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Advances in Wound Care

Travis A Motley, Joseph M Caporusso, Darrell L Lange, Robert A Eichelkraut, David Innes Cargill, Jaime E Dickerson
Objective: To compare outcomes of diabetic foot ulcers (DFUs) treated with clostridial collagenase ointment (CCO) or silver-containing products, both in combination with sharp debridement as needed. Approach: One hundred two subjects with qualifying DFUs were randomized to daily treatment with either CCO or a silver-containing product for 6 weeks followed by a 4 -week follow-up period. The primary outcome was the mean percent reduction in DFU area. A secondary outcome was the incidence of ulcer infections between groups...
October 1, 2018: Advances in Wound Care
Julie M West, Sumanas W Jordan, Ehud Mendel, Safdar N Khan, Rajiv Y Chandawarkar, Ian L Valerio
Objective: Infection prevention in spinal surgeries involving implantation of hardware is of utmost priority. Furthermore, successful eradication of infection in hardware salvage is likewise critical in maintaining the long-term retention of the spinal hardware construct. Approach: We report a retrospective case series of three cases where the utilization of a VAC with instillation (VACi) in conjunction with surgical debridement aided in infection control and eradication for both preimplantation and hardware salvage spine patients...
October 1, 2018: Advances in Wound Care
Melanie Rodrigues, Clark A Bonham, Caterina P Minniti, Kalpna Gupta, Michael T Longaker, Geoffrey C Gurtner
Objective: Sickle cell ulcers (SCUs) are a devastating comorbidity affecting patients with sickle cell disease (SCD). SCUs form over the medial or lateral malleoli of the lower extremity, are slow to heal, and prone to recidivism. Some SCUs may never heal, leading to chronic pain and foot deformities. There is no specific and effective therapy for SCUs. Systemic deferoxamine (DFO) has been demonstrated to prevent some of the sequelae of SCD by chelating iron. In this study, we tested the ability of DFO delivered via a transdermal delivery system (DFO-TDDS) to accelerate healing in a murine model of SCU...
October 1, 2018: Advances in Wound Care
Anne-Marie Salisbury, Dieter Mayer, Rui Chen, Steven L Percival
Objective: This study was set up to evaluate the efficacy of a concentrated surfactant-based wound dressing (with and without silver sulfadiazine [SSD]) on wound repair, by investigating their ability to enhance human dermal fibroblast proliferation and viability. In addition, the wound dressings were evaluated for their ability to suppress biofilms in a three-dimensional (3D) in vitro wound biofilm model and modulate the inflammatory cytokine interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNFα). Approach: Problematic biofilms are well known to affect fibroblast and keratinocyte viability...
September 1, 2018: Advances in Wound Care
Jose A Jaller, Ingrid Herskovitz, Luis J Borda, Joshua Mervis, Evan Darwin, Penelope A Hirt, Hadar Lev-Tov, Robert S Kirsner
Background: Despite the development of numerous wound treatment alternatives, 25% to 50% of leg ulcers and >30% of foot ulcers are not fully healed after 6 months of treatment. Autologous skin grafting is a time-tested therapy for these wounds; however, the creation of a new wound in the donor area yields a considerable limitation to this procedure. Innovation: Fractional autologous full-thickness skin grafting (FFTSG) is a technique wherein multiple small full-thickness skin grafts (FTSGs) are harvested with possibly minor donor-site comorbidities...
September 1, 2018: Advances in Wound Care
Denise R Cooper, Chunyan Wang, Rehka Patel, Andrea Trujillo, Niketa A Patel, Jamie Prather, Lisa J Gould, Mack H Wu
Objective: Chronically ill patients heal recalcitrant ulcerative wounds more slowly. Human adipose-derived stem cells (hADSCs) play an important role in tissue regeneration and exosomes secreted by hADSC contribute to their paracrine signaling. In addition to cytokines, lipids and growth factors, hADSC secrete mRNA, miRNA, and long noncoding (lnc) RNA into exosomes. In this study we examined the role of lncRNA MALAT1 (metastasis-associated lung adenocarcinoma transcript 1), an abundant lncRNA in exosomes from conditioned media (CM), on cell migration and ischemic wound healing...
September 1, 2018: 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
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