Risk factors of skin tear in older persons: a protocol for systematic review and meta-analysis.

INTRODUCTION: Skin tear (ST) will prolong the hospitalisation time of an older person, increase the cost of medical expenses and the difficulty in care for nursing staff, and seriously affect the quality of life of the older person. Early identification and intervention of the elderly at risk of ST are key factors in preventing the occurrence of ST in older persons. At present, risk factors for ST in older persons have not been systematically evaluated, let alone summarised to analyse risk factors for ST in older persons. Therefore, this systematic review and meta-analysis aims to synthesise existing research on risk factors for ST in older populations. METHODS AND ANALYSIS: The protocol is being reported by the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols statement. On 17 September 2023, we will start literature search in PubMed, Embase, Web of Science, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, Medline, Chinese Scientific Journal Database, Wan Fang Data Knowledge Service Platform, China National Knowledge Infrastructure, and Chinese Biomedical Literature Database. The language of the included literature is Chinese or English. Using RevMan V.5.4 software, we will perform a systematic review and meta-analysis of the final set of included studies to synthesise the data and draw meaningful conclusions. The Newcastle-Ottawa Quality Assessment Scale and the Agency for Healthcare Research and Quality will be used to assess the quality of the literature. The I2 test will be used to test heterogeneity. ETHICS AND DISSEMINATION: Ethical approval is not needed for this systematic review, as the study will not directly use information from human participants, and the data we use will be extracted from original studies. This systematic review and meta-analysis has been registered at the International Prospective Register of Systematic Reviews (PROSPERO). Once the systematic review and meta-analysis have been completed, we will publish our study in an academic journal. PROSPERO REGISTRATION NUMBER: CRD42023460810.

SPRR1B+ keratinocytes prime oral mucosa for rapid wound healing via STAT3 activation.

Oral mucosal wounds exhibit accelerated healing with reduced scarring compared to cutaneous wounds, representing an optimal wound healing paradigm. However, the specific cellular subtypes orchestrating the efficient healing of mucosal tissues remain elusive. Through a comprehensive analysis integrating bulk-mRNA and single-cell sequencing data during the wound healing process in oral mucosa and skin, we have delineated a distinct set of genes markedly upregulated during tissue repair. This collection of wound healing-associated genesets was highly enriched in a specific keratinocyte subpopulation identified as STAT3-activated SPRR1B+ keratinocytes. Notably, despite the inherent rapidity of oral mucosal healing, the induction of SPRR1B+ keratinocytes is evident in both skin and mucosal wound healing processes in murine model. Intriguingly, these wound healing-promoting SPRR1B+ keratinocytes, which are induced via STAT3 activation, inherently abundant in unwounded normal mucosa but absent in normal skin. SPRR1B knockdown significantly inhibits mucosal keratinocyte migration, a critical attribute for effective wound healing. In summary, through analysis of human oral and skin wound healing processes at single-cell resolution, coupled with validation in murine model, suggests STAT3-activated SPRR1B+ keratinocytes are associated with the rapid mucosal repair process. This discovery underscores the potential application of SPRR1B+ keratinocytes in the therapeutic management of chronic or non-healing wounds.

The Effect of Polynucleotide-Hyaluronic Acid Hydrogel in the Recovery After Mechanical Skin Barrier Disruption.

BACKGROUND: The epidermal barrier acts as a defense against external agents as well as helps to maintain body homeostasis. Polynucleotides (PN), exogenous DNA fragments, promote wound repair through their stimulatory and anti-inflammatory effects. Recent findings indicate a synergistic effect of PN and hyaluronic acid (HA) combinations in regulating inflammation and promoting cell proliferation. This study aims to elucidate the effects of PN and HA on repairing the epidermal barrier following its disruption by tape stripping (TS) in a mouse model. MATERIALS AND METHODS: After disrupting the epidermal barrier using TS, a formulation containing PN (14 mg/mL) and HA (6 mg/mL) was applied. Trans-epidermal water loss (TEWL) was measured at 0, 3, 6, 24, 48, and 72 h. Mice were euthanized after the final application at 72 h, and tissue samples were analyzed for epidermal/dermal thickness, neutrophil infiltration, and filaggrin expression. RESULTS: We observed a significant reduction in TEWL in the PN+HA group compared to that in the control group (20.8 ± 0.5 vs. 43.7 ± 0.5 g/m2h at 72 h, p < 0.05), indicating an improvement in barrier function. Histological evaluation showed decreased epidermal and dermal thickening in the PN+HA group compared to that in the control group (epidermal: 29.4 ± 2.2 vs. 57.9 ± 3.5 µm; dermal: 464.8 ± 25.9 vs. 825.9 ± 44.8 µm, both p < 0.05). Additionally, neutrophil infiltration in the dermis was significantly reduced, and filaggrin protein levels were significantly higher in the PN+HA group compared to those in the control group (4.8 ± 0.4 vs. 21.1 ± 3.3 for neutrophils; 0.84 ± 0.04 vs. 0.42 ± 0.03 for filaggrin, both p < 0.05). CONCLUSION: These results suggest that PN+HA may be an effective therapeutic strategy for repairing skin barrier damage.

PROTECTIVE EFFECT OF A NEW SUPEROXIDE-PRODUCING ENZYME COMPLEX FROM RASPBERRY IN RATS WITH THIRD-DEGREE THERMAL BURNS.

Thermal burns are the most common type of burn injuries. Medical treatment for burns is crucial, especially for third-degree burns and when a significant surface area of the body is affected. One of the most pressing issues in modern medicine is the search for new effective means to accelerate the healing of burn wounds. Oxygen radicals play a significant role in maintaining homeostasis, forming the body's resistance to infection, and ensuring the regeneration of organs and tissues. In this study, a superoxide (O2-)-producing enzyme (SPE) from raspberries was applied (topically to the skin, injected under the wound surface, with solution concentrations of 12.75% and 5%) after a third-degree thermal burn to determine its reparative effects on the skin. To assess the condition of the animals that had suffered burn injuries and the healing process, blood parameters were analyzed, and cytogenetic indices of bone marrow from the femur of the animals were studied: mitotic index, number of polyploid cells, and chromosomal aberrations. When analyzing hematological, cytogenetic, and histological parameters, significant differences were found between the «clean burn¼ groups and the groups in which SPE was used in different concentrations and methods of application. The use of SPE in both concentrations contributed to a reduction in the area of burn wounds compared to a «clean burn¼. The survival rate of animals for 30 days (before the end of the experiment) was 100% when using a 12.75% SPE solution and 50% when using a 5% SPE solution. The use of SPE led to significant differences in hematological parameters from the «clean burn¼ group throughout the entire duration of the experiment, showing a tendency to normalize the parameters. Under the influence of the 12.75% SPE solution, there was a tendency toward normalization of the mitotic index, along with a significant reduction in the percentage of polyploid cells and chromosomal aberrations, which may indicate its beneficial effects. This study found that a 12.75% SPE solution derived from raspberries was more effective and had healing properties on third-degree thermal burns, promoting rapid healing of the burn wound.

GelMA loaded with exosomes from human minor salivary gland organoids enhances wound healing by inducing macrophage polarization.

Non-healing skin wounds pose significant clinical challenges, with biologic products like exosomes showing promise for wound healing. Saliva and saliva-derived exosomes, known to accelerate wound repair, yet their extraction is difficult due to the complex environment of oral cavity. In this study, as a viable alternative, we established human minor salivary gland organoids (hMSG-ORG) to produce exosomes (MsOrg-Exo). In vitro, MsOrg-Exo significantly enhanced cell proliferation, migration, and angiogenesis. When incorporated into a GelMA-based controlled-release system, MsOrg-Exo demonstrated controlled release, effectively improving wound closure, collagen synthesis, angiogenesis, and cellular proliferation in a murine skin wound model. Further molecular analyses revealed that MsOrg-Exo promotes proliferation, angiogenesis and the secretion of growth factors in wound sites. Proteomic profiling showed that MsOrg-Exo's protein composition is similar to human saliva and enriched in proteins essential for wound repair, immune modulation, and coagulation. Additionally, MsOrg-Exo was found to modulate macrophage polarization, inducing a shift towards M1 and M2 phenotypes in vitro within 48 h and predominantly towards the M2 phenotype in vivo after 15 days. In conclusion, our study successfully extracted MsOrg-Exo from hMSG-ORGs, confirmed the effectiveness of the controlled-release system combining MsOrg-Exo with GelMA in promoting skin wound healing, and explored the potential role of macrophages in this action.

Novel Magnesium- and Silver-Loaded Dressing Promotes Tissue Regeneration in Cutaneous Wounds.

Wound healing is a dynamic process involving a complex interaction between many cells and mediators. Magnesium (Mg) is an essential element for cell stabilization. Mg was reported to stimulate the proliferation and migration of endothelial cells in angiogenesis in vitro. However, the function of Mg in wound healing is not known. We observed that the expression level of Mg in human wound tissue fluid was only 10% of that found in human blood serum. To confirm whether Mg is a suitable wound dressing material, we fabricated a Mg- or Mg-silver (Ag)-based polyethylene dressing to study its effect on wound healing. We observed that Mg and Ag were stably preserved in the constructed material and were able to be rapidly released in the moist environment. We also observed that the Mg-based dressing had good cellular compatibility without harmful extractables. Furthermore, Mg enhanced the antibacterial activity of Ag. In line with the observed increase in fibroblast migration in vitro, the Mg-Ag-based dressing improved acute and chronic wound repairs via an increase in neovascularization and basal cell proliferation. The present results show that a Mg-Ag-based coating can be manufactured as an optimal dressing for adjuvant wound therapy.

Platelet-Rich Plasma (PRP) Based on Simple and Efficient Integrated Preparation Precises Quantitatively for Skin Wound Repair.

Platelet-rich plasma (PRP) has become an important regenerative therapy. However, the preparation method of PRP has not been standardized, and the optimal platelet concentration for PRP used in skin wound repair is unclear, leading to inconsistent clinical efficacy of PRP. Therefore, the development of standardized preparation methods for PRP and the investigation of the dose-response relationship between PRP with different platelet concentrations and tissue regeneration plays an important role in the development and clinical application of PRP technology. This study has developed an integrated blood collection device from blood drawing to centrifugation. Response surface methodology was employed to optimize the preparation conditions, ultimately achieving a platelet recovery rate as high as 95.74% for PRP (with optimal parameters: centrifugation force 1730× g, centrifugation time 10 min, and serum separation gel dosage 1.4 g). Both in vitro and in vivo experimental results indicate that PRP with a (2×) enrichment ratio is the most effective in promoting fibroblast proliferation and skin wound healing, with a cell proliferation rate of over 150% and a wound healing rate of 78% on day 7.

Diving deep into healing: the promising role of fish skin in wound recovery.

Fish skin has emerged as a potential candidate for improving wound healing due to its notable results in human trials, in which it has been directly applied as a dressing on wounds. The current review explores the mechanisms by which fish skin can boost the wound healing process. The natural wound healing process involves inflammation at the wound site to initiate tissue repair. The body balances this inflammation through interleukin signaling, and imbalances can cause chronic wounds or scarring. The wound site also secretes epidermal growth factor, which activates the Ras/Raf/MEK/ERK and PI3K/Akt pathways. These pathways promote angiogenesis (ie, replacing injured blood vessels) and epithelialization (ie, replacing injured skin). Delays in these pathways increase the healing time. The rich contents of omega-3, collagen, and selenium in fish skin boost wound healing by inhibiting compounds that can cause over-inflammation during interleukin signaling. They also upregulate the Ras/Raf/MEK/ERK and PI3K pathways by altering lipid composition (via omega-3), binding with collagen receptors (via collagen), and modulating selenoproteins (via selenium). The mechanisms discussed in this review support the finding that fish skin is a promising candidate with a strong potential to naturally boost the wound healing process in clinical settings. Continued investigation into the application of fish skin as a practical and commercial wound healing agent is warranted. Future study of additional wound healing properties of fish skin, such as microbial protection of open wounds, is recommended.

A comparison of several separation processes for eggshell membrane powder as a natural biomaterial for skin regeneration.

BACKGROUND: Numerous studies have focused on skin damage, the most prevalent physical injury, aiming to improve wound healing. The exploration of biomaterials, specifically eggshell membranes (ESMs), is undertaken to accelerate the recovery of skin injuries. The membrane must be separated from the shell to make this biomaterial usable. Hence, this investigation aimed to identify more about the methods for membrane isolation and determine the most efficient one for usage as a biomaterial. METHODS AND MATERIALS: For this purpose, ESM was removed from eggs using different protocols (with sodium carbonate, acetic acid, HCl, calcium carbonate, and using forceps for separation). Consequently, we have examined the membranes' mechanical and morphological qualities. RESULTS: According to the analysis of microscopic surface morphology, the membranes have appropriate porosity. MTT assay also revealed that the membranes have no cytotoxic effect on 3T3 cells. The results indicated that the ESM had acquired acceptable coagulation and was compatible with blood. Based on the obtained results, Provacol 4 (0.5-mol HCl and neutralized with 0.1-mol NaOH) was better than other methods of extraction and eggshell separation because it was more cell-compatible and more compatible with blood. CONCLUSION: This study demonstrates that ESMs can be used as a suitable biomaterial in medical applications.

Hypoxia and Foxn1 alter the proteomic signature of dermal fibroblasts to redirect scarless wound healing to scar-forming skin wound healing in Foxn1-/- mice.

BACKGROUND: Foxn1-/- deficient mice are a rare model of regenerative skin wound healing among mammals. In wounded skin, the transcription factor Foxn1 interacting with hypoxia-regulated factors affects re-epithelialization, epithelial-mesenchymal transition (EMT) and dermal white adipose tissue (dWAT) reestablishment and is thus a factor regulating scar-forming/reparative healing. Here, we hypothesized that transcriptional crosstalk between Foxn1 and Hif-1α controls the switch from scarless (regenerative) to scar-present (reparative) skin wound healing. To verify this hypothesis, we examined (i) the effect of hypoxia/normoxia and Foxn1 signalling on the proteomic signature of Foxn1-/- (regenerative) dermal fibroblasts (DFs) and then (ii) explored the effect of Hif-1α or Foxn1/Hif-1α introduced by a lentiviral (LV) delivery vector to injured skin of regenerative Foxn1-/- mice with particular attention to the remodelling phase of healing. RESULTS: We showed that hypoxic conditions and Foxn1 stimulation modified the proteome of Foxn1-/- DFs. Hypoxic conditions upregulated DF protein profiles, particularly those related to extracellular matrix (ECM) composition: plasminogen activator inhibitor-1 (Pai-1), Sdc4, Plod2, Plod1, Lox, Loxl2, Itga2, Vldlr, Ftl1, Vegfa, Hmox1, Fth1, and F3. We found that Pai-1 was stimulated by hypoxic conditions in regenerative Foxn1-/- DFs but was released by DFs to the culture media exclusively upon hypoxia and Foxn1 stimulation. We also found higher levels of Pai-1 protein in DFs isolated from Foxn1+/+ mice (reparative/scar-forming) than in DFs isolated from Foxn1-/- (regenerative/scarless) mice and triggered by injury increase in Foxn1 and Pai-1 protein in the skin of mice with active Foxn1 (Foxn1+/+ mice). Then, we demonstrated that the introduction of Foxn1 and Hif-1α via lentiviral injection into the wounded skin of regenerative Foxn1-/- mice activates reparative/scar-forming healing by increasing the wounded skin area and decreasing hyaluronic acid deposition and the collagen type III to I ratio. We also identified a stimulatory effect of LV-Foxn1 + LV-Hif-1α injection in the wounded skin of Foxn1-/- mice on Pai-1 protein levels. CONCLUSIONS: The present data highlight the effect of hypoxia and Foxn1 on the protein profile and functionality of regenerative Foxn1-/- DFs and demonstrate that the introduction of Foxn1 and Hif-1α into the wounded skin of regenerative Foxn1-/- mice activates reparative/scar-forming healing.

Identifying the molecular mechanisms of action of wound healing properties of Mathan tailam and Mahamegarajanga tailam in Wistar albino rats: Evidence through IL-10/VEGF/TNF-α signalling pathways.

The Siddha system of medicine (SSM) is the oldest medical science practised in the ancient period of the southern part of India and Sri Lanka. Many formulations were described for wound healing in the SSM, with specific diagnostic differentiation in the Siddha literature. Most preparations for wound healing were available in the form of oil-based formulations, especially for external usage. Mathan tailam (MT) and Mahamegarajanga tailam (MMRT) have been used by Siddha physicians and traditional practitioners to treat wounds. Mathan tailam is a popular regimen for skin lacerations, burns, skin infections, diabetic wounds, and dermatitis. Mahamegarajanga tailam has long been used by traditional vaidyars to treat cuts and burns. Both MT and MMRT are clinically well-appreciated drugs for wound healing and need to be studied for their mechanisms of action for scientific documentation. In an in vivo study on albino rats -excisional wound model, the histopathological changes, histo-immune response, biomarker analysis, and mRNA expression were studied and analysed. Wounds treated with MT and MMRT healed faster (p < 0.05) than the untreated group (CNT). Histological investigation showed rapid re-epithelialization, dense collagen deposition, increased enzymatic antioxidant activities and decreased lipid peroxidation in the MT and MMRT groups. mRNA expression reveals MT and MMRT-treated tissues able to induce convergent cell motility in wound space. Our study for the first time provides strong in vivo experimental evidence that Mathan tailam and Mahamegarajanga tailam play a crucial role in promoting skin tissue wound healing through IL-6/VEGF/TNF-α mediated mechanisms. Traditional practices continue to teach us valuable lessons, as seen by their continuous use in their locality for years.

Copper-MOF and tannic acid-empowered composite cryogel as a skin substitute for accelerated deep wound healing.

The effective management of deep skin wounds remains a significant healthcare challenge that often deteriorates with bacterial infection, oxidative stress, tissue necrosis, and excessive production of wound exudate. Current medical approaches, including traditional wound dressing materials, cannot effectively address these issues. There is a great need to engineer advanced and multifunctional wound dressings to address this multifaceted problem effectively. Herein, a rationally designed composite cryogel composed of a Copper Metal-Organic Framework (Cu-MOF), tannic acid (TA), polyvinyl alcohol (PVA), and zein protein has been developed by freeze-thaw technique. Cryogels display a remarkable swelling capacity attributed to their interconnected microporous morphology. Moreover, dynamic mechanical behaviour with the characteristics of potent antimicrobial, antioxidant, and biodegradation makes it a desirable wound dressing material. It was further confirmed that the material is highly biocompatible and can release TA and copper ions in a controlled manner. In-vivo skin irritation in a rat model demonstrated that composite cryogel did not provoke any irritation/inflammation when applied to the skin of a healthy recipient. In a deep wound model, the composite cryogel significantly accelerates the wound healing rate. These findings highlight the multifunctional nature of composite cryogels and their promising potential for clinical applications as advanced wound dressings.

The stress-responsive gene ATF3 drives fibroblast activation and collagen production through transcriptionally activating TGF-ß receptor â ¡ in skin wound healing.

Skin wound is an emerging health challenge on account of the high-frequency trauma, surgery and chronic refractory ulcer. Further study on the disease biology will help to develop new effective approaches for wound healing. Here, we identified a wound-stress responsive gene, activating transcription factor 3 (ATF3), and then investigated its biological action and mechanism in wound healing. In the full-thickness skin wound model, ATF3 was found to promote fibroblast activation and collagen production, resulted in accelerated wound healing. Mechanically, ATF3 transcriptionally activated TGF-ß receptor Ⅱ via directly binding to its specific promoter motif, followed by the enhanced TGF-ß/Smad pathway in fibroblasts. Moreover, the increased ATF3 upon skin injury was partly resulted from hypoxia stimulation with Hif-1α dependent manner. Altogether, this work gives novel insights into the biology and mechanism of stress-responsive gene ATF3 in wound healing, and provides a potential therapeutic target for treatment.

Functional poly(e-caprolactone)/SerMA hybrid dressings with dimethyloxalylglycine-releasing property improve cutaneous wound healing.

Medical dressings with multifunctional properties, including potent regeneration capability and good biocompatibility, are increasingly needed in clinical practice. In this study, we reported a novel hybrid wound dressing (PCL/SerMA/DMOG) that combines electrospun PCL membranes with DMOG-loaded methacrylated sericin (SerMA) hydrogel. In such a design, DMOG molecules are released from the hybrid dressing in a sustained mannerin vitro. A series ofin vitroassays demonstrated that DMOG-loaded hybrid dressing has multiple biological functions, including promotion of human umbilical vein endothelial cells proliferation and migration,in vitrovascularization, and the generation of intracellular NO. When applied to the cutaneous wound, the PCL/SerMA/DMOG dressing significantly accelerated wound closure and tissue regeneration by promoting angiogenesis in the wound area, collagen deposition, and cell proliferation within the wound bed. These results highlight the potential clinical application of PCL/SerMA/DMOG hybrid dressings as promising alternatives for accelerating wound healing via improved biocompatibility and angiogenesis amelioration.

Trinitroglycerin-loaded chitosan nanogels accelerate angiogenesis in wound healing process.

Trinitroglycerin (TNG) with remarkable angiogenic, antibacterial, and antioxidative activity is a promising candidate to govern wound healing capacity. However, its clinical administration is limited due to associated complications and NO short half-life. In the current study, TNG-loaded chitosan nanogels (TNG-Ngs) were examined in-vitro and in-vivo to gain insight into their clinical application. We prepared TNG-Ngs and characterized their physiochemical properties. The potential of TNG-Ngs was assessed using biocompatibility, scratch assay, and a full-thickness skin wounds model, followed by histopathological and immunohistochemistry examinations. TNG-Ngs particle size 96 ± 18 and definite size distribution histogram. The loading capacity (LC) and encapsulation efficiency (EE) of prepared TNG-Ngs were 70.2 % and 2.1 %, respectively. The TNG-Ngs samples showed enhanced migration of HUVECs with no apparent cytotoxicity. The topical use of TNG-Ngs200 on the wounds revealed a complete wound closure ratio, skin component formation, less scar width, remarkable granulation tissue, promoted collagen deposition, and enhanced the relative mean density of α-SMA and CD31. TNG-Ngs accelerated wound healing by promoting collagen deposition and angiogenic activity, as well as reducing inflammation. The findings indicated that TNG-Ngs is expected to be well vascularized in the wound area and to be more effective in topical therapy.

Self-crosslinking hyaluronic acid-based hydrogel with promoting vascularization and ROS scavenging for wound healing.

Skin wound dressings are commonly utilized for the treatment of skin injuries, as they effectively facilitate wound healing and possess anti-inflammatory and antibacterial properties. However, conventional dressings fail to inhibit ROS production and promote vascularization, leading to delayed wound healing. Here, we developed injectable self-crosslinking hydrogels through thiolated hyaluronic acid (HASH/rhCOLIII) with enhancing the ROS inhibitory capacity while preserving the cell adhesion ability of hyaluronic acid. Additionally, recombinant humanized collagen type III (rhCOLIII) is incorporated via electrostatic adsorption to further enhance mechanical strength and angiogenesis properties of the hydrogel. The HASH/rhCOLIII demonstrated excellent biocompatibility, remarkable ROS scavenging ability, as well as hemostatic and angiogenic properties. Cell experiment results show that HASH/rhCOLIII has excellent biocompatibility and can significantly promote angiogenesis. Animal experiments results showed that HASH/rhCOLIII exhibits anti-inflammatory effects, significantly accelerating wound healing in a full-thickness skin defect model. These findings highlight that HASH/rhCOLIII hydrogel holds great promise as an advanced dressing for effective wound healing.

The Turkish version of the Skin Tear Knowledge Assessment Instrument (OASES): Validity and reliability study.

This study was conducted to adapt the Skin Tear Knowledge Assessment Instrument (OASES) into Turkish and to verify its validity and reliability. This study was conducted on 314 nurses in Türkiye between November 2023 and February 2024 to test the psychometric properties of OASES. The instrument consists of 20 items clustered into six domains. The cultural adaptation process was carried out according to the International Testing Commission guidelines: Turkish translation, expert panel, content validity, translation back to English, preliminary study and the final version of the instrument. To check the validity of the multiple-choice test, item difficulty and discriminating index were analysed. The reliability of the instrument was evaluated to the retest 14 days after the first test. Scale level content validity by 11 experts in wound care was 0,97 (I-CVI = 0.8-1.0). In the item analysed of the OASES, the item difficulty index was 0,51 (p-value = 0.34-0.76) and the discriminating index was 0.40 (D-value = 0.26-0.51). The 2-week test-retest intraclass correlation coefficient of the overall instrument was 0.90 (95% CI = 0.79-0.95). The Turkish version of OASES is a valid and reliable measurement instrument to evaluate nurses' knowledge levels regarding skin tears with acceptable psychometric properties. It can be applied in nursing education, research and practice to evaluate the knowledge of Turkish speaking nurses about skin tears.

Dynamic optical coherence tomography for imaging acute wound healing.

The aim of this study was to investigate acute wound healing with dynamic optical coherence tomography (D-OCT). From 22 patients with 23 split skin graft donor sites, vessels at four wound edges, the wound bed, and adjacent and unaffected skin of the contralateral leg were measured by D-OCT at six time points from surgery to 4 weeks of healing. Changes in vessel orientation, density, diameter, morphology and pattern in horizontal, vertical and 3D images were analysed for wound healing and re-epithelialization. At 300 µm depth, there were significant differences of blobs and serpiginous vessels between normal and wounded skin. The wound had significantly more vertically oriented vessels, a higher degree of branching, vessel density and diameter compared with healthy skin. 3D images showed increased angiogenesis from healthy skin towards the wound centre, significantly higher vessel density at the wound than at normal skin and the highest at the interface. During wound healing blobs, coils and serpiginous vessels occurred significantly more frequently in lesional than healthy skin. Vessel density was greatest at the beginning, decreased and then increased by 4 weeks post-surgery. D-OCT helps to evaluate acute wound healing by visualizing and quantifying blood vessel growth in addition to re-epithelialization.