Stress-Reducing Psychological Interventions as Adjuvant Therapies for Diabetic Chronic Wounds

2021 ◽  
Vol 17 ◽  
Author(s):  
Isadora Pombeiro ◽  
João Moura ◽  
Maria Graça Pereira ◽  
Eugénia Carvalho
Keyword(s):  
Wound Healing ◽  
Psychological Stress ◽  
Stress Reduction ◽  
Chronic Wounds ◽  
Major Complication ◽  
Limb Amputation ◽  
Adrenaline Release ◽  
New Applications ◽  
Improve Wound Healing

Background: Diabetic foot ulcers (DFUs) are a major complication of diabetes mellitus and a leading cause of lower limb amputation. Interventions to reduce psychological stress may have the potential to improve self-care and greatly reduce the morbidity and mortality associated with DFU. This review is focused on the consequences of psychological stress in wound healing and reflects on the effects of currently used psychological stress-reducing interventions in patients with DFU, proposing new applications for currently used stress-reduction interventions. Results: Stress is a natural and fundamental survival mechanism that becomes harmful when chronic. DFU is associated with high levels of anxiety and chronic psychological stress. Chronic stress induced cortisol and adrenaline release impairs wound healing, independently of the stressor. Psychological stress-reducing interventions, such as relaxation with guided imagery, biofeedback-assisted relaxation, mindfulness-based strategies, and hypnosis can lead to a reduction in perceived stress and improve wound healing, by reducing wound inflammation and pain, while improving glycemic control. All stress reduction interventions also lead to pain relief and improved patient’s quality of life.

A comparative study of phenytoin dressing versus honey dressing in the treatment of cronic ulcers in tertiary care hospital

2021 ◽  
Vol 19 (1) ◽  
pp. 05-09
Author(s):  
Sandesh M ◽  
Keyword(s):  
Wound Healing ◽  
Granulation Tissue ◽  
Chronic Wounds ◽  
Tertiary Care ◽  
Skin Grafting ◽  
Care Hospital ◽  
Tissue Formation ◽  
Granulation Tissue Formation ◽  
Diabetic Ulcers

Background: Diabetic foot infections are the leading cause of hospitalization morbidity and mortality in diabetics worldwide In India it accounts for 20% of hospitalizations. honey has been investigated to treat ulcers like pressure ulcers, venous ulcers, diabetic ulcers, traumatic wounds and burns. Phenytoin is also now known to promote wound healing and can be an alternative to normal saline specifically in chronic wounds related to diabetes. The present study compares these two modalities in management of diabetic ulcers. Objective: To compare the efficacy of topical phenytoin vs topical honey in chronic diabetic ulcers in terms of rate of wound healing, granulation tissue formation and quality of graft bed for skin grafting. Methods: A comparative prospective study of 50 patients with chronic diabetic ulcers selected based on a predefined criteria divided into two groups: Group A (Phenytoin group) (n=25) and Group B (honey group) (n=25). Final wound area was measured on 30th day. Comparison between the wound size reduction among two groups done at end of 30th day. Outcome was measured in terms of wound reduction, granulation tissue formation and quality of bed for skin grafting between the two groups. Results: This study has shown faster rate of wound healing, better granulation tissue formation and quality graft bed for skin grafting in patients who received topical phenytoin dressing as compared to topical honey dressing.

scholarly journals Keratinocyte and Fibroblast Wound Healing In Vitro Is Repressed by Non-Optimal Conditions but the Reparative Potential Can Be Improved by Water-Filtered Infrared A

Biomedicines ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1802
Author(s):  
Cornelia Wiegand ◽  
Uta-Christina Hipler ◽  
Peter Elsner ◽  
Jörg Tittelbach
Keyword(s):  
Gene Expression ◽  
Wound Healing ◽  
Inflammatory Response ◽  
Chronic Wounds ◽  
Cytokine Gene Expression ◽  
Optimal Conditions ◽  
Inflammatory Conditions ◽  
Anti Inflammatory ◽  
Improve Wound Healing

It is a general goal to improve wound healing, especially of chronic wounds. As light therapy has gained increasing attention, the positive influence on healing progression of water-filtered infrared A (wIRA), a special form of thermal radiation, has been investigated and compared to the detrimental effects of UV-B irradiation on wound closure in vitro. Models of keratinocyte and fibroblast scratches help to elucidate effects on epithelial and dermal healing. This study further used the simulation of non-optimal settings such as S. aureus infection, chronic inflammation, and anti-inflammatory conditions to determine how these affect scratch wound progression and whether wIRA treatment can improve healing. Gene expression analysis for cytokines (IL1A, IL6, CXCL8), growth (TGFB1, PDGFC) and transcription factors (NFKB1, TP53), heat shock proteins (HSP90AA1, HSPA1A, HSPD1), keratinocyte desmogleins (DSG1, DSG3), and fibroblast collagen (COL1A1, COL3A1) was performed. Keratinocyte and fibroblast wound healing under non-optimal conditions was found to be distinctly reduced in vitro. wIRA treatment could counteract the inflammatory response in infected keratinocytes as well as under chronic inflammatory conditions by decreasing pro-inflammatory cytokine gene expression and improve wound healing. In contrast, in the anti-inflammatory setting, wIRA radiation could re-initiate the acute inflammatory response necessary after injury to stimulate the regenerative processes and advance scratch closure.

scholarly journals An Overview of Cutaneous Wounds and the Beneficial Roles of Medicinal Plants in Promoting Wound Healing

2021 ◽  
Author(s):  
Nura Muhammad Umar ◽  
Thaigarajan Parumasivam ◽  
Seok-Ming Toh
Keyword(s):  
Wound Healing ◽  
Medicinal Plants ◽  
Molecular Mechanisms ◽  
Chronic Wounds ◽  
Therapeutic Agents ◽  
Biologically Active ◽  
Cutaneous Wounds ◽  
Active Substances ◽  
Significant Attention

It is undeniable that many patients worldwide suffer from various types of wounds, especially from chronic wounds. The complex and intricate process of wound healing has a severe impact on the patient's quality of life as well as causing an economic burden on healthcare institutions. Although various new therapies have become available for treating patients with acute and chronic wounds for the past decade, the available therapies are often expensive or accompanied by undesirable side effects. Hence, the discovery of a new arsenal for wound healing remains a hot topic of research. Recently, plants or herbs and their derivatives have garnered significant attention as a source of therapeutic agents to treat wounds. This is because plants provide a rich reservoir of phytochemicals that could potentially become effective and affordable therapeutic agents. Thus, the present review attempted to outline wound healing mechanisms and analysed some renowned medicinal plants with potential wound healing properties from the existing literature from various electronic databases. This review also sheds light on the plant's underlying molecular mechanisms and, wherever available, acknowledges the biologically active substances found in these plants.

scholarly journals Complement Activation and Inhibition in Wound Healing

2012 ◽  
Vol 2012 ◽  
pp. 1-14 ◽  
Author(s):  
Gwendolyn Cazander ◽  
Gerrolt N. Jukema ◽  
Peter H. Nibbering
Keyword(s):  
Wound Healing ◽  
Cell Death ◽  
Complement Activation ◽  
Chronic Wounds ◽  
Tissue Injury ◽  
Wound Care ◽  
Impaired Wound Healing ◽  
Complement Inhibitors ◽  
Improve Wound Healing ◽  
Specific Inhibitors

Complement activation is needed to restore tissue injury; however, inappropriate activation of complement, as seen in chronic wounds can cause cell death and enhance inflammation, thus contributing to further injury and impaired wound healing. Therefore, attenuation of complement activation by specific inhibitors is considered as an innovative wound care strategy. Currently, the effects of several complement inhibitors, for example, the C3 inhibitor compstatin and several C1 and C5 inhibitors, are under investigation in patients with complement-mediated diseases. Although (pre)clinical research into the effects of these complement inhibitors on wound healing is limited, available data indicate that reduction of complement activation can improve wound healing. Moreover, medicine may take advantage of safe and effective agents that are produced by various microorganisms, symbionts, for example, medicinal maggots, and plants to attenuate complement activation. To conclude, for the development of new wound care strategies, (pre)clinical studies into the roles of complement and the effects of application of complement inhibitors in wound healing are required.

scholarly journals Wound dressings: curbing inflammation in chronic wound healing

2021 ◽  
Author(s):  
Davide Vincenzo Verdolino ◽  
Helen A. Thomason ◽  
Andrea Fotticchia ◽  
Sarah Cartmell
Keyword(s):  
Wound Healing ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Wound Care ◽  
Healing Process ◽  
Standard Of Care ◽  
The Elderly ◽  
Wound Dressings ◽  
Wound Healing Process

Chronic wounds represent an economic burden to healthcare systems worldwide and a societal burden to patients, deeply impacting their quality of life. The incidence of recalcitrant wounds has been steadily increasing since the population more susceptible, the elderly and diabetic, are rapidly growing. Chronic wounds are characterised by a delayed wound healing process that takes longer to heal under standard of care than acute (i.e. healthy) wounds. Two of the most common problems associated with chronic wounds are inflammation and infection, with the latter usually exacerbating the former. With this in mind, researchers and wound care companies have developed and marketed a wide variety of wound dressings presenting different compositions but all aimed at promoting healing. This makes it harder for physicians to choose the correct therapy, especially given a lack of public quantitative data to support the manufacturers’ claims. This review aims at giving a brief introduction to the clinical need for chronic wound dressings, focusing on inflammation and evaluating how bio-derived and synthetic dressings may control excess inflammation and promote healing.

Changes of wound dimensions and pain assessment in response to hyperbaric oxygenation therapy

2018 ◽  
Vol 86 (4) ◽  
pp. 259
Author(s):  
Emilia Mikołajewska ◽  
Sławomir Wawrzyniak ◽  
Piotr Dzięgielewski ◽  
Aleksander Goch
Keyword(s):  
Wound Healing ◽  
Pain Assessment ◽  
Hyperbaric Oxygenation ◽  
Chronic Wounds ◽  
Healing Process ◽  
Adult Patients ◽  
Wound Healing Process ◽  
Before And After ◽  
Wound Length

Introduction. Novel approaches to wound healing can provide decreased risk of complications, wider possibilities of further treatment, rehabilitation and care, and improved patient’s quality of life. Most recent studies support the concept that HBOT accelerates the wound healing process. Aim. This paper aims at presentation and discussion the outcomes of a research on chronic wounds healing using the HBOT. Particular attention was paid to changes of wound dimensions and pain assessment in response to HBOT.Material and Methods. Inclusion criteria meet the medical records of eighty‑nine adult patients with chronic wounds aged 18–85 years treated with HBOT. Wound length, wound width and pain were measured twice: before and after treatment.Results. There have been observed favourable and statistically significant changes in all measured areas: pain assessment, wound length, and wound width. Improvement of pain assessment occured in 94.38% of patients, improvement of maximal wound length occurred in 94.38% of patients, improvement of maximal wound width occurred in 86.52% of patients.Conclusions. Application HBOT in adult patients with chronic wound is an effective method of treatment. Age above 62 years, sex (men), lack of obesity, and number of HBOT sessions higher than 29 can be regarded as useful prognostic signs, however there is need for further research.

scholarly journals Inflammation and neuropeptides: the connection in diabetic wound healing

2009 ◽  
Vol 11 ◽  
Author(s):  
Leena Pradhan ◽  
Christoph Nabzdyk ◽  
Nicholas D. Andersen ◽  
Frank W. LoGerfo ◽  
Aristidis Veves
Keyword(s):  
Wound Healing ◽  
Wound Repair ◽  
Major Complication ◽  
Limb Amputation ◽  
Diabetic Patients ◽  
Diabetic Wound ◽  
Molecular Events ◽  
Diabetic Wound Healing

Abnormal wound healing is a major complication of both type 1 and type 2 diabetes, with nonhealing foot ulcerations leading in the worst cases to lower-limb amputation. Wound healing requires the integration of complex cellular and molecular events in successive phases of inflammation, cell proliferation, cell migration, angiogenesis and re-epithelialisation. A link between wound healing and the nervous system is clinically apparent as peripheral neuropathy is reported in 30–50% of diabetic patients and is the most common and sensitive predictor of foot ulceration. Indeed, a bidirectional connection between the nervous and the immune systems and its role in wound repair has emerged as one of the focal features of the wound-healing dogma. This review provides a broad overview of the mediators of this connection, which include neuropeptides and cytokines released from nerve fibres, immune cells and cutaneous cells. In-depth understanding of the signalling pathways in the neuroimmune axis in diabetic wound healing is vital to the development of successful wound-healing therapies.

scholarly journals Reviewing the Physiology of Cutaneous Wound Healing and Evaluating the Effect of Exercise on it: A Narrative Review Article

2021 ◽  
Vol 19 (3) ◽  
Author(s):  
Fatima Riyahi ◽  
Simin Riahy ◽  
Mitra Yousefpour
Keyword(s):  
Wound Healing ◽  
Chronic Wounds ◽  
Herbal Medicines ◽  
The Body ◽  
Cutaneous Wound Healing ◽  
Skin Damage ◽  
Cutaneous Wound ◽  
Inflammatory Phase ◽  
Anti Inflammatory

Context: The skin is the most important organ of the body, and maintaining its integrity is important for health. Severe skin damage is life-threatening, and wound healing restores its integrity. One of the main health problems is impaired cutaneous wound healing. According to the importance of wound healing and the fact that unrepaired skin decreases the quality of life, many studies have investigated the effect of some natural and chemical substances on the length and quality of wound healing to find beneficial interventions for rapid and economical treatment. Objectives: This review was conducted to describe the physiology of cutaneous wound healing and some positive and negative factors affecting it with a focus on exercise. Methods: An electronic search without any time limitation was performed on the PubMed, Google Scholar, and Web of Science databases. The keywords were ‘wound’, ‘healing’, and ‘exercise’. Finally, according to the similarities or differences between the results and the relationship with the subject, 53 papers were selected and reviewed. Results: Wound healing is a complex physiological process with four overlapping processes. It seems that disturbance in the inflammatory phase of wound healing is the main factor in the impairment of healing. Traditionally, many chemical and herbal medicines and compounds have been used to speed up wound recovery due to their anti-inflammatory and antioxidative properties. Many studies have evaluated the effect of exercise, as complementary medicine, on wound healing, and they have examined the effect of different protocols of exercise on the speed of wound healing. According to the results of these studies, aerobic exercise, due to its anti-inflammatory and antioxidative effects, is a beneficial method in shortening the length of healing, especially in aged, obese, and diabetic individuals. Conclusions: Exercise as a low-cost intervention is a good strategy in the treatment of impaired and chronic wounds.

A Comprehensive Review of Wound Healing

2017 ◽  
Author(s):  
Raman Mehrzad ◽  
Paul Y Liu
Keyword(s):  
Wound Healing ◽  
Chronic Wounds ◽  
Wound Care ◽  
Rheumatologic Diseases ◽  
Current State ◽  
Vascular Insufficiency ◽  
Socioeconomic Burden ◽  
Medical Disciplines ◽  
Therapeutic Art

Unhealed wounds are a largely hidden epidemic, affecting 6.5 million Americans and costing about $25 billion a year, with numerous patients affected. Unhealed wounds result in lower quality of life and limit many all-day activities for patients. Despite this large socioeconomic burden, there have been only a few meaningful advances in the science of wound care. Wounds represent a cross section of many medical disciplines—diabetes, trauma, hypertension, vascular insufficiency, and rheumatologic diseases—and a multidisciplinary approach is typically needed. In this review, we provide an overview of wound healing, its pathophysiology, different types of wounds, and the current state of therapeutic art.   Key words: chronic wounds, infection, inflammation, mathematical modeling, ulcers, wounds

scholarly journals Assessment of wound area reduction on chronic wounds in dogs with photobiomodulation therapy: A randomized controlled clinical trial

2021 ◽  
pp. 2251-2259
Author(s):  
Somphong Hoisang ◽  
Naruepon Kampa ◽  
Suvaluk Seesupa ◽  
Supranee Jitpean
Keyword(s):  
Wound Healing ◽  
Adjunctive Therapy ◽  
Chronic Wounds ◽  
Photobiomodulation Therapy ◽  
Wound Area ◽  
Area Reduction ◽  
Wound Size ◽  
Significant Difference ◽  
L1 And L2 ◽  
Improve Wound Healing

Background and Aim: Chronic wounds are a clinical problem and require intensive standard wound care. However, this is sometimes insufficient to promote healing. Photobiomodulation therapy (PBMT) can be used as an adjunctive therapy to improve wound healing. Various PBMT devices with different properties and parameter settings as well as different animal species can influence a variety of clinical outcomes. This study aims to assess the use of 830 nm PBMT or simultaneous superpulsed and multiple wavelengths (SPMW; 660, 875, and 905 nm) PBMT on chronic wounds in client-owned dogs. Materials and Methods: This study included 21 client-owned dogs with chronic wounds allocated into three groups: (1) Control group (C) treated with irrigated saline and without PBMT (n=7); (2) L1 group treated with irrigated saline together with the radiation of 830 nm PBMT (n=7); and (3) L2 group treated with irrigated saline together with the radiation of simultaneous SPMW-PBMT (n=7). Wound healing was assessed on the basis of wound size reduction as a percentage of wound area every 2nd day for 15 days using image analysis software (ImageJ software®, National Institutes of Health, Rockville, Maryland, USA). Results: A significant difference in the percentage of wound area reduction was noted between the C and PBMT groups (L1 and L2; p<0.05). The average percentages of wound area reduction at the end of the study (15 days) were 42.39±20.58, 56.98±24.82, and 61.81±27.18 in the C, L1, and L2 groups, respectively. A steady decrease in wound size was noted in both PBMT and non-PBMT groups, and coefficients were 7.77, 8.95, and 10.01 in the C, L1, and L2 groups, respectively. The percentage of wound area reduction was found to be significantly different between the PBMT and non-BPMT groups on day 7 (p<0.05). Conclusion: Based on the results of the current study, using either 830 nm PBMT or simultaneous SPMW-PBMT can accelerate the chronic wound healing process in dogs with a significant reduction in wound area. Therefore, it can be used as an adjunctive therapy to improve wound healing in dogs with reduced treatment duration.

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