Histological and clinical evaluation of wound healing in pressure ulcers: a novel animal model

2021 ◽  
Vol 30 (Sup6) ◽  
pp. S12-S21
Author(s):  
Diana G Sami ◽  
Ahmed Abdellatif

Objective: Pressure ulcers (PUs) are a major healthcare problem, commonly associated with older people, patients who are bedbound and patients with diabetes. The impact of PUs can decrease patients' quality of life, and lead to high morbidity and mortality rates. In this study, we aimed to describe a novel PU model that simulates pressure ulcers in humans to provide a research tool for new drug testing. Method: Diabetes was induced using streptozocin in 75 adult Sprague Dawley rats. To create the PU, skin was sandwiched between two magnets, one of them implanted below the panniculus carnosus muscle and the other above the skin. The model was tested on nondiabetic rats and diabetic rats, each with pressure ulcers, compared to nondiabetic rats with excisional wounds. Results: Results showed that the PU model in diabetic (p-value<0.000001) and non-diabetic rats (p-value<0.05) exhibited significantly delayed healing (no healing over 21 days) compared with the excisional wound that was completely healed by day 21. Conclusion: Diabetic rats showed significant changes in intact skin compared with non-diabetic rats, as well as a significant delay in the healing process compared with the non-diabetic group. By effectively impairing the skin contraction otherwise seen in the rats, and thereby delaying healing and making it similar to that seen in hard-to-heal PUs in humans, this model provides an effective tool for wound healing research.

2020 ◽  
Vol 29 (11) ◽  
pp. 632-641
Author(s):  
Diana G Sami ◽  
Ahmed Abdellatif

Objective: Pressure ulcers (PUs) are a major healthcare problem, commonly associated with older people, patients who are bedbound and patients with diabetes. The impact of PUs can decrease patients' quality of life, and lead to high morbidity and mortality rates. In this study, we aimed to describe a novel PU model that simulates pressure ulcers in humans to provide a research tool for new drug testing. Method: Diabetes was induced using streptozocin in 75 adult Sprague Dawley rats. To create the PU, skin was sandwiched between two magnets, one of them implanted below the panniculus carnosus muscle and the other above the skin. The model was tested on nondiabetic rats and diabetic rats, each with pressure ulcers, compared to nondiabetic rats with excisional wounds. Results: Results showed that the PU model in diabetic (p-value<0.000001) and non-diabetic rats (p-value<0.05) exhibited significantly delayed healing (no healing over 21 days) compared with the excisional wound that was completely healed by day 21. Conclusion: Diabetic rats showed significant changes in intact skin compared with non-diabetic rats, as well as a significant delay in the healing process compared with the non-diabetic group. By effectively impairing the skin contraction otherwise seen in the rats, and thereby delaying healing and making it similar to that seen in hard-to-heal PUs in humans, this model provides an effective tool for wound healing research.


2016 ◽  
Vol 3 (1) ◽  
pp. 1-8
Author(s):  
Afriyanti Sandhi ◽  
Aditya Wardhana

Background: The hematopoietic growth factor erythropoietin (EPO) attracts attention due to its all-tissue-protective pleiotropic properties. The purpose of this study is to investigate the effect of EPO in experimental burn wounds healing. Methods: Fifteen healthy Sprague-Dawley, strain of Rattus Novergicus weighing 300-350 grams, were prepared to achieve deep dermal burns. Animals were randomized to receive either low-dose EPO injection (600 IU/mL), high-dose EPO injection (3000 IU/mL) or nothing (control group). After 14 days of observations, quantitative and qualitative assessments of wound healing was determined. Results: The size of the wound area and re-epithelialization rate percentage was determined on Day-0, Day-5, Day-10, and Day-14. The average of raw surface areas measurement (p value: 0.012 in day-5; 0.009 in day-10 and 0.000 in day-14) and healing percentage of the lesions (p value: 0.011 in day-5; 0.016 in day-10 and 0.010 in day-14) were significantly best in the low-dose EPO grup compared to the control group and high-dose EPO grup. The histopathology evaluation revealed that the highest score for for re-epithelialization, granulation tissue and neo-angiogenesis were achieved by the low-dose EPO injection group than in both control and high-dose EPO injection groups. Conclusion: In this animal study using Sprague-Dawley rats, Recombinant Human EPO (rHuEPO) injection administration prompted the evidences of improved re-epithelialization and wound healing process of the skin caused by deep dermal burns. These findings may lead to a new therapeutic approach to improve the clinical outcomes for the management of burns wound healing.


2017 ◽  
Vol 16 (2) ◽  
pp. 74-84 ◽  
Author(s):  
Junna Ye ◽  
Yutian Kang ◽  
Xiaofang Sun ◽  
Pengwen Ni ◽  
Minjie Wu ◽  
...  

Diabetes leads to amputation in approximately 15% to 20% of patients and is associated with high morbidity and mortality. Thus, improving the quality of wound healing in this condition is essential. Diabetes is associated with acute/chronic inflammation affecting all organs especially the foot, while, inhibition of microRNA-155 (miR-155) has been reported to improve or reduce inflammatory situation. However, the role of miR-155 inhibition in promoting diabetic wound healing is not clear. To further study the potential benefit of miR-155 inhibition, a study of male Sprague-Dawley rats was conducted and diabetes was induced by injection of streptozotocin. Real-time polymerase chain reaction (PCR), hematoxylin and eosin staining and immunohistochemistry were then performed. The PCR results confirmed that miR-155 expression was lower after miR-155 inhibition on days 3, 7, and 13 (all Ps <.05). The wound healing rate between the normal glucose group (N group), diabetic PBS group (PBS group) and the topical miR-155 inhibitor group was compared. Faster healing of cutaneous wounds was observed in the miR-155 inhibitor group than in the PBS group and normal glucose group ( P < .05). In addition, downregulation of inflammatory cells, including neutrophils (MPO-positive) and macrophages (CD68-positive), and upregulation of the angiogenic protein CD31 and markers indicative of fibroblast proliferation and collagen deposition, such as collagen 1, TGF-β1, and α-SMA, were observed. These data permit the observation that miR-155 inhibition possesses the potential to reduce inflammation in acute wounds. This property may benefit the healing of diabetic foot wounds.


2019 ◽  
Vol 2 (1) ◽  
pp. 14-17
Author(s):  
Nurul Aini Siagian ◽  
Syafira Nusaibah ◽  
Andayani Boang Manalu

Early mobilization includes factors that can affect the process of wound healing after surgery. Immediate mobilization in stages is very useful for the process of healing wounds and preventing infection and venous thrombosis. The purpose of this study was to determine whether there is a relationship between early mobilization and the process of healing wound post operative sectio caesarea at Sinar Husni General Hospital Medan Helvetia. The research design used was analytic survey with cross sectional approach. The sample in this study used the Consecutive Sampling method of data collection using a checklist sheet conducted on a sample of 19 respondents. The results of the study in this study are the majority of respondents who did early mobilization and who experienced rapid wound healing process as many as 4 people (21%) while the minority of respondents who did early mobilization and who experienced slow wound healing process were 1 person (5.3%). The majority of respondents who did not mobilize early and who experienced a slow wound healing process were 11 people (57.9%) and a minority who did not mobilize early and who experienced rapid healing as many as 4 people (21.1%). Statistical test results obtained p value = 0.046 <0.005. The conclusions of the results of this study indicate there is a relationship between early mobilization and the process of healing post operative sectio of caesarea. Suggestions The results of this study can be applied as a reference to improve nursing care services, especially in providing counseling and assistance to patients.


2017 ◽  
Vol 2 (1) ◽  
pp. 20-28
Author(s):  
Fitriani ◽  
Tenriwati

At present, the incidence of injuries in Indonesia is quite high, as seen from data on traffic accidents in the general public. There are several factors that affect wound healing, one of which is nutritional status. Based on the preliminary data retrieval conducted by researchers in the seruni surgery room in the last 1 month namely in March, it was found that the number of wounded patients was 109 patients, where the number of men was 78 (71.56%) while the number of women was 31 ( 28.44%) The purpose of this study was to determine the relationship between nutritional status and the wound healing process in RSUD. H. Andi. Sulthan Daeng Radja Kab. Bulukumba. This research uses the type of design of this research is quantitative research. This type of research uses analytic observational research with cross sectional approach. The sample of this study were 41 respondents taken by purposive sampling method. Data analysis in this study used the chi-square test (chi square test). The results of the analysis used the chi-square statistical test with a confidence level (α = 0.05). Based on the results of this test, the p value is 0.001, thus p <α (0.001 <0.05), then Ho is rejected and Ha is accepted. The conclusion of this study is that there is a relationship between nutritional status and the process of wound healing in RSUD. H. Andi. Sulthan Daeng Radja Kab. Bulukumba. Researchers suggest that this study be used as a material consideration in the fulfillment of nutrition in wound care patients in RSUD.H.A. Sulthan Daeng Radja Kab. Bulukumba and this research can be continued by conducting research related to the wound healing process and linking it with other variables.


2017 ◽  
Vol 11 (1) ◽  
pp. 109
Author(s):  
Reni Heryani ◽  
Ardenny Denny

<p align="center"><strong>A</strong><strong>BSTRAK</strong><strong></strong></p><p align="center"> </p><p>Salah satu tujuan pembangunan era <em>Millenium Development goals (MDG’s)</em> 2015 adalah perbaikan kesehatan maternal. Salah satu cara di dalam persalinan atau mengeluarkan bayi secara patologis yaitu dengan sectio caesarea. Menurut  statistik 3.509 kasus sectio caesarea, indikasi terbanyak adalah disproporsi cephalo pelvik (21%), sedangkan indikasi lain adalah gawat janin (14%), plasenta previa (11%), pernah sectio caesarea (11%), incoordinate uterine action (9%), preeklamsi dan hipertensi (7%). Penelitian ini menggunakan desain penelitian <em>Quasy Experiment</em> dengan <em>post test only with control.</em> Hasil penelitian menunjukkan bahwa umumnya responden memiliki umur tidak berisiko terhadap tindakan operasi yati sebanyak 15 orang (75%), sebagian responden pertama kali dilakukan operasi caesarea yaitu sebanyak 10 orang (50,0%), sebagian responden mengalami penyembuhan luka yang normal yaitu sebanyak 13 orang (65,0%), dan sebagian responden responden melakukan mobilisasi dini yaitu sebanyak 14  orang (70,0%). Secara statistik terdapat pengaruh mobilisasi dini terhadap penyembuhan luka post sectio caesarea di RSUD Arifin Achmad Pekanbaru (p value = 0.007). Disarankan bagi respnden dapat meningkatkan kesadarannya dalam meningkatkan derajat kesehatan melalui latihan mobilisasi dini untuk mempercepat proses penyembuhan luka akibat operasi.</p><p><em> </em></p><p><em>Kata Kunci      : </em><em>sectio </em><em>caesarea, mobilisasi, penyembuhan luka</em></p><p><em> </em></p><p align="center"><strong><em>ABSTRACT</em></strong></p><p><em> </em></p><p><em>One of the goals of development era of Millennium Development Goals (MDG's) in 2015 is the improvement of maternal health.</em><em> </em><em>One way in the delivery or the baby out with the pathological ie sectio caesarea. According to 3509 statistics compiled case sectio caesarea, an indication of cephalo pelvic disproportion is the highest (21%), while the other is an indication of fetal distress (14%), placenta previa (11%), never sectio caesarea (11%), incoordinate uterine action (9%), preeclampsia and hypertension (7%).</em><em> </em><em>This study research design quasy Experiment with post test only with control. The results showed that respondents generally have a lifespan of no risk for surgery yati many as 15 people (75%), the majority of respondents were first performed caesarea operation as many as 10 people (50.0%), the majority of respondents experienced a normal wound healing as many as 13 people (65.0%), and the majority of respondents respondents did early mobilization as many as 14 people (70.0%). There is a statistically significant relationship between early mobilization on wound healing post sectio caesarea (p value = 0.007). Suggested for respnden can increase awareness in improving health status through early mobilization exercises to accelerate the wound healing process as a result of the operation.</em></p><p><em> </em></p><em>Keywords: sectio caesarea, mobilization, wound healing</em>


2021 ◽  
Vol 22 (14) ◽  
pp. 7549
Author(s):  
Wiktor Paskal ◽  
Adriana M. Paskal ◽  
Piotr Pietruski ◽  
Albert Stachura ◽  
Kacper Pełka ◽  
...  

The aim of the study was to evaluate if a pre-incisional N-acetylcysteine (NAC) treatment altered the process of wound healing in a rat model. The dorsal skin of 24 Sprague-Dawley rats was incised in six locations. Before the incisions were made, skin was injected either with lidocaine and epinephrine (one side) or with these agents supplemented with 0.015%, 0.03%, or 0.045% NAC (contralaterally). Photographic documentation of the wound healing process was made at 11 time points. Rats were sacrificed 3, 7, 14, or 60 days after incision to excise scars for histological analysis. They included: Abramov scale scoring, histomorphometry analysis, and collagen fiber arrangement assessment. Skin pretreated with 0.03% NAC produced the shortest scars at all analyzed time points, though this result was statistically insignificant. At this NAC concentration the scars had smaller areas on the third day and were narrower on the day 4 compared with all the other groups (p < 0.05). On day 7, at the same concentration of NAC, the scars had a higher superficial concentration index (p = 0.03) and larger dermal proliferation area (p = 0.04). NAC addition to pre-incisional anesthetic solution decreased wound size and width at an early stage of scar formation at all concentrations; however, with optimal results at 0.03% concentration.


2021 ◽  
Vol 26 ◽  
pp. 2515690X2098676
Author(s):  
Ana Bertha Hernandez-Hernandez ◽  
Francisco Javier Alarcon-Aguilar ◽  
Mario Garcia-Lorenzana ◽  
Marco Aurelio Rodriguez-Monroy ◽  
Maria Margarita Canales-Martinez

Jatropha neopauciflora is an endemic species of Mexico. Its latex is used to treat wounds, scarring, oral infections, and loose teeth. To date, there are no studies that validate at a morphological level a wound-healing use in diabetes. The present research aimed to evaluate the wound-healing capacity of the latex of J. neopauciflora in the skin of healthy and streptozotocin-induced diabetic mice. Also, a chemical analysis of the latex through molecular exclusion chromatography and HPLC were performed. Male mice ( Mus musculus) of 7-week-old CD1 strain were used. Groups of healthy and diabetic mice were formed. A longitudinal cut of 1 cm was performed on the depilated skin. All treatments were topically applied to the wound area twice a day for ten days. At the end of the experiments, the skin sections were obtained from the wound area and stained with Hematoxylin-Eosin. Then we counted the number of active fibroblasts in all the experimental groups. In normal mice, the latex accelerated the wound-healing process and decreased the number of active fibroblasts, similarly to Recoveron. In diabetic mice, the latex and Recoveron increased the number of active fibroblasts. In normal and diabetic mice, a thin and orderly epidermis was observed. Molecular exclusion chromatography exhibited 58 fractions, 14 of which were subjected to HPLC, to detect catechin, a flavonoid with antioxidant, antimicrobial, and anti-inflammatory properties. J. neopauciflora latex can be useful for wound treatment in patients with diabetes mellitus because it accelerates and promotes the wound-healing process.


2021 ◽  
Vol 33 (2) ◽  
pp. 145
Author(s):  
Hendry Rusdy ◽  
Astri Suryani Pasaribu Saruksuk ◽  
Rahmi Syaflida Dalimunte ◽  
Gostry Aldica Dohude

Pendahuluan: Pencabutan gigi merupakan prosedur yang sering dilakukan di kedokteran gigi. Setelah pencabutan gigi akan dihasilkan suatu perlukaan. Proses penyembuhan luka dapat dipercepat pada kondisi tertentu. Salah satu bahan alami yang dapat membantu proses penyembuhan luka adalah getah tanaman betadine (Jatropha multifida L.). Penelitian bertujuan untuk menganalisis efektivitas getah tanaman betadine terhadap penyembuhan luka dan terhadap tanda-tanda infeksi pasca pencabutan gigi Metode: Desain penelitian studi eksperimental laboratorium dengan rancangan penelitian post-test only control group design menggunakan 30 ekor tikus Sprague-Dawley. Teknik pengambilan sampel yaitu convenience sampling. Sampel dibagi menjadi 2 kelompok yaitu kelompok perlakuan dan kelompok kontrol. Kelompok perlakuan diberikan getah tanaman betadine dan kelompok kontrol diberikan asam traneksamat secara oral menggunakan sonde lambung. Tunggu selama 4 jam setelah pemberian getah tanaman betadine dan asam traneksamat. Anestesi pada tikus menggunakan ketamin 50 mg/kg berat badan secara intramuskular kemudian dilakukan pencabutan pada gigi tikus. Pengamatan dilakukan dengan melihat kriteria klinis pada hari 1,3,7 dan diperhatikan sampai luka sembuh serta lihat tanda-tanda infeksi. Analisis data dilakukan dengan uji normalitasShapiro Wilik. Hasil penelitian menunjukkan bahwa data berdistribusi tidak normal. Analisis data dilanjutkan menggunakan uji statistik mann whitney. Hasil: Terdapat perbedaan signifikan penyembuhan luka soket pasca pencabutan gigi setelah diberikan getah betadine dan asam traneksamat dengan nilai p=0,037 (p<0,005). Simpulan: Pemberian getah tanaman betadine terbukti lebih efektif terhadap proses penyembuhan luka soket pasca pencabutan gigi dibandingkan dengan pemberian asam traneksamat. Kata kunci: tikus Sprague-Dawley; penyembuhan luka; pencabutan gigi; getah batang betadine ABSTRACTIntroduction: Tooth extraction is a procedure often performed in dentistry. Tooth extraction will always cause injuries. However, the wound healing process can be accelerated under certain conditions. One of the natural ingredients that can accelerate the wound healing process is betadine (Jatropha multifida L.) plant sap. The study was aimed to analyzed the effect of betadine plant sap on wound healing and signs of infection after tooth extraction. Methods: Experimental laboratory study design with post-test only control group design was conducted towards 30 Sprague-Dawley rats. The sampling technique was convenience sampling. The sample was divided into two groups, the treatment group and the control group. The treatment group was administered with betadine plant sap, and the control group was administered with tranexamic acid orally using a gastric probe, then waited 4 hours after. The anaesthesia was then performed using 50 mg/kg body weight of ketamine intramuscularly. The extraction was performed after. Observations was conducted at the clinical criteria on days 1, 3, and 7 and continue to be monitored until the wound heals. Then, the signs of infection were observed. Data analysis was carried out using the Shapiro Wilk normality test. The results showed that the data was not normally distributed. Thus, data analysis was continued using the Mann Whitney statistical test. Results: The results showed a significant difference in the healing of socket wounds after tooth extraction after being administered with betadine sap and tranexamic acid with a value of p=0.037 (p<0.005). Conclusions: Administration of betadine plant sap is proven to be more effective in accelerating the healing process of socket wounds after tooth extraction than tranexamic acid. Keywords: Sprague-Dawley rats; wound healing; pencabutan gigi; getah batang betadine 


2018 ◽  
Vol 10 (2) ◽  
pp. 146-151
Author(s):  
Nadya Putri Nabila

Diabetes mellitus (DM) is one of the most common chronic diseases experienced by the world population and ranks fourth cause of death in developing countries. Long-term complications of diabetes mellitus one of them is diabetic ulcer (15%) and is the most cause (85%) of amputation in patients with diabetes mellitus. Currently, more than 5,000 modern types of dressings are reported to be available to treat wounds, especially diabetic ulcers. To know the process of wound healing diabetic ulcer was done with the design of case study research with a sample of 2 people and this study was conducted for 4 weeks. The study was conducted at the Maitis Efrans Wound Care clinic in Bengkulu City. The result was obtained that the assessment of diabetic ulcer wounds before modern wound care on the respondents was a total score of 54 and the respondents two total score of 50 were stated wound regeneration. The healing process of the responder's second ulcers progressed, the total score of one respondent was 30 and the respondent two was 28. Respondents. Progress on the two respondents stated better influenced by wound healing factor that is, age factor.


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