DECISION TREES FOR SEGMENTATION AND ASSESSMENT OF WOUND HEALING PROCESS OF DIABETIC PATIENTS

2019 ◽  
Vol 31 (04) ◽  
pp. 1950029
Author(s):  
K. S. Babu ◽  
Sukanta Sabut ◽  
Y. B. Ravi Kumar

Wound healing is a slow process in diabetic patients due to levels of insulin variations in the body. Thus, we present an automated system to analyze and assess different stages of wound healing process of diabetic patients. The diabetic wound healing stages have been defined into three types, such as the level of tissues present in the wound: The percentage of granulations tissues, Necrotic tissues and Slough tissues present in the diabetic patients. The performance of the proposed method shall be assessed based on the clear accuracy of segmentation of wound region present in the patient body. The Decision Tree-based Segmentation method has yielded a good segmentation accuracy of 98.32% in comparison with the ground truth results of clinical data. Further, the assessment of wound healing stages of proposed method has given a good accuracy of measuring the stages of diabetic patients by measuring the percentage of different types of tissues present in the wound region. Based on the results of classification accuracy of the proposed method, we assess whether the wound is going to heal quickly or not. Thus, we presented an algorithm of Decision Trees for the purpose of segmentation and assessment of wound healing process of diabetic patients.

Author(s):  
Swathi Balaji ◽  
Abdul Q. Sheikh ◽  
Lee Morris ◽  
Foong Y. Lim ◽  
Timothy M. Crombleholme ◽  
...  

Chronic ulcers are a leading cause of morbidity in diabetic patients. Diabetes is associated with major changes in the wound microenvironment and disruption of normal wound healing process, characterized by a prolonged inflammatory phase with elevated levels of wound proteases and increased degradation of extracellular matrix (ECM) components [1]. This impedes wound healing due to a lack of provisional matrix, impaired recruitment and survival of endothelial (EC) and endothelial precursor (EPC) cells, and insufficient neovascularization, resulting in delayed healing. Therefore, strategies focused on restoring the diabetic wound microenvironment by decreasing ECM degradation and promoting neovascularization are promising for development of new therapies to treat chronic diabetic ulcers.


2020 ◽  
Vol 10 (1) ◽  
pp. 37-45 ◽  
Author(s):  
Ran Wei ◽  
Shijun Nie ◽  
Jing Ma ◽  
Changmei Feng ◽  
Hongyu Kuang

Diabetic wound ulcers and unhealed ulcerations have caused in severe difficulties of diabetic patients all around the world. The anti-microbial peptides (AMP) and nanomaterials have been demonstrated beneficial in diabetic wound healing studies. Diabetic wound healing process can be delayed significantly due to the infection issues. Hence in this report, biologically synthesized cerium oxide (CeO2) nanoparticles incorporated with reduced graphene oxide (RGO) and AMP for effective and rapid diabetic wound healing have been reported. At first, reduced graphene oxide was prepared from graphene oxide to prepare CeO2/RGO nanocomposites. Biocompatible AMP (IP-1) functionalized CeO2/RGO nanocomposites were accordingly prepared to study the diabetic wound healing process. Rats, the wound healing models with the wound size of about 1.5 cm2 were tested with the as-prepared samples. Further, the prepared samples were tested in a wound healing model of rate with the wound of size 1.5 cm2. Almost complete recovery of wounds i.e., 100% closure of wound area was observed after 2 weeks of treatment by the prepared samples. Biocompatible AMP (IP-1) functionalized CeO2/RGO nanocomposites enhances rapid keratinocytes proliferation by short time thereby it proves the enhanced ability of the prepared samples to act as a wound healing in-vivo drugs. HE and MTC staining protocols to illustrate histological observations elucidates the keratinocytes creation by biocompatible AMP (IP-1) functionalized CeO2/RGO nanocomposites.


Author(s):  
Manoj Kumar ◽  
Amareshappa . ◽  
Anjali Bharadwaj ◽  
Shailaja S. V.

Wound healing has been the burning problem in a surgical practice because of a remarkable increase in the number of traumatic cases. A wound causes a number of changes in the body that can affect the healing process, including changes in energy, protein, carbohydrate, fat, vitamin and mineral metabolism. Various Ayurveda literatures, particularly, Sushruta Samhita, which is said to be an ancient textbook of surgery in Ayurveda, has mentioned about the diet for the person suffering from the wound, and the author said that diet plays a very important role in the wound healing process. Sushruta - The father of surgery has scientifically classified it in a systemic manner, whose wealth of clinical material and the principles of management are valid even today. Shalya Tantra (surgical branch in Ayurveda Science) is one of the important branch of Ayurveda, in which surgical and para-surgical techniques has described for management of various diseases. Vrana is the most important and widely described chapter of Shalya Tantra. Vrana (wound) is one of them, which have been managed by human being from starting of civilization. Under the circumstances, the first thing which the men came across was the injury from different sources which caused him the Vrana. Vrana is seen as debilitating and scaring disorder, usually seen affecting the human being at any age. Well balanced nutrition plays an essential role in the wound healing.


Author(s):  
Mahender K ◽  
Ravi D ◽  
Chaitanya Kumar K ◽  
Mothilal K

Wounds are nothing but any damage to the tissue or skin that can be healed. The wound healing process is usually built in the human body to self heal many wounds. When there is an injury in the body, there is an inflammatory response that is generated in the body, and the cells begin to raise the collagen levels in the skin which enables to increase the healing process. Ficus species of plants are famous for their potency to treat diseases in various Indian systems of medicine and the tree is commonly called as a banyan. Especially the plant in the species benghalensis is used to treat rheumatism, wounds and other skin related problems like an ulcer. The herbal gels were prepared using the incorporation of the aqueous extracts of the plant Ficus benghalensis into carbopol gel. They were investigated for the wound healing potential compared to the betadine drug standard. The gels at a concentration 200mg/g of the gel showed better activity compared to the gel at 100mg/g and the standard drug, betadine.


2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Rachmi Fanani Hakim ◽  
Fakhrurrazi ◽  
Dinni

Wound healing entails a sequence of complex biological processes, which is a protective function of the body that focuses on a quick recovery. Reducing wound healing time is crucial in a wound as it lowers the chance of infection and decreases complications and costs. Papaya extract was obtained by a maceration method. It contains papain enzyme, flavonoid, saponin, and alkaloid, which act as an anti-inflammatory, astringent substance, vasodilator, antioxidant, analgesic, with antifungal, and antibacterial properties, and increase the collagen synthesis. This study aimed to assess the effect of Carica papaya extract application toward incised wound healing process in mice (Mus musculus) clinically and histologically. This experimental laboratory study was performed using 24 mice weighing between 30 and 40 grams and 12 and 14 weeks of age as experimental animals. Each group was incised along 5 mm at the labial gingiva under both of mandible anterior teeth with a depth reaching alveolar bone. Papaya extract was applied topically in the morning and evening for 14 days. The clinical result was obtained by assessing the length of wound closure measured every day for 14 days. Based on the statistic test result, it showed that the papaya extract has a significant effect (p≤0.05) toward the healing process of an incised oral wound in mice. Histologically at day 14, 75% concentration papaya extract showed perfect epithelial layer and fibrillation.


2021 ◽  
Vol 5 (3) ◽  
pp. 095-104
Author(s):  
IM Cardoso-Daodu ◽  
CP Azubuike ◽  
MO Ilomuanya

Chronic wounds occur when one wound healing process or a sequence of wound healing events are affected resulting in slow healing of the wound thereby placing the patient in deep pain. Various diseases and conditions can delay the process of wound healing. Wound healing can be classified into four main stages: hemostasis, inflammation, remodeling, and scar tissue formation with each phase overlapping one another. The skin is the largest organ in the body. It protects the entire external surface of the human body and is the primary site of interaction with the outside environment. There is therefore a need to fabricate an ideal dressing through scientific research and investigations. Hydrogels are a three-dimensional network of hydrophilic polymers that can swell in water and absorb copious amounts of water while maintaining their structure because of their chemical or physical crosslinking of individual polymer chains. A hydrogel must be composed of at least 10% water. Hydrogels possess the flexibility and water percentage which is remarkably like tissues. They are biocompatible and biodegradable which makes them ideal for dermal wound healing.


2020 ◽  
Vol 5 (01) ◽  
pp. 1-10
Author(s):  
Risa Umami ◽  
Riwayati Malika

Diabetes mellitus (DM) is characterized by an increase in glucose levels in the blood due to disorders of glucose metabolism in the body. The pancreas organ of people with DM has a weakness in producing the hormone insulin. As a result, the distribution of blood glucose to other organs of the body is inhibited so that glucose levels in the blood increase which causes DM sufferers to experience longer wound healing than normal humans. Binahong leaves contain alkaloids, saponins and flavonoids which have antibacterial activity which can accelerate the wound healing process. The purpose of this study was to determine the antibacterial effect of binahong leaf extract ointment (Anredera cordifolia) against Staphylococcus aureus bacteria from diabetic wounds. This research includes antibacterial test for binahong leaf extract ointment (Anredera cordifolia) with variations in the concentration of 10%, 20%, and 30% of the concentration of binahong leaf extract of 25% which resulted in a wound coverage percentage of up to 100%, namely at 30% ointment concentration. The conclusion of this study is that there was no wound closure for negative control and positive control in the form of oxytetracycline, the percentage of wound closure was 85%.


2019 ◽  
Vol 2019 ◽  
pp. 1-13 ◽  
Author(s):  
Hadeel A. Al-Rawaf ◽  
Sami A. Gabr ◽  
Ahmad H. Alghadir

Background. Circulating micro-RNAs are differentially expressed in various tissues and could be considered as potential regulatory biomarkers for T2DM and related complications, such as chronic wounds. Aim. In the current study, we investigated whether ginger extract enriched with [6]-gingerol-fractions either alone or in combination with vitamin D accelerates diabetic wound healing and explores underlying molecular changes in the expression of miRNA and their predicted role in diabetic wound healing. Methods. Diabetic wounded mice were treated with [6]-gingerol-fractions (GF) (25 mg/kg of body weight) either alone or in combination with vitamin D (100 ng/kg per day) for two weeks. Circulating miRNA profile, fibrogenesis markers, hydroxyproline (HPX), fibronectin (FN), and collagen deposition, diabetic control variables, FBS, HbA1c, C-peptide, and insulin, and wound closure rate and histomorphometric analyses were, respectively, measured at days 3, 6, 9, and 15 by RT–PCR and immunoassay analysis. Results. Treatment of diabetic wounds with GF and vitamin D showed significant improvement in wound healing as measured by higher expression levels of HPX, FN, collagen, accelerated wound closure, complete epithelialization, and scar formation in short periods (11-13 days, (P<0.01). On a molecular level, three circulating miRNAs, miR-155, miR-146a, and miR-15a, were identified in diabetic and nondiabetic skin wounds by PCR analysis. Lower expression in miR-155 levels and higher expression of miR-146a and miR-15a levels were observed in diabetic skin wounds following treatment with gingerols fractions and vitamin D for 15 days. The data showed that miRNAs, miR-146a, miR-155, and miR-15a, correlated positively with the expression levels of HPX, FN, and collagen and negatively with FBS, HbA1c, C-peptide, and insulin in diabetic wounds following treatment with GF and /or vitamin D, respectively. Conclusion. Treatment with gingerols fractions (GF) and vitamin D for two weeks significantly improves delayed diabetic wound healing. The data showed that vitamin D and gingerol activate vascularization, fibrin deposition (HPX, FN, and collagen), and myofibroblasts in such manner to synthesize new tissues and help in the scar formation. Accordingly, three miRNAs, miR-155, miR-146a, and miR-15, as molecular targets, were identified and significantly evaluated in wound healing process. It showed significant association with fibrin deposition, vascularization, and reepithelialization process following treatment with GF and vitamin D. It proposed having anti-inflammatory action and promoting new tissue formation via vascularization process during the wound healing. Therefore, it is very interesting to consider miRNAs as molecular targets for evaluating the efficiency of nondrug therapy in the regulation of wound healing process.


Author(s):  
А.А. Супильников ◽  
В.Н. Шабалин

Цель исследования - оценка возможности использования интегральных гематологических индексов для выбора оптимальной модели ушивания послеоперационных ран в эксперименте. Методика. Исследование проводили на 297 белых беспородных крысах-самцах массой 190-210 г, которые были разделены на 3 группы, по 99 крыс в каждой. Одна группа являлась контрольной, у второй группы крыс был смоделирован раневой процесс с натяжением брюшной стенки; у третьей группы животных - модель раневого процесса с применением трансплантата нанокомпозитного материала. Определяли следующие интегральные гематологические индексы: индекс Кребса; коэффициент Бредекка; лейкоцитарный индекс; индекс соотношения нейтрофилов и моноцитов; индекс соотношения лимфоцитов и моноцитов; индекс соотношения лимфоцитов и эозинофилов; коэффициент отношения альбуминов к глобулинам; оксипролиновый коэффициент. Результаты. Установлены статистически значимые колебания показателей интегральных гематологических индексов в динамике заживления послеоперационной раны у крыс. Заключение. На основе полученных результатов был сделан вывод, что особенности динамики интегральных гематологических индексов, выявленные на различных моделях раневого процесса, отражают неспецифические и специфические защитные реакции организма в целом, позволяют делать прогноз дальнейшего течения и исхода раневого процесса, а также обеспечивают возможность выбора оптимальной модели ушивания послеоперационной раны. The article presents results of predicting the wound healing process using integral hematological indexes. The aim of the study was to describe the dynamics of integral hematological indexes of wound healing process in rats to predict its outcome. The study included 297 white mongrel male rats weighing 190-210 g, which were divided into three groups, 99 rats in each. One group was a control group; in the second group, a wound healing process with abdominal wall tension was modeled; in the third group, a wound healing process with a graft was modeled. The following integrated hematological indexes were determined: Krebs index; Bredeck index; leukocyte index; neutrophil/monocyte ratio; lymphocyte/monocyte ratio; lymphocyte/eosinophil ratio; albumin/globulin ratio; and oxyproline coefficient. The study showed that changes in values of integral hematological indexes were mostly statistically and clinically significant. We concluded that changes in integral hematological indexes in different models of wound healing reflect nonspecific and specific protective responses of the body as a whole and allow to predict further course and outcome of the wound healing process.


2021 ◽  
Vol 18 ◽  
Author(s):  
Saima Tufail ◽  
Muhammad Irfan Siddique ◽  
Muhammad Sarfraz ◽  
Muhammad Farhan Sohail ◽  
Muhammad Nabeel Shahid ◽  
...  

Introduction: The pleiotropic effects of statins are recently explored for wound healing through angiogenesis and lymph-angiogenesis that could be of great importance in diabetic wounds. Aim: Aim of the present study is to fabricate nanofilm embedded with simvastatin loaded chitosan nanoparticles (CS-SIM-NPs) has been reported herein to explore the efficacy of SIM in diabetic wound healing. Methods: The NPs, prepared via ionic gelation, were 173nm ± 2.645 in size with a zeta potential -0.299 ± 0.009 and PDI 0.051 ± 0.088 with excellent encapsulation efficiency (99.97%). The optimized formulation (CS: TPP, 1:1) that exhibited the highest drug release (91.64%) was incorporated into polymeric nanofilm (HPMC, Sodium alginate, PVA), followed by in vitro characterization. The optimized nanofilm was applied to the wound created on the back of diabetes-induced (with alloxan injection 120 mg/kg) albino rats. Results: The results showed significant (p < 0.05) improvement in the wound healing process compared to the diabetes-induced non-treated group. The results highlighted the importance of nanofilms loaded with SIM-NPs in diabetic wound healing through angiogenesis promotion at the wound site. Conclusion: Thus, CS-SIM-NPs loaded polymeric nanofilms could be an emerging diabetic wound healing agent in the industry of nanomedicines.


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