Use of low-frequency contact ultrasonic debridement with and without polyhexamethylene biguanide in hard-to-heal leg ulcers: an RCT protocol

2021 ◽  
Vol 30 (5) ◽  
pp. 372-379
Author(s):  
Alison Vallejo ◽  
Marianne Wallis ◽  
David McMillan ◽  
Eleanor Horton
Keyword(s):  
Wound Healing ◽  
Controlled Trial ◽  
Low Frequency ◽  
Laboratory Method ◽  
Wound Management ◽  
Tissue Samples ◽  
Bacterial Colony ◽  
Culture Techniques ◽  
Polyhexamethylene Biguanide

Objective: The purpose of this research is to investigate the effect of low-frequency contact ultrasonic debridement therapy (LFCUD) in hard-to-heal wounds with suspected biofilm, and compare the effect with or without a surfactant antimicrobial on bacterial colony counts and wound healing rates. Method: A single-blinded randomised controlled trial (RCT) will investigate the combination of LFCUD and the antiseptic polyhexamethylene biguanide with a surfactant betaine (referred to in this paper as PHMB) as a topical solution post-treatment and in a sustained dressing, compared with use of LFCUD alone. Potential participants from a community wound clinic (n=50) will be invited to take part in the 12-week trial. Wound swabs and tissue samples will be analysed for bacterial type and quantity, before and after treatments, using traditional culture techniques and advanced molecular methods. Wound healing, pain, quality of life and biofilm (via a specifically designed tool) will also be measured. Discussion: Bacteria have the potential to cause a hard-to-heal wound, particularly when antibiotics are too frequently and unnecessarily prescribed, resulting in antibiotic-resistant microorganisms. Appropriate care is vital when caring for hard-to-heal wounds to avoid these scenarios. With no simple laboratory method available to identify or treat wound biofilm, clinicians rely on their expertise in wound management. This study aims to provide in vivo evidence on the effectiveness of PHMB, to prevent the reformation of biofilm when applied after LFCUD. The aim is to provide evidence-based and more cost-effective wound care.

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 Advances in surgical applications of growth factors for wound healing

2019 ◽  
Vol 7 ◽  
Author(s):  
Sho Yamakawa ◽  
Kenji Hayashida
Keyword(s):  
Wound Healing ◽  
Growth Factors ◽  
Growth Factor ◽  
Animal Studies ◽  
Healing Process ◽  
Clinical Importance ◽  
Topical Administration ◽  
Wound Management ◽  
Future Research

Abstract Growth factors have recently gained clinical importance for wound management. Application of recombinant growth factors has been shown to mimic cell migration, proliferation, and differentiation in vivo, allowing for external modulation of the healing process. Perioperative drug delivery systems can enhance the biological activity of these growth factors, which have a very short in vivo half-life after topical administration. Although the basic mechanisms of these growth factors are well understood, most have yet to demonstrate a significant impact in animal studies or small-sized clinical trials. In this review, we emphasized currently approved growth factor therapies, including a sustained release system for growth factors, emerging therapies, and future research possibilities combined with surgical procedures. Approaches seeking to understand wound healing at a systemic level are currently ongoing. However, further research and consideration in surgery will be needed to provide definitive confirmation of the efficacy of growth factor therapies for intractable wounds.

scholarly journals Nanobiomaterials for vascular biology and wound management: A review

2018 ◽  
Vol 7 (2) ◽  
Author(s):  
Ajay Vikram Singh ◽  
Donato Gemmati ◽  
Anurag Kanase ◽  
Ishan Pandey ◽  
Vatsala Misra ◽  
...  
Keyword(s):  
Wound Healing ◽  
Tissue Repair ◽  
Wound Care ◽  
Viable Cell ◽  
Clinical Science ◽  
Wound Management ◽  
Clinical Practices ◽  
Hydrogel Scaffold ◽  
Extracellular Matrix Components

Nanobiomaterials application into tissue repair and ulcer management is experiencing its golden age due to spurring diversity of translational opportunity to clinics. Over the past years, research in clinical science has seen a dramatic increase in medicinal materials at nanoscale those significantly contributed to tissue repair. This chapter outlines the new biomaterials at nanoscale those contribute state of the art clinical practices in ulcer management and wound healing due to their superior properties over traditional dressing materials. Designing new recipes for nanobiomaterials for tissue engineering practices spanning from micro to nano-dimension provided an edge over traditional wound care materials those mimic tissue in vivo. Clinical science stepped into design of artificial skin and extracellular matrix components emulating the innate structures with higher degree of precision. Advances in materials sciences polymer chemistry have yielded an entire class of new nanobiomaterials ranging from dendrimer to novel electrospun polymer with biodegradable chemistries and controlled molecular compositions assisting wound healing adhesives, bandages and controlled of therapeutics in specialized wound care. Moreover, supportive regenerative medicine is transforming into rational, real and successful component of modern clinics providing viable cell therapy of tissue remodeling. Soft nanotechnology involving hydrogel scaffold revolutionized the wound management supplementing physicobiochemical and mechanical considerations of tissue regeneration. Moreover, this chapter also reviews the current challenges and opportunities in specialized nanobiomaterials formulations those are desirable for optimal localized wound care considering their in situ physiological microenvironment.

scholarly journals Hypoxia Preconditioned Serum (HPS)-Hydrogel Can Accelerate Dermal Wound Healing in Mice—An In Vivo Pilot Study

Biomedicines ◽  
2022 ◽  
Vol 10 (1) ◽  
pp. 176
Author(s):  
Jun Jiang ◽  
Ursula Kraneburg ◽  
Ulf Dornseifer ◽  
Arndt F. Schilling ◽  
Ektoras Hadjipanayi ◽  
...  
Keyword(s):  
Wound Healing ◽  
Wound Repair ◽  
Lymphatic Vessels ◽  
Scar Tissue ◽  
Tissue Samples ◽  
Medicine Research ◽  
Dermal Wound Healing ◽  
Wound Model ◽  
Dermal Wound

The ability to use the body’s resources to promote wound repair is increasingly becoming an interesting area of regenerative medicine research. Here, we tested the effect of topical application of blood-derived hypoxia preconditioned serum (HPS) on wound healing in a murine wound model. Alginate hydrogels loaded with two different HPS concentrations (10 and 40%) were applied topically on full-thickness wounds created on the back of immunocompromised mice. We achieved a significant dose-dependent wound area reduction after 5 days in HPS-treated groups compared with no treatment (NT). On average, both HPS-10% and HPS-40% -treated wounds healed 1.4 days faster than NT. Healed tissue samples were investigated on post-operative day 15 (POD 15) by immunohistology and showed an increase in lymphatic vessels (LYVE-1) up to 45% with HPS-40% application, while at this stage, vascularization (CD31) was comparable in the HPS-treated and NT groups. Furthermore, the expression of proliferation marker Ki67 was greater on POD 15 in the NT-group compared to HPS-treated groups, in accordance with the earlier completion of wound healing observed in the latter. Collagen deposition was similar in all groups, indicating lack of scar tissue hypertrophy as a result of HPS-hydrogel treatment. These findings show that topical HPS application is safe and can accelerate dermal wound healing in mice.

scholarly journals hucMSC Exosome Ameliorates Pressure Ulcers Through Inhibition of HMGB1.

2021 ◽  
Author(s):  
Fei Yan ◽  
Meihua Gong ◽  
Furong Li ◽  
Li Yu
Keyword(s):  
Stem Cells ◽  
Wound Healing ◽  
Pressure Ulcers ◽  
Healing Process ◽  
Wound Healing Process ◽  
Human Umbilical Cord ◽  
Mrna Levels ◽  
Tissue Samples ◽  
New Perspective

Abstract Background: Pressure ulcers (PU) are a chronic wound for elderly populations. Previous works have shown that exosomes from stem cells contain cytokines and growth factors that play a role in tissue repair and can represent a therapeutic strategy for wound healing. Thus, as a new cell-free treatment model, fully understanding the extraction of exosomes and its mechanism of action can help promote the management of clinically chronic refractory wound healing. Material and Methods: In this study, we initially isolated exosomes from human umbilical cord mesenchymal stem cells (hucMSC-Exo) and examined their roles in wound healing. Different time points were evaluated for 15 mice which were randomly divided into three groups to serve three I-R circles and took different dose of hucMSC-Exo. Quantitative real-time polymerase chain reaction (qRT-PCR) was applied to analyze collagen mRNA levels in tissue samples. HMGB1 content was explored by western blot and immunohistochemistry. Comparing α-SAM, CD34, HMGB1 were used to investigate the potential mechanisms.Results: We found that hucMSC-Exo could be taken up by fibroblasts and significantly regulate and improve fibroblast fibrotic status and in-vivo PU wound healing. Further, we observed that hucMSC-Exo treatment of PU wound was able to downregulate the expression of HMGB1 previously shown to have a deleterious role in the wound healing process. Conclusion: Our study indicates that hucMSC-Exo regulates the repair of pressure ulcer wounds in part by inhibiting HMGB1. Exosome treatment has opened up a new perspective in regenerative medicine and trauma management.

scholarly journals Growth Factor-Reinforced ECM Fabricated from Chemically Hypoxic MSC Sheet with Improved In Vivo Wound Repair Activity

2017 ◽  
Vol 2017 ◽  
pp. 1-11 ◽  
Author(s):  
Hui-Cong Du ◽  
Lin Jiang ◽  
Wen-Xin Geng ◽  
Jing Li ◽  
Rui Zhang ◽  
...  
Keyword(s):  
Wound Healing ◽  
Growth Factor ◽  
Wound Repair ◽  
Cost Effective ◽  
Tissue Growth ◽  
Wound Management ◽  
Skin Defect ◽  
Therapeutic Benefits ◽  
Collagen Iii

MSC treatment can promote cutaneous wound repair through multiple mechanisms, and paracrine mediators secreted by MSC are responsible for most of its therapeutic benefits. Recently, MSC sheet composed of live MSCs and their secreted ECMs was reported to promote wound healing; however, whether its ECM alone could accelerate wound closure remained unknown. In this study, Nc-ECM and Cc-ECM were prepared from nonconditioned and CoCl2-conditioned MSC sheets, respectively, and their wound healing properties were evaluated in a mouse model of full-thickness skin defect. Our results showed that Nc-ECM can significantly promote wound repair through early adipocyte recruitment, rapid reepithelialization, enhanced granulation tissue growth, and augmented angiogenesis. Moreover, conditioning of MSC sheet with CoCl2 dramatically enriched its ECM with collagen I, collagen III, TGF-β1, VEGF, and bFGF via activation of HIF-1α and hence remarkably improved its ECM’s in vivo wound healing potency. All the Cc-ECM-treated wounds completely healed on day 7, while Nc-ECM-treated wounds healed about 85.0%±8.6%, and no-treatment wounds only healed 69.8%±9.6% (p<0.05). Therefore, we believe that such growth factor-reinforced ECM fabricated from chemically hypoxic MSC sheet has the potential for clinical translation and will lead to a MSC-derived, cost-effective, bankable biomaterial for wound management.

Erythropoetin stimulates tissue repair in experimental wounds

2021 ◽  
Vol 9-10 (219-220) ◽  
pp. 17-22
Author(s):  
Medet Toleubayev ◽  
◽  
Mariya Dmitriyeva ◽  
Saken Kozhakhmetov ◽  
Nurbek Igissinov ◽  
...  
Keyword(s):  
Wound Healing ◽  
Standard Treatment ◽  
Model Material ◽  
Wound Management ◽  
Tissue Samples ◽  
Human Erythropoietin ◽  
Wound Size ◽  
Complex Process ◽  
Standard Treatment Group ◽  
Stimulate Cell Proliferation

The efficacy of recombinant human erythropoietin (EPO) is being studied in the context of wound management. The ability of EPO to stimulate cell proliferation was found, which is of great importance in the complex process of wound healing. The aim of this study is to evaluate the results of using EPO for wound healing in a rat model. Material and methods. We examined 24 wounds simulated in the interscapular region of a rat, which were divided into 2 groups: a group with standard treatment, a group with EPO treatment at a dosage of 400 IU/kg, s/c. Planimetry of the wound was performed at the appointed time. Also, histological examination of wound tissue samples was carried out. Results. Differences in reduction and change in wound size in the EPO group were more significant than in the standard treatment group. Conclusions. The experiment demonstrated an improvement in wound healing with EPO treatment compared with standard treatment, which led to a decrease in wound size and a shorter healing period. Keywords: erythropoietin, EPO, angiogenesis, wound treatment.

scholarly journals Epigallocatechin Gallate: The Emerging Wound Healing Potential of Multifunctional Biomaterials for Future Precision Medicine Treatment Strategies

Polymers ◽  
2021 ◽  
Vol 13 (21) ◽  
pp. 3656
Author(s):  
Mazlan Zawani ◽  
Mh Busra Fauzi
Keyword(s):  
Wound Healing ◽  
Precision Medicine ◽  
Chronic Wounds ◽  
Healing Process ◽  
Epigallocatechin Gallate ◽  
Wound Management ◽  
Wound Healing Process ◽  
Ability To Act

Immediate treatment for cutaneous injuries is a realistic approach to improve the healing rate and minimise the risk of complications. Multifunctional biomaterials have been proven to be a potential strategy for chronic skin wound management, especially for future advancements in precision medicine. Hence, antioxidant incorporated biomaterials play a vital role in the new era of tissue engineering. A bibliographic investigation was conducted on articles focusing on in vitro, in vivo, and clinical studies that evaluate the effect and the antioxidants mechanism exerted by epigallocatechin gallate (EGCG) in wound healing and its ability to act as reactive oxygen species (ROS) scavengers. Over the years, EGCG has been proven to be a potent antioxidant efficient for wound healing purposes. Therefore, several novel studies were included in this article to shed light on EGCG incorporated biomaterials over five years of research. However, the related papers under this review’s scope are limited in number. All the studies showed that biomaterials with scavenging ability have a great potential to combat chronic wounds and assist the wound healing process against oxidative damage. However, the promising concept has faced challenges extending beyond the trial phase, whereby the implementation of these biomaterials, when exposed to an oxidative stress environment, may disrupt cell proliferation and tissue regeneration after transplantation. Therefore, thorough research should be executed to ensure a successful therapy.

scholarly journals Regenerative Skin Wound Healing in Mammals: State-of-the-Art on Growth Factor and Stem Cell Based Treatments

2015 ◽  
Vol 36 (1) ◽  
pp. 1-23 ◽  
Author(s):  
Bizunesh M. Borena ◽  
Ann Martens ◽  
Sarah Y. Broeckx ◽  
Evelyne Meyer ◽  
Koen Chiers ◽  
...  
Keyword(s):  
Wound Healing ◽  
Stem Cell ◽  
Growth Factor ◽  
Wound Repair ◽  
Cell Types ◽  
Skin Wound ◽  
Wound Management ◽  
Skin Wound Healing

Mammal skin has a crucial function in several life-preserving processes such as hydration, protection against chemicals and pathogens, initialization of vitamin D synthesis, excretion and heat regulation. Severe damage of the skin may therefore be life-threatening. Skin wound repair is a multiphased, yet well-orchestrated process including the interaction of various cell types, growth factors and cytokines aiming at closure of the skin and preferably resulting in tissue repair. Regardless various therapeutic modalities targeting at enhancing wound healing, the development of novel approaches for this pathology remains a clinical challenge. The time-consuming conservative wound management is mainly restricted to wound repair rather than restitution of the tissue integrity (the so-called “restitutio ad integrum”). Therefore, there is a continued search towards more efficacious wound therapies to reduce health care burden, provide patients with long-term relief and ultimately scarless wound healing. Recent in vivo and in vitro studies on the use of skin wound regenerative therapies provide encouraging results, but more protracted studies will have to determine whether the effect of observed effects are clinically significant and whether regeneration rather than repair can be achieved. For all the aforementioned reasons, this article reviews the emerging field of regenerative skin wound healing in mammals with particular emphasis on growth factor- and stem cell-based therapies.

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