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Advances in Wound Care

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https://www.readbyqxmd.com/read/28116227/the-effectiveness-of-negative-pressure-therapy-in-diabetic-foot-ulcers-with-elevated-protease-activity-a-case-series
#1
Valentina Izzo, Marco Meloni, Laura Giurato, Valeria Ruotolo, Luigi Uccioli
Objective: Despite several works have described the usefulness of negative pressure therapy (NPT) in the treatment of diabetic foot ulcers (DFUs), no studies have reported its ability in the proteases modulation in DFUs. The aim of this work was to evaluate the role of NPT as a protease-modulating treatment in DFUs. Approach: We conducted a prospective study of a series of diabetic patients affected by chronic DFUs. Each ulcer was assessed for matrix metalloproteinases (MMPs) activity with a protease status diagnostic test at the baseline and after 2 weeks of NPT...
January 1, 2017: Advances in Wound Care
https://www.readbyqxmd.com/read/28116226/a-retrospective-comparison-of-the-performance-of-two-negative-pressure-wound-therapy-systems-in-the-management-of-wounds-of-mixed-etiology
#2
Theresa Hurd, Alan Rossington, Paul Trueman, Jennifer Smith
Objective: Negative pressure wound therapy (NPWT) has been shown to be effective in the management of chronic and surgical wounds. The two most widely used modalities of NPWT are vacuum-assisted closure (V.A.C.) therapy (KCI, Inc., San Antonio, Texas) and the RENASYS NPWT system (Smith & Nephew, Hull, United Kingdom). This evaluation compares the performance of the two systems in the management of wounds of mixed etiology. Approach: The evaluation is based on retrospective evaluation of more than 1,000 patients treated with NPWT in a community setting in Canada...
January 1, 2017: Advances in Wound Care
https://www.readbyqxmd.com/read/28116225/hyperbaric-oxygen-therapy-for-the-compromised-graft-or-flap
#3
REVIEW
Ashish Francis, Richard C Baynosa
Significance: Tissue grafts and flaps are used to reconstruct wounds from trauma, chronic disease, tumor extirpation, burns, and infection. Despite careful surgical planning and execution, reconstructive failure can occur due to poor wound beds, radiation, random flap necrosis, vascular insufficiency, or ischemia-reperfusion (IR). Traumatic avulsions and amputated composite tissues-compromised tissue-may fail from crush injury and excessively large sizes. While never intended, these complications result in tissue loss, additional surgery, accrued costs, and negative psychosocial patient effects...
January 1, 2017: Advances in Wound Care
https://www.readbyqxmd.com/read/28116224/stromal-cell-derived-growth-factor-1-alpha-elastin-like-peptide-fusion-protein-promotes-cell-migration-and-revascularization-of-experimental-wounds-in-diabetic-mice
#4
Agnes Yeboah, Tim Maguire, Rene Schloss, Francois Berthiaume, Martin L Yarmush
Objective: In previous work, we demonstrated the development of a novel fusion protein containing stromal cell-derived growth factor-1 alpha juxtaposed to an elastin-like peptide (SDF1-ELP), which has similar bioactivity, but is more stable in elastase than SDF1. Herein, we compare the ability of a single topical application of SDF1-ELP to that of SDF1 in healing 1 × 1 cm excisional wounds in diabetic mice. Approach: Human Leukemia-60 cells were used to demonstrate the chemotactic potential of SDF1-ELP versus SDF1 in vitro...
January 1, 2017: Advances in Wound Care
https://www.readbyqxmd.com/read/28116223/the-incorporation-of-radionuclides-after-wounding-by-a-dirty-bomb-the-impact-of-time-for-decorporation-efficacy-and-a-model-for-cases-of-disseminated-fragmentation-wounds
#5
Alexis Rump, Daniela Stricklin, Andreas Lamkowski, Stefan Eder, Michael Abend, Matthias Port
Objective: In the case of a terrorist attack by a "dirty bomb" there is a risk of internal contamination with radionuclides through inhalation and wounds. We studied the efficacy of a decorporation treatment depending on the initiation time and duration. Approach: Based on biokinetic models, we simulated the impact of different diethylenetriaminepentaacetic acid treatments on the committed effective dose after the incorporation of plutonium-239. Results: For the same level of radioactivity, the dose was higher after the fast absorption from the wound than after a slow invasion following inhalation...
January 1, 2017: Advances in Wound Care
https://www.readbyqxmd.com/read/28078188/new-innovations-for-deep-partial-thickness-burn-treatment-with-acell-matristem-matrix
#6
Justine S Kim, Alexander J Kaminsky, J Blair Summitt, Wesley P Thayer
Objective: Burn injuries remain a large financial burden on the healthcare system. According to CDC statistics (2010), nonfatal and hospitalized burns in the U.S. cost $1.8 billion for an annual incidence of ∼486,000 cases. To date, no technique proves to be the ideal therapy of deep partial-thickness burns. In this study, we review a trial usage of ACell (ACell, Inc.) wound matrix on deep partial-thickness burns. Approach: Burn patients were admitted through the Vanderbilt Emergency Department. Three were consented to receive ACell therapy...
December 1, 2016: Advances in Wound Care
https://www.readbyqxmd.com/read/28078187/bioelectric-field-enhancement-the-influence-on-membrane-potential-and-cell-migration-in-vitro
#7
Marcy C Purnell, Terence J Skrinjar
Objective: The extracellular matrix consists of critical components that affect fibroblast polarization and migration. The existence of both intrinsic and extrinsic electrical signals that play essential roles in the development, physiology, regeneration, and pathology of cells was discovered over a century ago. In this study, we study how the Bioelectric Field Enhancement (BEFE) device and its generated electromagnetic field (EMF) by continuous direct current (DC) significantly affect the membrane potential and cell migration of fibroblasts in vitro...
December 1, 2016: Advances in Wound Care
https://www.readbyqxmd.com/read/28078186/soluble-receptor-for-advanced-glycation-end-products-improves-stromal-cell-derived-factor-1-activity-in-model-diabetic-environments
#8
Melissa Przyborowski Olekson, Renea A Faulknor, Henry C Hsia, Ann Marie Schmidt, François Berthiaume
Objective: In diabetes, hyperglycemia causes the accumulation of advanced glycation end products (AGEs) that trigger reactive oxygen species (ROS) generation through binding the receptor for AGEs (RAGE). Because exogenous growth factors have had little success in enhancing chronic wound healing, we investigated whether hyperglycemia-induced AGEs interfere with cellular responses to extracellular signals. We used stromal cell-derived factor-1 (SDF-1), an angiogenic chemokine also known to promote stem cell recruitment in skin wounds...
December 1, 2016: Advances in Wound Care
https://www.readbyqxmd.com/read/28078185/cxcl11-expression-by-keratinocytes-occurs-transiently-between-reaching-confluence-and-cellular-compaction
#9
Arthur C Huen, Archana Marathi, Peter K Nam, Alan Wells
Objective: To investigate whether differentiation or cellular confluence is responsible for CXCL11 expression patterns in re-epithelialization. Approach:In vitro model systems of re-epithelialization using the HaCaT keratinocyte cell line were utilized in monitoring expression of differentiation markers, including desmoplakin and various cytokeratins while evaluating for an association with chemokine CXCL11 expression. Results: CXCL11 expression was elevated in sparse culture with peak expression near the time of confluence...
December 1, 2016: Advances in Wound Care
https://www.readbyqxmd.com/read/27867755/nutritional-aspects-of-gastrointestinal-wound-healing
#10
REVIEW
Kaushik Mukherjee, Sandra L Kavalukas, Adrian Barbul
Significance: Although the wound healing cascade is similar in many tissues, in the gastrointestinal tract mucosal healing is critical for processes such as inflammatory bowel disease and ulcers and healing of the mucosa, submucosa, and serosal layers is needed for surgical anastomoses and for enterocutaneous fistula. Failure of wound healing can result in complications including infection, prolonged hospitalization, critical illness, organ failure, readmission, new or worsening enterocutaneous fistula, and even death...
November 1, 2016: Advances in Wound Care
https://www.readbyqxmd.com/read/27867754/a-small-chimeric-fibronectin-fragment-accelerates-dermal-wound-repair-in-diabetic-mice
#11
Denise C Hocking, James R Brennan, Carol H Raeman
Objective: During wound repair, soluble fibronectin is converted into biologically active, insoluble fibrils via a cell-mediated process. This fibrillar, extracellular matrix (ECM) form of fibronectin stimulates cell processes critical to tissue repair. Nonhealing wounds show reduced levels of ECM fibronectin fibrils. The objective of this study was to produce a small, recombinant wound supplement with the biological activity of insoluble fibronectin fibrils. Approach: A chimeric fibronectin fragment was produced by inserting the integrin-binding Arg-Gly-Asp (RGD) loop from the tenth type III repeat of fibronectin (FNIII10) into the analogous site within the heparin-binding, bioactive fragment of the first type III repeat (FNIII1H)...
November 1, 2016: Advances in Wound Care
https://www.readbyqxmd.com/read/27867753/diabetic-wounds-exhibit-decreased-ym1-and-arginase-expression-with-increased-expression-of-il-17-and-il-20
#12
Phillip J Finley, Cory E DeClue, Scott A Sell, Joseph M DeBartolo, Laurie P Shornick
Objective: Impaired wound healing in diabetic (DB) patients is a significant health problem; however, the roles that cytokines and innate immune cells contribute to this impaired healing are not completely understood. Approach: A mouse model was used to compare the innate immune response during DB and normal wound healing. Two 5-mm full-thickness wounds were created on the dorsal skin of BKS.Cg-m+/+Leprdb/J (DB) and C57BL/6 (wild-type) mice. Innate immune cell markers and cytokine mRNA levels were measured in wound biopsies during the first week of healing...
November 1, 2016: Advances in Wound Care
https://www.readbyqxmd.com/read/27867752/comparing-the-effectiveness-of-polymer-debriding-devices-using-a-porcine-wound-biofilm-model
#13
Holly N Wilkinson, Andrew J McBain, Christian Stephenson, Matthew J Hardman
Objective: Debridement to remove necrotic and/or infected tissue and promote active healing remains a cornerstone of contemporary chronic wound management. While there has been a recent shift toward less invasive polymer-based debriding devices, their efficacy requires rigorous evaluation. Approach: This study was designed to directly compare monofilament debriding devices to traditional gauze using a wounded porcine skin biofilm model with standardized application parameters. Biofilm removal was determined using a surface viability assay, bacterial counts, histological assessment, and scanning electron microscopy (SEM)...
November 1, 2016: Advances in Wound Care
https://www.readbyqxmd.com/read/27785380/the-management-of-combat-wounds-the-british-military-experience
#14
REVIEW
Steven L A Jeffery
The concept of the military wound is not an easy entity to define as the wounds seen in conflict can be of many types: those caused by recognized or improvised weapon systems may have similarities to civilian wounds as well as the wounds soldiers sustain outside of battle. This article will focus on the current treatment approaches to combat wounds sustained by the deployed UK Armed Forces personnel.
October 1, 2016: Advances in Wound Care
https://www.readbyqxmd.com/read/27785379/extracellular-bacterial-proteases-in-chronic-wounds-a-potential-therapeutic-target
#15
REVIEW
Louise Suleman
Significance: Bacterial biofilms are considered to be responsible for over 80% of persistent infections, including chronic lung infections, osteomyelitis, periodontitis, endocarditis, and chronic wounds. Over 60% of chronic wounds are colonized with bacteria that reside within a biofilm. The exaggerated proteolytic environment of chronic wounds, more specifically elevated matrix metalloproteinases, is thought to be one of the possible reasons as to why chronic wounds fail to heal. However, the role of bacterial proteases within chronic wounds is not fully understood...
October 1, 2016: Advances in Wound Care
https://www.readbyqxmd.com/read/27785378/targeting-microtubules-for-wound-repair
#16
REVIEW
Rabab A Charafeddine, Joshua D Nosanchuk, David J Sharp
Significance: Fast and seamless healing is essential for both deep and chronic wounds to restore the skin and protect the body from harmful pathogens. Thus, finding new targets that can both expedite and enhance the repair process without altering the upstream signaling milieu and causing serious side effects can improve the way we treat wounds. Since cell migration is key during the different stages of wound healing, it presents an ideal process and intracellular structural machineries to target. Recent Advances and Critical Issues: The microtubule (MT) cytoskeleton is rising as an important structural and functional regulator of wound healing...
October 1, 2016: Advances in Wound Care
https://www.readbyqxmd.com/read/27785377/peroxy-pyruvic-acid-containing-topical-anti-infective-a-potential-candidate-for-a-wound-instillation-solution
#17
Edwin D Neas, Julie A Dunn, Evelyn Dimaano Silva, A Morgan Chambers, Gary J Luckasen, Adam Jaskowiak
Objective: Evaluate the therapeutic properties of a peroxy pyruvic acid (PPA)-containing topical anti-infective in a human ex-vivo model that replicates the natural conditions of a human chronic wound. Approach: Wound material was extracted from patients with nonhealing diabetic ulcers, venous stasis ulcers, and arterial wounds. Microbial species were identified, and wound colonization was quantified. Extracted samples were then exposed to a PPA-containing topical anti-infective as an instillation solution with negative pressure wound therapy NPWT at concentrations of 1,000, 1,500, or 2,500 ppm for a period of 1, 5, or 10 min to determine the effect of exposure on isolated pathogens, including effect on proteins...
October 1, 2016: Advances in Wound Care
https://www.readbyqxmd.com/read/27785376/platelet-hyperactivity-in-tnfsf14-light-knockout-mouse-model-of-impaired-healing
#18
Sandeep Dhall, Zubair A Karim, Fadi T Khasawneh, Manuela Martins-Green
Objective: Impaired and chronic wounds occur due to defects in one or more of the overlapping stages of healing. However, problems related to the vascular system are critical for nonhealing, and chronic wounds in humans often show the presence of fibrin cuffs/clots. We hypothesized that these clots are due to alterations in platelet function; hence, we have investigated whether alterations in platelet function are present during impaired healing. Approach: Platelets were subjected to different agonists to determine the rate of aggregation and evaluate the molecules involved in adhesion and aggregation that could lead to faster thrombosis and potentially contribute to impaired wound healing...
October 1, 2016: Advances in Wound Care
https://www.readbyqxmd.com/read/27679752/plastic-surgery-challenges-in-war-wounded-ii-regenerative-medicine
#19
REVIEW
Ian L Valerio, Jennifer M Sabino, Christopher L Dearth
Background: A large volume of service members have sustained complex injuries during Operations Iraqi Freedom (OIF) and Enduring Freedom (OEF). These injuries are complicated by contamination with particulate and foreign materials, have high rates of bacterial and/or fungal infections, are often composite-type defects with massive soft tissue wounds, and usually have multisystem involvement. While traditional treatment modalities remain a mainstay for optimal wound care, traditional reconstruction approaches alone may be inadequate to fully address the scope and magnitude of such massive complex wounds...
September 1, 2016: Advances in Wound Care
https://www.readbyqxmd.com/read/27679751/plastic-surgery-challenges-in-war-wounded-i-flap-based-extremity-reconstruction
#20
Jennifer M Sabino, Julia Slater, Ian L Valerio
Scope and Significance: Reconstruction of traumatic injuries requiring tissue transfer begins with aggressive resuscitation and stabilization. Systematic advances in acute casualty care at the point of injury have improved survival and allowed for increasingly complex treatment before definitive reconstruction at tertiary medical facilities outside the combat zone. As a result, the complexity of the limb salvage algorithm has increased over 14 years of combat activities in Iraq and Afghanistan. Problem: Severe poly-extremity trauma in combat casualties has led to a large number of extremity salvage cases...
September 1, 2016: Advances in Wound Care
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