treated until closure with purified VEGF-E derived from orf virus stain NZ-2. Tissue samples were harvested to measure gene expression using quantitative PCR and to observe ST formation through histological examination and changes in cell populations by immunofluorescence...
August 1, 2018: Advances in Wound Care
Anna Flattau, Hanna Gordon, Giacomo Vinces, William J Ennis, Caterina P Minniti
Objective: Sickle cell ulcers affect as many as 15% of patients with sickle cell disease in the United States and severely impact quality of life. An understanding of baseline healing patterns is important to inform study design for future trials that test therapies for this disease. Approach: In this study, an electronic wound management system was leveraged to analyze retrospective data on 133 unique sickle cell patients who were treated across 114 wound healing centers, and to describe their characteristics and healing patterns as compared with those of venous ulcer patients...
August 1, 2018: Advances in Wound Care
Michael S Hu, Wan Xing Hong, Michael Januszyk, Graham G Walmsley, Anna Luan, Zeshaan N Maan, Shawn Moshrefi, Ruth Tevlin, Derrick C Wan, Geoffrey C Gurtner, Michael T Longaker, H Peter Lorenz
Objective: In early gestation, fetal wounds heal without fibrosis in a process resembling regeneration. Elucidating this remarkable mechanism can result in tremendous benefits to prevent scarring. Fetal mouse cutaneous wounds before embryonic day (E)18 heal without scar. Herein, we analyze expression profiles of fetal and postnatal wounds utilizing updated gene annotations and pathway analysis to further delineate between repair and regeneration. Approach: Dorsal wounds from time-dated pregnant BALB/c mouse fetuses and adult mice at various time points were collected...
August 1, 2018: Advances in Wound Care
Michael S Hu, Michael T Longaker
No abstract text is available yet for this article.
August 1, 2018: Advances in Wound Care
Lindsay Kalan, Elizabeth A Grice
Significance: Culture-independent methods have revealed the diverse and dynamic bacterial communities that colonize chronic wounds. Only recently have studies begun to examine fungal colonization and interactions with the bacterial component of the microbiome, their relationship with the host, and influence on wound outcomes. Recent Advances: Studies using culture-independent sequencing methods reveal that fungi often go undetected in wounds. Candida spp. and Cladosporidium spp. are the most commonly identified fungi in wounds...
July 1, 2018: Advances in Wound Care
Ulrich Blache, Martin Ehrbar
Significance: Diseases related to vascular malfunction, hyper-vascularization, or lack of vascularization are among the leading causes of morbidity and mortality. Engineered, vascularized tissues as well as angiogenic growth factor-releasing hydrogels could replace defective tissues. Further, treatments and testing of novel vascular therapeutics will benefit significantly from models that allow for the study of vascularized tissues under physiological relevant in vitro conditions. Recent Advances: Inspired by fibrin, the provisional matrix during wound healing, naturally derived and synthetic hydrogel scaffolds have been developed for vascular engineering...
July 1, 2018: Advances in Wound Care
Jacqueline Larouche, Sumit Sheoran, Kenta Maruyama, Mikaël M Martino
Significance: The immune system plays a central role in orchestrating the tissue healing process. Hence, controlling the immune system to promote tissue repair and regeneration is an attractive approach when designing regenerative strategies. This review discusses the pathophysiology of both acute and chronic wounds and possible strategies to control the immune system to accelerate chronic wound closure and promote skin regeneration (scar-less healing) of acute wounds. Recent Advances: Recent studies have revealed the key roles of various immune cells and immune mediators in skin repair...
July 1, 2018: Advances in Wound Care
Witold W Kilarski
Significance: Growth of distinctive blood vessels of granulation tissue is a central step in the post-developmental tissue remodeling. Even though lymphangiogenesis is a part of the regeneration process, the significance of the controlled restoration of lymphatic vessels has only recently been recognized. Recent Advances: Identification of lymphatic markers and growth factors paved the way for the exploration of the roles of lymphatic vessels in health and disease. Emerging pro-lymphangiogenic therapies use vascular endothelial growth factor (VEGF)-C to combat fluid retention disorders such as lymphedema and to enhance the local healing process...
July 1, 2018: Advances in Wound Care
Vera B Morhenn
Significance: Better understanding of wound healing could lead to improved treatment(s) of multiple sclerosis (MS) and psoriasis (Pso). Recent Advances: New concepts in the events of wound healing, such as the roles of the innate and adaptive immune systems, have generated targets for treating these debilitating diseases. Innovation: That in MS and Pso defective wound healing is responsible for the diseases' progression has not been hypothesized to date. Conclusion: Impaired initiation of wound repair by oligodendrocyte precursor cells or oligodendrocytes may play a role in MS, and a lack of inhibition of the proliferative phase in wound healing may explain the pathophysiology involved in Pso...
June 1, 2018: Advances in Wound Care
Katy L Townsend, Jen Akeroyd, Duncan S Russell, Jamie J Kruzic, Bria L Robertson, William Lear
Objective: To compare the tolerability and mechanical tensile strength of acute skin wounds closed with nylon suture plus a novel suture bridge device (SBD) with acute skin wounds closed with nylon suture in a porcine model. Approach: Four Yucatan pigs each received 12 4.5 cm full-thickness incisions that were closed with 1 of 4 options: Suture bridge with nylon, suture bridge with nylon and subdermal polyglactin, nylon simple interrupted, and nylon simple interrupted with subdermal polyglactin. Epithelial reaction, inflammation, and scarring were examined histologically at days 10 and 42...
June 1, 2018: Advances in Wound Care
Marco Meloni, Valentina Izzo, Laura Giurato, Costantino Del Giudice, Valerio Da Ros, Valerio Cervelli, Roberto Gandini, Luigi Uccioli
Objective: To establish the rate of clinical recurrence of critical limb ischemia (CLI) in diabetic patients with ischemic foot ulcers (DFUs) treated by percutaneous transluminal angioplasty (PTA). Approach: The study group was composed of 304 patients with ischemic DFUs treated by PTA. We evaluated the rate of clinical recurrence of CLI requiring a second PTA (repeated PTA [rePTA]), the factors related to CLI relapse, and the outcomes of rePTA patients. The follow-up was 12.5 ± 6.6 months. Results: Seventy-four of 304 patients (24...
June 1, 2018: Advances in Wound Care
Pascale Mutti Tacani, Rogério Eduardo Tacani, Aline Fernanda Perez Machado, Débora Montezello, João Carlos Guedes Sampaio Góes, Angela Gonçalves Marx, Richard Eloin Liebano
Marjolin's ulcers (MU) are skin malignancies that form over burn injuries. These very aggressive ulcers can result in functional and wound healing impairment, and require a well thought out treatment plan. Physiotherapy offers resources to help promote recovery of these patients, as described in this case report, in which the patient with a history of burn in the lower limbs evolved to malignancy 32 years later. This patient underwent tumor resection of the left foot, with recurrence and lymphadenectomy . Physical therapy included the application of high-frequency generator (HFG) for wound healing and exercises for functional recovery...
May 1, 2018: Advances in Wound Care
Carla Roberta Tim, Cintia Cristina Santi Martignago, Viviane Ribeiro da Silva, Estefany Camila Bonfim Dos Santos, Fabiana Nascimento Vieira, Nivaldo Antonio Parizotto, Richard Eloin Liebano
Objective: Technological advances have provided new alternatives to the analysis of skin flap viability in animal models; however, the interrater validity and reliability of these techniques have yet to be analyzed. The present study aimed to evaluate the interrater validity and reliability of three different methods: weight of paper template (WPT), paper template area (PTA), and photographic analysis. Approach: Sixteen male Wistar rats had their cranially based dorsal skin flap elevated. On the seventh postoperative day, the viable tissue area and the necrotic area of the skin flap were recorded using the paper template method and photo image...
May 1, 2018: Advances in Wound Care
Sylvia van Kogelenberg, Zhilian Yue, Jeremy N Dinoro, Christopher S Baker, Gordon G Wallace
Significance: Skin tissue damage is a major challenge and a burden on healthcare systems, from burns and other trauma to diabetes and vascular disease. Although the biological complexities are relatively well understood, appropriate repair mechanisms are scarce. Three-dimensional bioprinting is a layer-based approach to regenerative medicine, whereby cells and cell-based materials can be dispensed in fine spatial arrangements to mimic native tissue. Recent Advances: Various bioprinting techniques have been employed in wound repair-based skin tissue engineering, from laser-induced forward transfer to extrusion-based methods, and with the investigation of the benefits and shortcomings of each, with emphasis on biological compatibility and cell proliferation, migration, and vitality...
May 1, 2018: Advances in Wound Care
Thiago Saikali Farcic, Cristiano Schiavinato Baldan, Aline Fernanda Perez Machado, Leonardo Affonso Massabki Caffaro, Igor Fagioli Bordello Masson, Raquel Aparecida Casarotto
Objective: The aim of this study was to evaluate the organization of collagen fibers in the healing process of rat Achilles tendon rupture using different times of ultrasound therapy (TUS). Approach: Forty Wistar rats were selected. Among these, 32 were submitted to total tenotomy of the calcaneous tendon and divided into 5 groups: control group (CG, n  = 8), without tenotomy or any treatment; tenotomy group ( n  = 8), with tenotomy and without treatment; TUS groups-TUS3 ( n  = 8), TUS4 ( n  = 8), and TUS5 ( n  = 8)-submitted to tenotomy and treated with TUS for 3, 4, and 5 min per effective radiating area (ERA), respectively...
April 1, 2018: Advances in Wound Care
Jiali Lei, Suset Rodriguez, Maanasa Jayachandran, Elizabeth Solis, Katrina Epnere, Francisco Perez-Clavijo, Stephen Wigley, Anuradha Godavarty
Objective: Venous leg ulcers (VLUs) are one of the most common complications in lower extremity wounds. To date, clinicians employ visual inspection of the wound site during its healing process by monitoring surface granulation and reduction in wound size across weeks of treatment. In this study, a handheld near-infrared optical scanner (NIROS) has been developed at the Optical Imaging Laboratory to differentiate healing from nonhealing VLUs based on differences in blood flow to the wound and its surroundings...
April 1, 2018: Advances in Wound Care
Francesca Uberti, Vera Morsanuto, Sabrina Ghirlanda, Sara Ruga, Nausicaa Clemente, Cristina Boieri, Renzo Boldorini, Claudio Molinari
Objective: Wound healing is a dynamic, interactive, and complex process that involves a series of events, including inflammation, migration, proliferation, granulation tissue formation, and matrix remodeling. Despite the high frequency of serious slow-healing wounds, there is still no adequate therapy. The aim of this study is to evaluate a new highly diluted acetylcholine (Ach) formulation obtained through a sequential kinetic activation (SKA) method applied to a wound healing in vivo model to verify the hypothesis that a low dose of Ach could be a more physiological stimulus for healing, by stimulating muscarinic and nicotinic receptors and their related intracellular pathways...
April 1, 2018: Advances in Wound Care
Lene Bay, Kasper N Kragh, Steffen R Eickhardt, Steen S Poulsen, Lise Mette R Gjerdrum, Khaled Ghathian, Henrik Calum, Magnus S Ågren, Thomas Bjarnsholt
Objective: The bacterial composition and distribution were evaluated in acute standardized epidermal wounds and uninjured skin by a molecular in situ technology benchmarked to conventional culturing. This was done to reveal whether bacterial biofilm is present in acute wounds. Approach: On the buttock of 26 healthy volunteers, 28 suction blisters were made and de-roofed. Four wounds were biopsied immediately after wounding, whereas the remaining 24 wounds were treated daily with sterile deionized water and covered with a moisture-retaining dressing...
April 1, 2018: Advances in Wound Care
Melissa L Fernandez, Dario Stupar, Tristan Croll, David Leavesley, Zee Upton
Significance: Chronic wounds are a major burden to patients and to healthcare systems worldwide. These wounds are difficult to heal and treatment is often lengthy and expensive. This has led to research efforts focussed on the wound environment attempting to understand the underlying pathological mechanisms of impaired wound healing. While some of this research has translated to advancements in wound therapies and implementation of new treatment options, chronic wounds remain a significant challenge to treat...
March 1, 2018: Advances in Wound Care
Caroline E Fife, Kristen A Eckert, Marissa J Carter
Significance: We compare real-world data from the U.S. Wound Registry (USWR) with randomized controlled trials and publicly reported wound outcomes and develop criteria for honest reporting of wound outcomes, a requirement of the new Quality Payment Program (QPP). Recent Advances: Because no method has existed by which wounds could be stratified according to their likelihood of healing among real-world patients, practitioners have reported fantastically high healing rates. The USWR has developed several risk-stratified wound healing quality measures for diabetic foot ulcers (DFUs) and venous leg ulcers (VLUs) as part of its Qualified Clinical Data Registry (QCDR)...
March 1, 2018: Advances in Wound Care
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