scholarly journals The Topical Effect of rhGDF-5 Embedded in a Collagen–Gelatin Scaffold for Accelerated Wound Healing

2022 ◽  
Vol 12 (2) ◽  
pp. 867
Author(s):  
Wiebke Eisler ◽  
Manuel Held ◽  
Afshin Rahmanian-Schwarz ◽  
Jennifer Schiefer ◽  
Shahab Rahmanian ◽  
...  
Keyword(s):  
Wound Healing ◽  
Collagen Scaffold ◽  
Human Growth ◽  
Collagen Matrix ◽  
Wound Dressings ◽  
High Dose ◽  
Thickness Skin ◽  
Composite Product ◽  
Exogenous Growth Factors ◽  
Complex Wounds

The application of exogenous growth factors such as the recombinant human growth and differentiation factor 5 (rhGDF-5) represents a major research topic with great potential for the treatment of complex wounds. In a randomized, controlled minipig study, the topical effect of rhGDF-5 on full-thickness skin defects was evaluated. A total of 60 deep dermal wounds were either treated with rhGDF-5 embedded in an innovative collagen scaffold or another commonly used collagen matrix or left untreated. Wound healing was analyzed by planimetric analysis to determine wound closure over time. After 21 days, the areas of the initial wounds were excised, and the newly formed tissue was examined histologically. In comparison to untreated wounds, all examined matrices accelerated dermal wound healing. The largest acceleration of wound healing was seen with the high-dose rhGDF-5-treated wounds, which, compared to the untreated wounds, accelerated wound healing by 2.58 days, improved the neoepidermal thickness by 32.40 µm, and increased the epidermal cell density by 44.88 cells. The innovative collagen scaffold delivered rhGDF-5 adequately, served as a template to guide proliferating and restructuring cells, and accelerated wound healing. Thus, this composite product offers a novel tool for developing effective wound dressings in regenerative medicine.

scholarly journals Effects of Caffeine Consumption on Autologous Full-Thickness Skin Graft Healing in an Animal Model

2021 ◽  
Author(s):  
Tommy Supit ◽  
Neni Susilaningsih ◽  
Awal Prasetyo ◽  
Keyword(s):  
Wound Healing ◽  
Skin Graft ◽  
Collagen Synthesis ◽  
High Dose ◽  
Full Thickness ◽  
Caffeine Consumption ◽  
Full Thickness Skin Graft ◽  
Full Thickness Skin ◽  
Thickness Skin ◽  
Medium Dose

Abstract Background There exists contradictory evidence that states both the beneficial and deleterious effects of caffeine on wound healing. The general population might unknowingly consume caffeine that negatively affects wound healing. The main objective of this study is to investigate the effect of daily caffeine consumption on wound healing, specifically full-thickness skin graft (FTSG). Methods Forty Sprague-Dawley rats were randomized into four groups of equal size: control-dose (CD), low-dose (LD), medium-dose (MD), and high-dose (HD) caffeine groups. After autologous FTSG, all subjects in the intervention group were given daily pure caffeine gavage. The FTSG was explanted 7 days posttransplant. The graft viability, secondary contraction, and adherence were evaluated macroscopically, while fibroblast and collagen deposition was analyzed microscopically with hematoxylin eosin stain. Results The least graft viability (72.8 ± 20.7%, clinical wound assessment scale [CWAS] 2.4), highest secondary contraction (11.4 ± 10.5%), and fibroblast count (331.8 ± 88.6 cells/5 high power fields) were observed in the MD group. More collagen synthesis was observed in subjects who consumed caffeine. The level of secondary contraction, fibroblast count as well as graft viability and collagen synthesis were positively correlated. Conclusions Daily consumption of caffeine impairs graft viability when given in medium dose and increases collagen synthesis, irrespective of dosage. This study was in experimental rats; the results are not directly translatable to humans.

533 Evaluation of growth hormone use in patients with large burns and complex wounds

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S114-S115
Author(s):  
Rita Gayed ◽  
Lindsey Lindsey ◽  
Rohit Mittal ◽  
Juvonda Hodge ◽  
Walter L Ingram
Keyword(s):  
Growth Hormone ◽  
Wound Healing ◽  
Adverse Events ◽  
Human Growth Hormone ◽  
Human Growth ◽  
Burn Patients ◽  
Adequate Nutrition ◽  
Therapy Cost ◽  
Hormone Use ◽  
Complex Wounds

Abstract Introduction Large burn injuries lead to an extensive and prolonged catabolic state that results in loss of body mass and impaired wound healing. To combat this hypermetabolic response, different strategies have been employed including early excision and grafting, infection control, early nutrition and anabolic therapies such as oxandrolone. Human growth hormone is of interest for burn patients because of its anabolic properties. While its use has been associated with worse outcomes in the critically ill adult with sepsis, it has shown improved outcomes when used in pediatric burn patients. The purpose of this study was to retrospectively evaluate the appropriateness of human growth hormone use, its adverse events and cost in patients with large burns or complex wounds and poor wound healing. Methods This was an IRB approved, retrospective, single center chart review from 2011 to 2019 assessing human growth hormone prescribing patterns in the burn unit. The primary objective was appropriateness of use, defined as documentation of poor wound healing prior to initiation despite adequate nutrition delivery and use of standard anabolic therapies (i.e. oxandrolone). Secondary objectives included perceived benefit, adverse events and median therapy cost per patient of human growth hormone. Results Thirty-eight patients were included in the study, 79% of which were adults, with a median total body surface area involvement of 50% (IQR 40 to 71). Only forty-one per cent of patients receiving human growth hormone met our predefined criteria for appropriateness; this was primarily driven by poor documentation of wound healing. However, 80% of patients were receiving adequate nutrition and oxandrolone, indicating appropriate clinical use. Most adult patients received a dose of 20mg daily, while pediatrics received the weight based 0.2mg/kg daily dose. The median duration of treatment was 24 days (IQR 13–35) and median time from admission to growth hormone initiation was 27 days (IQR 12–34). Overall clinical improvement was noted in 53% of patients, as evident by increased weight, prealbumin and/or documentation of improved wound healing. The most common adverse effect noted was hyperglycemia, followed by new sepsis onset. The median therapy cost per patient was $42,000. Conclusions Human growth hormone may serve as a salvage therapy for large burns with poorly healing wounds. Prior to initiating therapy, nutrition must be optimized and standard, more researched anabolic therapies should be started. While receiving therapy, patients should be monitored for both hyperglycemia and the development of new sepsis.

Fabrication of sliver nanoparticles/polyvinyl alcohol/gelatin ternary nanofiber mats for wound healing application

2020 ◽  
Vol 35 (2) ◽  
pp. 287-298
Author(s):  
Somaya Amer ◽  
Noha Attia ◽  
Samir Nouh ◽  
Mahmoud El-Kammar ◽  
Ahmed Korittum ◽  
...  
Keyword(s):  
Wound Healing ◽  
Polyvinyl Alcohol ◽  
Wound Dressings ◽  
Full Thickness ◽  
Microbial Invasion ◽  
Thickness Skin ◽  
Nanofiber Mats ◽  
Full Thickness Wound

Purpose In this study, we aimed to determine the regenerative and antimicrobial impact of the electrospun nanofiber mats, with/without silver nanoparticles (AgNPs), on full-thickness skin wounds in rabbits. Methods Polyvinyl alcohol was combined with gelatin to provide biocompatible electrospun binary nanofiber mats. AgNPs were added to the polyvinyl alcohol/gelatin mixture to obtain ternary nanofiber-AgNPs mats. Binary and ternary nanofiber mats were characterized by scanning electron microscopy before being applied as wound dressings in vivo. Subsequently, wound healing was evaluated. Results Both nanofiber/nanofiber-AgNPs mats improved the microscopic quality of the healed skin, albeit without obvious acceleration of the healing rate. As well, both types of nanofiber mats were able to combat microbial invasion into the wound bed. Conclusions Both binary polyvinyl alcohol/gelatin and ternary polyvinyl alcohol/gelatin/AgNPs nanofiber mats developed in the present study depicted similar regenerative and antimicrobial potential when applied as full-thickness wound dressing. However, in comparison to the binary nanofiber mats, no obvious synergistic effect was observed after loading nanofibers with AgNPs.

scholarly journals Injectable and Antioxidative HT/QGA Hydrogel for Potential Application in Wound Healing

Gels ◽  
2021 ◽  
Vol 7 (4) ◽  
pp. 204
Author(s):  
Yikun Ren ◽  
Dan Zhang ◽  
Yuanmeng He ◽  
Rong Chang ◽  
Shen Guo ◽  
...  
Keyword(s):  
Wound Healing ◽  
Potential Application ◽  
Healing Process ◽  
Antioxidant Properties ◽  
High Water ◽  
Wound Dressings ◽  
High Water Content ◽  
Wound Healing Process ◽  
Thickness Skin ◽  
Chitosan Hydrogels

Hydrogels have gained a niche in the market as wound dressings due to their high water content and plasticity. However, traditional hydrogel wound dressings are difficult to fully adapt to irregular-shaped wound areas. Additionally, excessive reactive oxygen species (ROS) accumulated in the damaged area impede the wound healing process. Therefore, hydrogels with injectable and antioxidant properties offer promising qualities for wound healing, but their design and development remain challenges. In this study, HT/QGA (tyramine-grafted hyaluronic acid/gallic acid-grafted quaternized chitosan) hydrogels with injectable and antioxidant properties were prepared and characterized. This hydrogel exhibited excellent injectability, favorable antioxidant activity, and good biocompatibility. Moreover, we evaluated the therapeutic effect of HT/QGA hydrogel in a full-thickness skin injury model. These results suggested that HT/QGA hydrogel may offer a great potential application in wound healing.

515 Evaluation of growth hormone use in patients with large burns and complex wounds

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S104-S105
Author(s):  
Rita Gayed ◽  
Lindsey Lindsey ◽  
Rohit Mittal ◽  
Juvonda Hodge ◽  
Walter L Ingram
Keyword(s):  
Growth Hormone ◽  
Wound Healing ◽  
Adverse Events ◽  
Human Growth Hormone ◽  
Human Growth ◽  
Burn Patients ◽  
Adequate Nutrition ◽  
Therapy Cost ◽  
Hormone Use ◽  
Complex Wounds

Abstract Introduction Large burn injuries lead to an extensive and prolonged catabolic state that results in loss of body mass and impaired wound healing. To combat this hypermetabolic response, different strategies have been employed including early excision and grafting, infection control, early nutrition and anabolic therapies such as oxandrolone. Human growth hormone is of interest for burn patients because of its anabolic properties. While its use has been associated with worse outcomes in the critically ill adult with sepsis, it has shown improved outcomes when used in pediatric burn patients. The purpose of this study was to retrospectively evaluate the appropriateness of human growth hormone use, its adverse events and cost in patients with large burns or complex wounds and poor wound healing. Methods This was an IRB approved, retrospective, single center chart review from 2011 to 2019 assessing human growth hormone prescribing patterns in the burn unit. The primary objective was appropriateness of use, defined as documentation of poor wound healing prior to initiation despite adequate nutrition delivery and use of standard anabolic therapies (i.e., oxandrolone). Secondary objectives included perceived benefit, adverse events and median therapy cost per patient of human growth hormone. Results Thirty-eight patients were included in the study, 79% of which were adults, with a median total body surface area involvement of 50% (IQR 40 to 71). Only forty-one per cent of patients receiving human growth hormone met our predefined criteria for appropriateness; this was primarily driven by poor documentation of wound healing. However, 80% of patients were receiving adequate nutrition and oxandrolone, indicating appropriate clinical use. Most adult patients received a dose of 20mg daily, while pediatrics received the weight based 0.2mg/kg daily dose. The median duration of treatment was 24 days (IQR 13–35) and median time from admission to growth hormone initiation was 27 days (IQR 12–34). Overall clinical improvement was noted in 53% of patients, as evident by increased weight, prealbumin and/or documentation of improved wound healing. The most common adverse effect noted was hyperglycemia, followed by new sepsis onset. The median therapy cost per patient was $42,000. Conclusions Human growth hormone may serve as a salvage therapy for large burns with poorly healing wounds. Prior to initiating therapy, nutrition must be optimized and standard, more researched anabolic therapies should be started. While receiving therapy, patients should be monitored for both hyperglycemia and the development of new sepsis.

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