Outcomes and Predictors of Wound Healing among Patients with Complex Diabetic Foot Wounds Treated with a Dermal Regeneration Template (Integra)

A primary aim in wound-healing research is to construct an inexpensive, biodegradable dermal regeneration template with heightened moisture retention and permeability properties. The presence of moisture is important for optimal burn wound healing as it creates an environment for re-epithelialization and minimizes the risk of infections. Permeability can be achieved through a process known as electrospinning. This scaffold fabrication technique creates a mat of randomly oriented nanofibers that can readily mimic native extracellular matrix. Novel electrospun silk fibroin scaffolds were fabricated with poloxamer 407 (P407) and Manuka honey additives for a burn wound dermal regeneration template application. Enhanced human dermal fibroblast adhesion and cell infiltration were observed with the inclusion of P407, and scaffolds incorporated with Manuka honey demonstrated increased water uptake and a higher cell density within the scaffolds at the end of a 28-day period. Overall, this study established that both the silk fibroin/P407 and silk fibroin/Manuka honey scaffolds have the potential to be successful dermal regeneration templates, with P407 increasing surface wettability and Manuka honey modulating moisture retention.

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The use of Integra dermal regeneration matrix in the surgical treatment of a recurrent, extensive malignant skin lesion in the temporal region

Orvosi Hetilap ◽

10.1556/oh.2013.29535 ◽

2013 ◽

Vol 154 (6) ◽

pp. 225-227 ◽

Cited By ~ 1

Author(s):

Csaba Halmy ◽

Zoltán Nádai ◽

Krisztián Csőre ◽

Adrienne Vajda ◽

Róbert Tamás

Keyword(s):

Surgical Treatment ◽

Skin Lesion ◽

Surgical Management ◽

Skin Grafting ◽

Skin Tumor ◽

Temporal Region ◽

Aesthetic Result ◽

Malignant Skin ◽

Dermal Regeneration Template ◽

Dermal Regeneration

Authors report on the use of Integra dermal regeneration template after excision of an extended, recurrent skin tumor in the temporal region. The area covered with Integra was 180 cm2. Skin grafting to cover Integra was performed on the 28th day. Both Integra and the skin transplant were taken 100%. Integra dermal regeneration template can provide good functional and aesthetic result in the surgical management of extended skin tumors over the skull. Orv. Hetil., 2013, 154, 225–227.

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A study of effectiveness of topical recombinant human platelet derived growth factor for wound healing in patients with chronic diabetic foot ulcers at tertiary health care center

Medpusle International Journal of Surgery ◽

10.26611/1061028 ◽

2019 ◽

Vol 10 (2) ◽

pp. 62-64

Author(s):

Shirish Maskepatil ◽

◽

Sanjay Prabu Warad ◽

Keyword(s):

Health Care ◽

Wound Healing ◽

Growth Factor ◽

Diabetic Foot ◽

Human Platelet ◽

Care Center ◽

Platelet Derived Growth Factor ◽

Foot Ulcers ◽

Diabetic Foot Ulcers ◽

Health Care Center

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The Mesenchymal Stem Cell-Derived Exosomal Long Noncoding RNA H19 Promotes Wound Healing in Diabetic Foot Ulcers by Up-Regulating PTEN via MicroRNA-152-3p

SSRN Electronic Journal ◽

10.2139/ssrn.3408040 ◽

2019 ◽

Author(s):

Bo Li ◽

Song Luan ◽

Jing Chen ◽

Yue Zhou ◽

Tingting Wang ◽

...

Keyword(s):

Wound Healing ◽

Stem Cell ◽

Mesenchymal Stem Cell ◽

Diabetic Foot ◽

Long Noncoding Rna ◽

Noncoding Rna ◽

Foot Ulcers ◽

Diabetic Foot Ulcers

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The Effects of Silver-Releasing Foam Dressings on Diabetic Foot Ulcer Healing

Journal of Clinical Medicine ◽

10.3390/jcm10071495 ◽

2021 ◽

Vol 10 (7) ◽

pp. 1495

Author(s):

Yu-Chi Wang ◽

Hsiao-Chen Lee ◽

Chien-Lin Chen ◽

Ming-Chun Kuo ◽

Savitha Ramachandran ◽

...

Keyword(s):

Wound Healing ◽

Diabetic Foot ◽

Healing Rate ◽

Early Period ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Wound Management ◽

Control Group ◽

Diabetic Patients ◽

High Morbidity

Diabetic foot ulcers (DFUs) are a serious complication in diabetic patients and lead to high morbidity and mortality. Numerous dressings have been developed to facilitate wound healing of DFUs. This study investigated the wound healing efficacy of silver-releasing foam dressings versus silver-containing cream in managing outpatients with DFUs. Sixty patients with Wagner Grade 1 to 2 DFUs were recruited. The treatment group received silver-releasing foam dressing (Biatain® Ag Non-Adhesive Foam dressing; Coloplast, Humlebaek, Denmark). The control group received 1% silver sulfadiazine (SSD) cream. The ulcer area in the silver foam group was significantly reduced compared with that in the SSD group after four weeks of treatment (silver foam group: 76.43 ± 7.41%, SSD group: 27.00 ± 4.95%, p < 0.001). The weekly wound healing rate in the silver foam group was superior to the SSD group during the first three weeks of treatment (p < 0.05). The silver-releasing foam dressing is more effective than SSD in promoting wound healing of DFUs. The effect is more pronounced in the initial three weeks of the treatment. Thus, silver-releasing foam could be an effective wound dressing for DFUs, mainly in the early period of wound management.

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Skin regeneration is accelerated by a lower dose of multipotent mesenchymal stromal/stem cells—a paradigm change

Stem Cell Research & Therapy ◽

10.1186/s13287-020-02131-6 ◽

2021 ◽

Vol 12 (1) ◽

Author(s):

Gertraud Eylert ◽

Reinhard Dolp ◽

Alexandra Parousis ◽

Richard Cheng ◽

Christopher Auger ◽

...

Keyword(s):

Stem Cells ◽

Wound Healing ◽

Low Dose ◽

Dose Range ◽

High Dose ◽

Full Thickness ◽

Burn Wound ◽

Dermal Regeneration Template ◽

Yorkshire Pigs ◽

Stromal Stem Cells

Abstract Background Multipotent mesenchymal stromal/stem cell (MSC) therapy is under investigation in promising (pre-)clinical trials for wound healing, which is crucial for survival; however, the optimal cell dosage remains unknown. The aim was to investigate the efficacy of different low-to-high MSC dosages incorporated in a biodegradable collagen-based dermal regeneration template (DRT) Integra®. Methods We conducted a porcine study (N = 8 Yorkshire pigs) and seeded between 200 and 2,000,000 cells/cm2 of umbilical cord mesenchymal stromal/stem cells on the DRT and grafted it onto full-thickness burn excised wounds. On day 28, comparisons were made between the different low-to-high cell dose groups, the acellular control, a burn wound, and healthy skin. Result We found that the low dose range between 200 and 40,000 cells/cm2 regenerates the full-thickness burn excised wounds most efficaciously, followed by the middle dose range of 200,000–400,000 cells/cm2 and a high dose of 2,000,000 cells/cm2. The low dose of 40,000 cells/cm2 accelerated reepithelialization, reduced scarring, regenerated epidermal thickness superiorly, enhanced neovascularization, reduced fibrosis, and reduced type 1 and type 2 macrophages compared to other cell dosages and the acellular control. Conclusion This regenerative cell therapy study using MSCs shows efficacy toward a low dose, which changes the paradigm that more cells lead to better wound healing outcome.

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