Complex Wound Management

2019 ◽  
Vol 35 (06) ◽  
pp. 672-677
Author(s):  
Tom Shokri ◽  
Sameep Kadakia ◽  
Yadranko Ducic
Keyword(s):  
Wound Healing ◽  
Social Stigma ◽  
Healing Process ◽  
Wound Management ◽  
Treatment Modalities ◽  
Complex Wound ◽  
Impaired Speech ◽  
Tissue Restoration ◽  
Underlying Pathophysiology ◽  
Complex Wounds

AbstractDespite the generous blood supply, and resultant healing capacity within the head and neck, complex wounds in this area may be extremely debilitating and present an obstacle to treatment for the reconstructive surgeon. Delayed, incomplete, or otherwise suboptimal wound healing within this anatomical region may lead to both functional and aesthetically displeasing outcomes, resulting in impaired speech or swallowing, social stigma, and, in severe cases, exposure of critical underlying structures. Due to implications, with regard to wound formation following surgical intervention, the facial reconstructive surgeon, in particular, must be familiar with the multitude of treatment modalities available. This article serves as a review of the underlying pathophysiology of wound healing, local and systemic processes that may influence the healing process, and treatments that facilitate tissue restoration while mitigating future complications.

scholarly journals Polymer-Based Scaffolds Loaded with Aloe vera Extract for the Treatment of Wounds

Pharmaceutics ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 961
Author(s):  
Sibusiso Alven ◽  
Vuyolwethu Khwaza ◽  
Opeoluwa O. Oyedeji ◽  
Blessing A. Aderibigbe
Keyword(s):  
Wound Healing ◽  
Chronic Wounds ◽  
Mechanical Performance ◽  
Healing Process ◽  
Aloe Vera ◽  
Antimicrobial Properties ◽  
Biological Properties ◽  
Wound Management ◽  
Wound Healing Process ◽  
Treatment Of Wounds

The treatment of wounds is one challenging biomedical field due to delayed wound healing common in chronic wounds. Several factors delay wound healing, including microbial infections, malnutrition, underlying physiological conditions, etc. Most of the currently used wound dressing materials suffer from poor antimicrobial properties, poor biodegradability and biocompatibility, and weak mechanical performance. Plant extracts, such as Aloe vera, have attracted significant attention in wound management because of their interesting biological properties. Aloe vera is composed of essential constituents beneficial for the wound healing process, such as amino acids, vitamins C and E, and zinc. Aloe vera influences numerous factors that are involved in wound healing and stimulates accelerated healing. This review reports the therapeutic outcomes of aloe vera extract-loaded polymer-based scaffolds in wound management.

scholarly journals Photobiomodulation of Human Fibroblasts and Keratinocytes with Blue Light: Implications in Wound Healing

2020 ◽  
Author(s):  
Francesca Rossi ◽  
Giada Magni ◽  
Francesca Tatini ◽  
Martina Banchelli ◽  
Federica Cherchi ◽  
...  
Keyword(s):  
Wound Healing ◽  
Blue Light ◽  
Chronic Wounds ◽  
Human Fibroblasts ◽  
Healing Process ◽  
Research Area ◽  
Wound Management ◽  
Blue Led ◽  
Led Light ◽  
New Research

In recent years, photobiomodulation (PBM) has been recognized as a physical therapy in wound management. Despite several published research papers, the mechanism underlying photobiomodulation is still not completely understood. The investigation about application of blue light to improve wound healing is a relatively new research area. Tests in selected patients evidenced a stimulation of the healing process in superficial and chronic wounds treated with a blue LED light emitting at 420 nm; a study in animal model pointed out a faster healing process in superficial wound, with an important role of fibroblasts and myofibroblasts. Here we present a study aiming at evidencing the effects of blue light on the proliferation and metabolism in fibroblasts and keratinocytes. Different light doses were used to treat the cells, evidencing inhibitory and stimulatory effects. Electrophysiology was used to investigate the effects on membrane currents, while Raman spectroscopy revealed the mitochondrial Cytochrome C (Cyt C) oxidase dependence on blue light irradiation. In conclusion, we observed that the blue LED light can be used to modulate the activity of human fibroblasts, and the effects in wound healing are particularly evident when studying the fibroblasts and keratinocytes co-cultures.

scholarly journals Loss of Diacylglycerol Kinase α Enhances Macrophage Responsiveness

2021 ◽  
Vol 12 ◽  
Author(s):  
Laryssa C. Manigat ◽  
Mitchell E. Granade ◽  
Suchet Taori ◽  
Charlotte Anne Miller ◽  
Luke R. Vass ◽  
...  
Keyword(s):  
Wound Healing ◽  
T Cell ◽  
Healing Process ◽  
Cell Activity ◽  
Regulatory Function ◽  
Burned Area ◽  
Wound Healing Process ◽  
Wound Model ◽  
Complex Wound

The diacylglycerol kinases (DGKs) are a family of enzymes responsible for the conversion of diacylglycerol (DAG) to phosphatidic acid (PA). In addition to their primary function in lipid metabolism, DGKs have recently been identified as potential therapeutic targets in multiple cancers, including glioblastoma (GBM) and melanoma. Aside from its tumorigenic properties, DGKα is also a known promoter of T-cell anergy, supporting a role as a recently-recognized T cell checkpoint. In fact, the only significant phenotype previously observed in Dgka knockout (KO) mice is the enhancement of T-cell activity. Herein we reveal a novel, macrophage-specific, immune-regulatory function of DGKα. In bone marrow-derived macrophages (BMDMs) cultured from wild-type (WT) and KO mice, we observed increased responsiveness of KO macrophages to diverse stimuli that yield different phenotypes, including LPS, IL-4, and the chemoattractant MCP-1. Knockdown (KD) of Dgka in a murine macrophage cell line resulted in similar increased responsiveness. Demonstrating in vivo relevance, we observed significantly smaller wounds in Dgka-/- mice with full-thickness cutaneous burns, a complex wound healing process in which macrophages play a key role. The burned area also demonstrated increased numbers of macrophages. In a cortical stab wound model, Dgka-/- brains show increased Iba1+ cell numbers at the needle track versus that in WT brains. Taken together, these findings identify a novel immune-regulatory checkpoint function of DGKα in macrophages with potential implications for wound healing, cancer therapy, and other settings.

scholarly journals Novel formulation approaches for wound healing

2020 ◽  
Vol 11 (SPL4) ◽  
pp. 937-948
Author(s):  
Tanaji D Nandgude ◽  
Syed Nateque Naser
Keyword(s):  
Wound Healing ◽  
Healing Process ◽  
Cell Types ◽  
Wound Management ◽  
Wound Healing Process ◽  
Anatomic Structure ◽  
Tissue Integrity ◽  
Molecular Events ◽  
Acute Injuries ◽  
Healing Wounds

A wound is damage to the typical anatomic structure. Wound healing is an immediate therapeutic response to injury. It is a creation of the combined response of some cell types towards injury. Wound healing takes place by a sequence of molecular events which cooperate to fix tissue integrity and cell work. In typical healthy individual under ordinary conditions, these physiological events take place smoothly. Though sometimes, these molecular events are arrested, this brings about in struggle to heal. There is an assortment of approaches for the way toward managing and controlling both acute injuries (acute wounds) and ceaseless non-mending wounds (chronic non-healing wounds). The principal objective of these two cases is to achieve better-wound healing. Ideal formulations of wound healing should not only enhance the healing process but also reduce pain, infection and loss of electrolytes, proteins and liquids from the injury. A broad scope of items typically introduced with target various parts of the wound healing process depends on numerous types of wounds and novel polymers utilised for the conveyance of medications to both acute and ceaseless injuries. These include alginate, hydrocolloids, hydrofibers, polyurethane, and hydrogels. This article gives particular importance to different novel approaches in the management of wound healing. This review draws out the data and hopes to provide understanding into traditional, current and imminent techniques and methods for wound management.

Use of Antibiotic-Impregnated Absorbable Beads and Tissue Coverage of Complex Wounds

2016 ◽  
Vol 82 (11) ◽  
pp. 1068-1072 ◽  
Author(s):  
Terris L. White ◽  
Alfred T. Culliford ◽  
Martin Zomaya ◽  
Gary Freed ◽  
Christopher P. Demas
Keyword(s):  
Wound Management ◽  
Fasciocutaneous Flaps ◽  
Local Antibiotics ◽  
Standard Management ◽  
Systemic Antibiotic Therapy ◽  
Infected Wounds ◽  
Complex Wound ◽  
High Concentrations ◽  
Multicenter Retrospective Review ◽  
Complex Wounds

The treatment of complex wounds is commonplace for plastic surgeons. Standard management is debridement of infected and devitalized tissue and systemic antibiotic therapy. In cases where vital structures are exposed within the wound, coverage is obtained with the use of vascularized tissue using both muscle and fasciocutaneous flaps. The use of nondissolving polymethylmethacrylate and absorbable antibiotic-impregnated beads has been shown to deliver high concentrations of antibiotics with low systemic levels of the same antibiotic. We present a multicenter retrospective review of all cases that used absorbable antibiotic-impregnated beads for complex wound management from 2003 to 2013. A total of 104 cases were investigated, flap coverage was used in 97 cases (93.3%). Overall, 15 patients (14.4%) required reoperation with the highest groups involving orthopedic wounds and sternal wounds. The advantages of using absorbable antibiotic-impregnated beads in complex infected wounds have been demonstrated with minimal disadvantages. The utilization of these beads is expanding to a variety of complex infectious wounds requiring high concentrations of local antibiotics.

scholarly journals Collagen-Based Nanofibers for Skin Regeneration and Wound Dressing Applications

Polymers ◽  
2021 ◽  
Vol 13 (24) ◽  
pp. 4368
Author(s):  
Zintle Mbese ◽  
Sibusiso Alven ◽  
Blessing Atim Aderibigbe
Keyword(s):  
Wound Healing ◽  
Wound Dressing ◽  
Cellular Proliferation ◽  
Healing Process ◽  
Skin Regeneration ◽  
Wound Dressings ◽  
Wound Management ◽  
Major Constituent ◽  
Wound Healing Process ◽  
Frequent Change

Skin regeneration after an injury is very vital, but this process can be impeded by several factors. Regenerative medicine is a developing biomedical field with the potential to decrease the need for an organ transplant. Wound management is challenging, particularly for chronic injuries, despite the availability of various types of wound dressing scaffolds in the market. Some of the wound dressings that are in clinical practice have various drawbacks such as poor antibacterial and antioxidant efficacy, poor mechanical properties, inability to absorb excess wound exudates, require frequent change of dressing and fails to offer a suitable moist environment to accelerate the wound healing process. Collagen is a biopolymer and a major constituent of the extracellular matrix (ECM), making it an interesting polymer for the development of wound dressings. Collagen-based nanofibers have demonstrated interesting properties that are advantageous both in the arena of skin regeneration and wound dressings, such as low antigenicity, good biocompatibility, hemostatic properties, capability to promote cellular proliferation and adhesion, and non-toxicity. Hence, this review will discuss the outcomes of collagen-based nanofibers reported from the series of preclinical trials of skin regeneration and wound healing.

scholarly journals A CASE STUDY ON WOUND HEALING BY VRUNA SHODHAN CHIKITSA

2020 ◽  
Vol p5 (01) ◽  
pp. 2638-2640
Author(s):  
Vijayalakshmi Hadimani
Keyword(s):  
Wound Healing ◽  
Prevalence Rate ◽  
Causative Factor ◽  
Chronic Ulcer ◽  
Wound Management ◽  
Treatment Modalities ◽  
Treat Ment ◽  
Mucus Membrane ◽  
Surgical Field

An ulcer is the break in the continuity of skin or mucus membrane either by molecular death or traumatic removal1. It is essential to treat ulcer in surgical field as prevalence rate of chronic ulcer is 4.5 / 1000 popu-lation in India. These ulcers mostly caused by trauma, poor blood supply, diabetes, infections, and periph-eral vascular disorders etc. Ulcers heal when the causative factor will be removed and by the proper wound management, Acharya Sushruth, has explained 60 Vruna upakrams2(60 treatment modalities for wound) for the treat-ment of Dusta Vruna (chronic ulcer), among that Vruna Shodhan (wound cleaning) and Vruna Ropan (wound healing) modalities have been applied in this case, and observed the wound healing in detail and successful results noted

scholarly journals Haruan Extract (Channa striatus) as an Effective Mediator in Promoting Wound Healing

2021 ◽  
Author(s):  
Ahmad Farouk Musa ◽  
Cheang Jia Min
Keyword(s):  
Fatty Acids ◽  
Extracellular Matrix ◽  
Wound Healing ◽  
Granulation Tissue ◽  
Healing Process ◽  
Skin Grafting ◽  
Treatment Modalities ◽  
Wound Healing Process ◽  
Channa Striatus ◽  
The Government

Wound healing remains a major issue in surgery. None of the existing treatment modalities in caring for wounds can yet claim to be the holy grail of wound management. Channa striatus, locally known in Malaysia as Haruan, is a freshwater air-breathing carnivorous fish that is proven to influence the different phases of wound healing. As a medicinal fish, not only does Haruan have a high content of amino and fatty acids, which are essential in collagen fibre synthesis during wound recovery, it also abounds in arachidonic acid and polyunsaturated fatty acids that promote prostaglandin synthesis, a vital component of the healing process. Moreover, its antinociceptive effects could potentially reduce wound pain, an important factor in wound healing. Proteomic studies show that a quarter of the total protein detected in freeze- and spray-dried C. striatus extract are actin, myosin and tropomyosin – all molecules that play a role in the wound healing process. Proteomic profiling also reveals that Haruan possesses two types of collagen namely collagen type-I and type-II that confer tensile strength during the healing process. It is proven that collagen along with other components of the extracellular matrix form the granulation tissue which, when contracted, closes the wound and concomitantly aligns the collagen fibres in the extracellular matrix. Hence, it is inferred that Haruan promotes the maturation of granulation tissue, thereby expediting the wound healing process itself. Consequently, it could mediate a faster recovery from surgical wound coupled with a lower incidence of wound infection due to an improved and accelerated wound healing process. Additionally, Haruan has demonstrated its ability in promoting angiogenesis and cell proliferation in wound bed preparation for skin grafting. Furthermore, a Haruan aerosol concentrate can act as a wound dressing at the donor site thereby enhancing the healing process while simultaneously exhibiting some antinociceptive properties. Haruan’s exceptional ability in promoting wound healing together with its potential use in skin grafting would be instrumental in the field of surgery. In essence, the cumulated benefits from all the processes involved would translate into a significant reduction of hospitalisation cost; that would immensely benefit not only the patient, but also the government.

scholarly journals Bioinspired mechanically active adhesive dressings to accelerate wound closure

2019 ◽  
Vol 5 (7) ◽  
pp. eaaw3963 ◽  
Author(s):  
S. O. Blacklow ◽  
J. Li ◽  
B. R. Freedman ◽  
M. Zeidi ◽  
C. Chen ◽  
...  
Keyword(s):  
Wound Healing ◽  
Wound Closure ◽  
Healing Process ◽  
Skin Wound ◽  
Wound Management ◽  
In Vivo Studies ◽  
Skin Wound Healing ◽  
Accelerate Wound Healing

Inspired by embryonic wound closure, we present mechanically active dressings to accelerate wound healing. Conventional dressings passively aid healing by maintaining moisture at wound sites. Recent developments have focused on drug and cell delivery to drive a healing process, but these methods are often complicated by drug side effects, sophisticated fabrication, and high cost. Here, we present novel active adhesive dressings consisting of thermoresponsive tough adhesive hydrogels that combine high stretchability, toughness, tissue adhesion, and antimicrobial function. They adhere strongly to the skin and actively contract wounds, in response to exposure to the skin temperature. In vitro and in vivo studies demonstrate their efficacy in accelerating and supporting skin wound healing. Finite element models validate and refine the wound contraction process enabled by these active adhesive dressings. This mechanobiological approach opens new avenues for wound management and may find broad utility in applications ranging from regenerative medicine to soft robotics.

scholarly journals Nanomaterials for Wound Healing and Infection Control

Materials ◽  
2019 ◽  
Vol 12 (13) ◽  
pp. 2176 ◽  
Author(s):  
Mara Madalina Mihai ◽  
Monica Beatrice Dima ◽  
Bogdan Dima ◽  
Alina Maria Holban
Keyword(s):  
Wound Healing ◽  
Bacterial Infections ◽  
Healing Process ◽  
Ease Of Use ◽  
Wound Management ◽  
Maximum Diameter ◽  
Wound Healing Process ◽  
Classic Approach ◽  
Function Preservation ◽  
Ideal Technique

Wound healing has been intensely studied in order to develop an “ideal” technique that achieves expeditious recovery and reduces scarring to the minimum, thus ensuring function preservation. The classic approach to wound management is represented by topical treatments, such as antibacterial or colloidal agents, in order to prevent infection and promote a proper wound-healing process. Nanotechnology studies submicroscopic particles (maximum diameter of 100 nm), as well as correlated phenomena. Metal nanoparticles (e.g., silver, gold, zinc) are increasingly being used in dermatology, due to their beneficial effect on accelerating wound healing, as well as treating and preventing bacterial infections. Other benefits include: ease of use, less frequent dressing changes and a constantly moist wound environment. This review highlights recent findings regarding nanoparticle application in wound management.

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