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Non-healing wounds treatments

William J Nahm, Jorge A Mota, Sarah Rojas, Brian J Hizon, Chris Gordon
BACKGROUND Classical pyoderma gangrenosum is a rare, inflammatory, neutrophilic dermatosis that commonly presents with severe ulcerations on the lower extremities and is often misdiagnosed and mistreated. Delay in treatments can lead to worsening of the ulcerations and allows for multiple comorbid factors. Pyoderma gangrenosum is most commonly treated with immunosuppressants or anti-inflammatory agents and is often worsened by surgical procedures due to the presence of pathergy. In acute cases, a course of anti-inflammatory treatments works well in alleviating symptoms and reducing ulcerations and residual scarring...
July 19, 2018: American Journal of Case Reports
Nicola Ivins, Chris Braumann, Jan-Birger Kirchhoff, Uhl Waldemar, Nia J Jones
OBJECTIVE: To evaluate the safety and performance of a gelling fibre dressing, with respect to wound exudate management, maceration and periwound skin conditions. METHOD: Complex (non-healing) surgical or chronic wounds healing by secondary intention were treated with a gelling fibre dressing (Biosorb, Acelity) as part of a prospective, two-centre case series product evaluation study. Dressing performance was evaluated at each change, and weekly for up to four weeks or until the wound healed, if this was in less than four weeks...
July 2, 2018: Journal of Wound Care
Hanna Kaufman, Maxim Gurevich, Eran Tamir, Elad Keren, Lipkin Alexander, Paul Hayes
OBJECTIVE: Oxygen plays a central role in wound healing. Recent technological advances have miniaturised oxygen delivery systems, with novel topical oxygen therapy allowing patients to receive oxygen therapy 24 hours a day while remaining completely mobile. Here we aim to examine the efficacy and safety of continuous topical oxygen diffusion in a 'real-world' setting. METHODS: Topical oxygen therapy (TOT) was evaluated in patients with chronic, non-healing wounds in a tertiary referral specialist clinic...
July 2, 2018: Journal of Wound Care
Evan S Darwin, Erica R Thaler, Hadar A Lev-Tov
Chronic wounds are an enormous burden to society, costing billions of dollars annually in the US alone. Despite the extensive research into methods to heal chronic wounds, many remain unhealed for months to years. There is a need to focus on patient reported outcomes to improve quality of life in patients with non-healing wounds. Wound odor has a significant impact on patient quality of life; however, relatively little information is available on the management of wound odor. We review the current data available on wound odor and discuss the need for standardized objective measures of odor to improve research quality...
July 17, 2018: Giornale Italiano di Dermatologia e Venereologia: Organo Ufficiale, Società Italiana di Dermatologia e Sifilografia
Yu Zhang, Qiang Zhang, Hui Chen, Changli Wang
AIMS: Bcell lymphoma 9 (BCL9)-Wnt/β-catenin pathway, a key signaling pathway related to epithelial-mesenchymal transition (EMT), is widely considered to be involved in invasion in various malignant tumors. However, the dysregulation of BCL9/β-catenin pathway in non-small cell lung cancer (NSCLC) has not been revealed. This study aimed to investigate the correlation between chemotherapy resistance and BCL9/Wnt/β-catenin signaling dysfunction. MAIN METHODS: We performed BCL9 knockdown using a lentivirus-mediated sh-RNA interference in cisplatin-resistant (CR) lung cancer cells...
July 13, 2018: Life Sciences
Anne Purcell, Thomas Buckley, Jennie King, Wendy Moyle, Andrea P Marshall
Background: The physical, occupational, social and psychological impact of chronic leg ulcers (CLUs) on an individual is considerable. Wound-related pain (WRP), the most common symptom, is frequently reported as moderate to severe and mostly occurs at dressing change. WRP pain may not be alleviated by oral analgesics alone. Persistent poorly controlled leg ulcer pain can negatively impact wound healing and health-related quality of life (HRQoL). Methods: A pilot, parallel group, non-blinded, randomised controlled trial was conducted in six procedure clinics located in a public community nursing service in New South Wales, Australia to evaluate eutectic mixture of local anaesthetics (EMLA®) on painful CLUs when used as a primary dressing...
2018: Pilot and Feasibility Studies
Dariusz Bazaliński, Paweł Więch, Dorota Kaczmarska, Izabela Sałacińska, Maria Kózka
RATIONALE: Effective wound healing depends on the adequate choice of the wound cleansing method, to enable rapid removal of necrotic tissue. Negative pressure wound therapy (NPWT) is an effective non-invasive technique for management of wounds of varied aetiology, including deep tissue injuries caused by pressure. PATIENT CONCERNS: This article discusses a case of an 82-year-old female receiving hospice care at home owing to progressing untreated thoracic spinal stenosis, bedridden for 4 years, incapable of self-care...
July 2018: Medicine (Baltimore)
Olivia Ngo, Evan Niemann, Vivinya Gunasekaran, Prabagar Sankar, Miriam Putterman, Alec Lafontant, Sumati Nadkarni, Rose Ann DiMaria-Ghalili, Michael Neidrauer, Leonid Zubkov, Michael Weingarten, David Margolis, Peter A Lewin
This paper details the systematic approach used to develop a viable clinical prototype of a therapeutic ultrasound applicator and discusses the rationale and deliberations that led to the design strategy. The applicator was specifically devised to treat chronic wounds and - to the best of the author's knowledge - is the first truly wearable device with a proven record of reducing healing time, directly translating to a reduction of healthcare costs. The prototype operates in the kHz (20-100) range of frequencies and uses non-cavitational and non-thermal levels of ultrasound energy...
May 14, 2018: IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control
Yongwen Li, Hongbing Zhang, Hao Gong, Yin Yuan, Ying Li, Cong Wang, Weiting Li, Zihe Zhang, Minghui Liu, Hongyu Liu, Jun Chen
BACKGROUND: Metastasis is the leading cause of cancer mortality and is a major hurdle for lung cancer treatment. Invadopodia, which are cancer-specific protrusive structures, play a crucial role in the metastatic cascade through degradation of the basement membrane and surrounding stroma. Cortactin, a critical component of invadopodia, frequently used as an invadopodia marker, a universally important player in invadopodia function, and is frequently overexpressed in cancer, but the exact mechanism of regulation is not yet fully understood...
July 9, 2018: Journal of Experimental & Clinical Cancer Research: CR
Patricia Rousselle, Fabienne Braye, Guila Dayan
Cutaneous wound healing in adult mammals is a complex multi-step process involving overlapping stages of blood clot formation, inflammation, re-epithelialization, granulation tissue formation, neovascularization, and remodelling. Re-epithelialization describes the resurfacing of a wound with new epithelium. The cellular and molecular processes involved in the initiation, maintenance, and completion of epithelialization are essential for successful wound closure. A variety of modulators are involved, including growth factors, cytokines, matrix metalloproteinases, cellular receptors, and extracellular matrix components...
July 5, 2018: Advanced Drug Delivery Reviews
Johannes Menzel-Severing, Matthias Zenkel, Naresh Polisetti, Elisabeth Sock, Michael Wegner, Friedrich E Kruse, Ursula Schlötzer-Schrehardt
Understanding transcription factor (TF) regulation of limbal epithelial stem/progenitor cells (LEPCs) may aid in using non-ocular cells to regenerate the corneal surface. This study aimed to identify and characterize TF genes expressed specifically in LEPCs isolated from human donor eyes by laser capture microdissection. Using a profiling approach, preferential limbal expression was found for SoxE and SoxF genes, particularly for Sox9, which showed predominantly cytoplasmic localization in basal LEPCs and nuclear localization in suprabasal and corneal epithelial cells, indicating nucleocytoplasmic translocation and activation during LEPC proliferation and differentiation...
July 6, 2018: Scientific Reports
J M Rios Ruh, L López Capdevila, A Domínguez Sevilla, J Roman Verdasco, A Santamaría Fumas, J M Sales Pérez
OBJECTIVE: We present a case series report of patients with Charcot foot treated by single-stage surgery with static circular fixation. MATERIAL AND METHOD: Retrospective review of 10 cases treated with static circular external fixation since 2016, with the following inclusion criteria: 1) Deformity with any of the following: ulcers, osteoporosis, osteomyelitis or instability 2) peripheral neuropathy, 3) failed orthopaedic treatment. EXCLUSION CRITERIA: 1) peripheral vascular obstruction without revascularization, 2) inability to comply with treatment, 3) non-ambulatory patients, 4) medical contraindication for surgery...
July 3, 2018: Revista Española de Cirugía Ortopédica y Traumatología
Mildred Lopez Pineiro, Eric Willis, Chen Yao, Susan Y Chon
Sunitinib is a multi-targeted receptor tyrosine kinase inhibitor used for the treatment of multiple different types of malignancies. Serious grade 3-4 adverse events occur in <10% of the patient population and usually improve with dose reduction. One of the more rarely reported side effects of sunitinib therapy is the development of pyoderma gangrenosum-like ulcerations in the lower extremities. These pyoderma gangrenosum-like ulcerations are difficult to treat and distinguish from similar-appearing dermatological diagnoses...
2018: SAGE Open Medical Case Reports
Maria López-Parra, Dolors Gil-Rey, Esmeralda López-González, Eva-Maria González-Rodríguez, Isabel Simó-Sánchez, Francisco Zamora-Carmona, Lidia Roqueta-Andreu, Marta Arizu-Puigvert, Dolors Abril-Sabater, Àngels Moreno-Álvarez, Àngels López-Bonet, Gisela López-Hidalgo, Helena Costa-Ventura, Laura García-Pardo, Mireia Rico-Liberato, Miriam García-Borràs, Maria Teresa Arnal-Leris, Mònica Sianes-Gallén, Roser Vives
BACKGROUND: Surgical wounds are covered to prevent bleeding, absorb the exudates, and provide a barrier against external contamination. Currently, in our hospital, after orthopedic surgery, traditional occlusive dressing of sterile gauze and non-woven hypoallergenic adhesive tape is placed. Some of the newest dressings have been shown to reduce the incidence of blisters compared with traditional dressing or colloid adhesive dressings. However, there are no comparative evaluations between the different types of dressings and their contribution to the overall results of the healing process...
July 5, 2018: Trials
Mengyao Sun, Xiaona Ma, Chen Tu, Xiaopeng Wang, Jianqiang Qu, Shuang Wang, Shengxiang Xiao
MicroRNAs (miRNAs) participate in the development and progression of melanoma. However, while dysregulation of microRNA-378 (miR-378) has been seen in various cancer types, its clinical importance and function in melanoma is poorly elucidated. In this work, miR-378 expression in melanoma and in adjacent non-cancerous tissue was evaluated with quantitative real time polymerase chain reaction (qRT-PCR). A series of assays (wound healing, Transwell and nude mouse subcutaneous tumor model) were used to investigate the implications of abnormal miR-378 regulation on melanoma cell migration and invasion in vitro, and on tumorigenicity in vivo...
July 4, 2018: Cell Biology International
Dalia H Abdelkader, Murtaza M Tambuwala, Christopher A Mitchell, Mohamed A Osman, Sanaa A El-Gizawy, Ahmed M Faheem, Mohamed El-Tanani, Paul A McCarron
Insulin plays an important role in the wound healing process, but its method of delivery to the wound bed and subsequent effect on rate of healing is less well investigated. In this study, we evaluated the therapeutic effectiveness of topical human insulin delivery using a nanoparticulate delivery system suspended in a structured hydrogel vehicle. Poly(lactide-co-glycolide) (PLGA) nanoparticles (NP) of 202.6 nm diameter and loaded with 33.86 μg insulin per milligram of polymer were formulated using a modified double-emulsion solvent evaporation technique and dispersed in a dilatant hydrogel (poly(vinyl alcohol)-borate)...
July 3, 2018: Drug Delivery and Translational Research
Haicheng Tang, Jianjie Zhu, Wenwen Du, Shunlin Liu, Yuanyuan Zeng, Zongli Ding, Yang Zhang, Xueting Wang, Zeyi Liu, Jianan Huang
BACKGROUND: Despite advances in diagnosis and treatment, the survival of non-small cell lung cancer (NSCLC) patients remains poor. There is therefore a strong need to identify potential molecular targets for the treatment of NSCLC. In the present study, we investigated the function of CPNE1 in the regulation of cell growth, migration and invasion. METHODS: Quantitative real-time PCR (qRT-PCR) was used to detect the expression of CPNE1 and miR-335-5p. Western blot and immunohistochemical assays were used to investigate the levels of CPNE1 and other proteins...
July 3, 2018: Journal of Experimental & Clinical Cancer Research: CR
Zipporah Iheozor-Ejiofor, Katy Newton, Jo C Dumville, Matthew L Costa, Gill Norman, Julie Bruce
BACKGROUND: Traumatic wounds (wounds caused by injury) range from abrasions and minor skin incisions or tears, to wounds with extensive tissue damage or loss as well as damage to bone and internal organs. Two key types of traumatic wounds considered in this review are those that damage soft tissue only and those that involve a broken bone, that is, open fractures. In some cases these wounds are left open and negative pressure wound therapy (NPWT) is used as a treatment. This medical device involves the application of a wound dressing through which negative pressure is applied and tissue fluid drawn away from the area...
July 3, 2018: Cochrane Database of Systematic Reviews
Diana R Alves, Simon P Booth, Paola Scavone, Pascale Schellenberger, Jonathan Salvage, Cinzia Dedi, Naing-Tun Thet, A Toby A Jenkins, Ryan Waters, Keng W Ng, Andrew D J Overall, Anthony D Metcalfe, Jonathan Nzakizwanayo, Brian V Jones
Biofilm formation in wounds is considered a major barrier to successful treatment, and has been associated with the transition of wounds to a chronic non-healing state. Here, we present a novel laboratory model of wound biofilm formation using ex-vivo porcine skin and a custom burn wound array device. The model supports high-throughput studies of biofilm formation and is compatible with a range of established methods for monitoring bacterial growth, biofilm formation, and gene expression. We demonstrate the use of this model by evaluating the potential for bacteriophage to control biofilm formation by Staphylococcus aureus , and for population density dependant expression of S...
2018: Frontiers in Cellular and Infection Microbiology
Rongfeng Shi, Weishuai Lian, Shilong Han, Chuanwu Cao, Yinpeng Jin, Yifeng Yuan, Hui Zhao, Maoquan Li
Diabetic ischemic ulcer is an intractable diabetic complication. Angiogenesis is a critical factor for wound healing in patients with diabetic foot wounds. Sustained gene delivery could be notably necessary in modulating gene expression in chronic ulcer healing and might be a promising approach for diabetic foot ulcers. In the present study, Sprague-Dawley rats were used to establish diabetic foot ulcer models by streptozotocin and skin biopsy punch. The plasmids expressing VEGF-A and PDGF-B were prepared and then incorporated with polylactic-co-glycolic acid (PLGA) nanospheres to upregulate genes expression...
June 28, 2018: Gene Therapy
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